Presenting characteristics and clinical outcome of patients with COVID-19 in South Korea: A nationwide retrospective observational study

Abstract

Background: More than 13,0 0 0 cases were reported to be infected with COVID-19 by RT-PCR in South Korea. Most studies report clinical characteristics of hospitalized patients with COVID-19; the full spectrum of disease severity has thus not yet been well described.Methods: Using retrospective observational methods, this study analyzed factors affecting early clinical symptoms, clinical progress, and severity of disease for COVID-19 positive patients released from quarantine to provide information on establishing optimized care for new patients. The medical data of 7803 laboratory-confirmed patients who had been discharged or died by April 30, 2020 were analyzed using multivariate logistic regression analysis.Findings: On admission, 7383 (94 • 5%) patients were asymptomatic or showed mild illness, and 372 (4 • 8%) patients were severe illness. Also, 48 (0 0 • 6%) were hospitalized with critically ill when diagnosed. Most patients with asymptomatic or mild illness on admission remained mild until discharge, 253 (3 • 4%) progressed to severe illness, and 83 (1 • 1%) died in hospital. However, the case fatality were 29 • 8% and 62 • 5% in severe and critically ill patients, respectively. At admission, 73 • 0% of hospitalized patients had symptoms; most common were cough (42 • 5%), sputum (28 • 8%), and fever (20 • 1%). Only 35 • 2% of laboratory confirmed patients admitted to the temporary care facility complained of symptoms. Increasing odds of being critically ill was associated with older age (OR 28 • 93, 95% CI 13 • 34-62 • 75 for age > 70y, vs. age < 50 y; p < 0 • 0 0 01), being male (OR 2 • 15, 95% CI1 • 59-2 • 89; p < 0 • 0 0 01), fever (OR 2 • 52, 95% CI 1.84-3 • 45; p < 0 • 0 0 01), and shortness of breath (OR 7 • 40, 95% CI 5 • 37-10 • 19; p < 0 • 0 0 01). Comorbid illness significantly increased risk of critical illness or death.Interpretation: Most cases were discharged as asymptomatic or recovered from mild illness, and only 9 • 7% developed severe disease requiring oxygen therapy or more. Case fatality rate was 2 • 9%, and markedly increased in those over age 50. Risk factors such as age, sex, fever, shortness of breath, and underlying disease can be useful in predicting future clinical severity. Additionally, the number of confirmed asymptomatic COVID-19 patients significantly contribute to continued spread.

Clinical characteristicsandrisk factorsofpatients with coronavirusdisease (COVID-19) in a Tertiary Hospitalof Colombia. (Characteristicsofpatients with COVID-19)

“…The average age of the population studied was 53 years, which is a value higher than the series reported in Spain by Khan et al(2020), and in China by Bi et al(2020), and moderately higher than the South Korean series by Park et al(2020), and lower than the Italian series by Trecarichi et al(2020).…”

Prevalence of Coronavirus Disease 2019 (COVID-19) in Different Clinical Stages before the National COVID-19 Vaccination Programme in Malaysia: A Systematic Review and Meta-Analysis

“…Moreover, a study in Dakar, West Africa, revealed that about 14.7% of the COVID-19 cases have severe symptoms [ 48 ]. A lower percentage was observed in the severe (4.8%) and critical (0.6%) cases in the South Korean population involving 7803 COVID-19 patients and in the Thai population with a low prevalence rate of severe cases at 6.4% [ 49 , 50 ].…”

Development and external validation of the DOAT and DOATS scores: simple decision support tools to identify disease progression among nonelderly patients with mild/moderate COVID-19

“…Several studies demonstrated the association between the clinical characteristics such as older age, male sex, symptoms of COVID-19 (fever, cough, fatigue, and short of breath) and comorbidities (hypertension, diabetes, and CKD) and its severity or activity [24][25][26]. Addition of blood test may increase the accuracy of prediction of the disease progression [10].…”