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Article: Case fatality risk of the first pandemic wave of novel coronavirus disease 2019 (COVID-19) in China

TitleCase fatality risk of the first pandemic wave of novel coronavirus disease 2019 (COVID-19) in China
Authors
KeywordsNovel coronavirus diseases 2019
severe acute respiratory syndrome coronavirus 2
case fatality risk
China
Issue Date2020
PublisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/
Citation
Clinical Infectious Diseases, 2020, Epub 2020-05-15 How to Cite?
AbstractObjective: To assess the case fatality risk (CFR) of COVID-19 in mainland China, stratified by region and clinical category, and estimate key time-to-event intervals. Methods: We collected individual information and aggregated data on COVID-19 cases from publicly available official sources from December 29, 2019 to April 17, 2020. We accounted for right-censoring to estimate the CFR and explored the risk factors for mortality. We fitted Weibull, gamma, and lognormal distributions to time-to-event data using maximum-likelihood estimation. Results: We analyzed 82,719 laboratory-confirmed cases reported in mainland China, including 4,632 deaths, and 77,029 discharges. The estimated CFR was 5.65% (95%CI: 5.50%-5.81%) nationally, with highest estimate in Wuhan (7.71%), and lowest in provinces outside Hubei (0.86%). The fatality risk among critical patients was 3.6 times that of all patients, and 0.8-10.3 fold higher than that of mild-to-severe patients. Older age (OR 1.14 per year; 95%CI: 1.11-1.16), and being male (OR 1.83; 95%CI: 1.10-3.04) were risk factors for mortality. The time from symptom onset to first healthcare consultation, time from symptom onset to laboratory confirmation, and time from symptom onset to hospitalization were consistently longer for deceased patients than for those who recovered. Conclusions: Our CFR estimates based on laboratory-confirmed cases ascertained in mainland China suggest that COVID-19 is more severe than the 2009 H1N1 influenza pandemic in hospitalized patients, particularly in Wuhan. Our study provides a comprehensive picture of the severity of the first wave of the pandemic in China. Our estimates can help inform models and the global response to COVID-19.
Persistent Identifierhttp://hdl.handle.net/10722/283686
ISSN
2019 Impact Factor: 8.313
2015 SCImago Journal Rankings: 4.742
PubMed Central ID

 

DC FieldValueLanguage
dc.contributor.authorDeng, X-
dc.contributor.authorYang, J-
dc.contributor.authorWang, W-
dc.contributor.authorWang, X-
dc.contributor.authorZhou, J-
dc.contributor.authorChen, Z-
dc.contributor.authorLi, J-
dc.contributor.authorChen, Y-
dc.contributor.authorYan, H-
dc.contributor.authorZhang, J-
dc.contributor.authorZhang, Y-
dc.contributor.authorWang, Y-
dc.contributor.authorQiu, Q-
dc.contributor.authorGong, H-
dc.contributor.authorWei, X-
dc.contributor.authorWang, L-
dc.contributor.authorSun, K-
dc.contributor.authorWu, P-
dc.contributor.authorAjelli, M-
dc.contributor.authorCowling, BJ-
dc.contributor.authorViboud, C-
dc.contributor.authorYu, H-
dc.date.accessioned2020-07-03T08:22:41Z-
dc.date.available2020-07-03T08:22:41Z-
dc.date.issued2020-
dc.identifier.citationClinical Infectious Diseases, 2020, Epub 2020-05-15-
dc.identifier.issn1058-4838-
dc.identifier.urihttp://hdl.handle.net/10722/283686-
dc.description.abstractObjective: To assess the case fatality risk (CFR) of COVID-19 in mainland China, stratified by region and clinical category, and estimate key time-to-event intervals. Methods: We collected individual information and aggregated data on COVID-19 cases from publicly available official sources from December 29, 2019 to April 17, 2020. We accounted for right-censoring to estimate the CFR and explored the risk factors for mortality. We fitted Weibull, gamma, and lognormal distributions to time-to-event data using maximum-likelihood estimation. Results: We analyzed 82,719 laboratory-confirmed cases reported in mainland China, including 4,632 deaths, and 77,029 discharges. The estimated CFR was 5.65% (95%CI: 5.50%-5.81%) nationally, with highest estimate in Wuhan (7.71%), and lowest in provinces outside Hubei (0.86%). The fatality risk among critical patients was 3.6 times that of all patients, and 0.8-10.3 fold higher than that of mild-to-severe patients. Older age (OR 1.14 per year; 95%CI: 1.11-1.16), and being male (OR 1.83; 95%CI: 1.10-3.04) were risk factors for mortality. The time from symptom onset to first healthcare consultation, time from symptom onset to laboratory confirmation, and time from symptom onset to hospitalization were consistently longer for deceased patients than for those who recovered. Conclusions: Our CFR estimates based on laboratory-confirmed cases ascertained in mainland China suggest that COVID-19 is more severe than the 2009 H1N1 influenza pandemic in hospitalized patients, particularly in Wuhan. Our study provides a comprehensive picture of the severity of the first wave of the pandemic in China. Our estimates can help inform models and the global response to COVID-19.-
dc.languageeng-
dc.publisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/-
dc.relation.ispartofClinical Infectious Diseases-
dc.rightsPre-print: Journal Title] ©: [year] [owner as specified on the article] Published by Oxford University Press [on behalf of xxxxxx]. All rights reserved. Pre-print (Once an article is published, preprint notice should be amended to): This is an electronic version of an article published in [include the complete citation information for the final version of the Article as published in the print edition of the Journal.] Post-print: This is a pre-copy-editing, author-produced PDF of an article accepted for publication in [insert journal title] following peer review. The definitive publisher-authenticated version [insert complete citation information here] is available online at: xxxxxxx [insert URL that the author will receive upon publication here]. -
dc.subjectNovel coronavirus diseases 2019-
dc.subjectsevere acute respiratory syndrome coronavirus 2-
dc.subjectcase fatality risk-
dc.subjectChina-
dc.titleCase fatality risk of the first pandemic wave of novel coronavirus disease 2019 (COVID-19) in China-
dc.typeArticle-
dc.identifier.emailWu, P: pengwu@hku.hk-
dc.identifier.emailCowling, BJ: bcowling@hku.hk-
dc.identifier.authorityWu, P=rp02025-
dc.identifier.authorityCowling, BJ=rp01326-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1093/cid/ciaa578-
dc.identifier.pmid32409826-
dc.identifier.pmcidPMC7239217-
dc.identifier.hkuros310745-
dc.identifier.volumeEpub 2020-05-15-
dc.identifier.spageciaa578-
dc.identifier.epageciaa578-
dc.publisher.placeUnited States-

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