Abstract
The current outbreak of coronavirus disease 2019 (COVID-19) has been defined as a pandemic by the World Health Organization. We aimed to evaluate the clinical features and virological course of non-severe COVID-19 patients with or without symptoms who were admitted to a Chinese cabin hospital. In this retrospective single center study, we reviewed 252 laboratory-confirmed COVID-19 patients treated at one temporary cabin hospital in Wuhan, China. Demographic, clinical, serial chest computed tomography (CT), and serial viral test data were compared between asymptomatic and symptomatic patients. The association between clinical features and symptomatic status or patient referral status was analyzed. Among all 252 patients, 74 (29.4%) were asymptomatic and 138 (54.76%) had more than two family members who developed COVID-19. The probability for family clustering was similar between asymptomatic and symptomatic patients (59.70 vs. 61.64%, P = 0.79). Asymptomatic patients and symptomatic patients were equally likely to reach a virus-free state during their stay at the cabin hospital (93.15 vs. 86.44%, P = 0.13). The initial chest CT screening showed that 81 (32.1%) patients had no visible pneumonia, 52 (20.6%) had unilateral pneumonia, and 119 (47.2%) had bilateral pneumonia. Symptomatic patients had a higher chance to have bilateral pneumonia (P < 0.0001) and were less likely to show improvement on the follow-up CT scan (P = 0.0002). In total, 69 (27.4%) patients were referred to the designated hospital and only 23 (9.1%) patients were referred due to the progression of pneumonia. Non-severe COVID-19 patients can transmit the disease regardless of their symptomatic status. It is highly recommended that asymptomatic patients be identified and quarantined to eliminate the transmission of COVID-19.
Highlights
The severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), which causes coronavirus disease 2019 (COVID-19), is currently spreading rapidly around the world (Zhou et al, 2020a)
Seventy-four (29.4%) patients had no symptoms, consistent with a study that observed 34.6% of COVID19 patients were asymptomatic on-board the Princess Cruise (Mizumoto et al, 2020)
Thirty-six asymptomatic patients were found to have pneumonia, which is consistent with a previous report that some asymptomatic patients had abnormal CT imaging features (Shi et al, 2020)
Summary
The severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), which causes coronavirus disease 2019 (COVID-19), is currently spreading rapidly around the world (Zhou et al, 2020a). On March 11, COVID-19 was characterized as a pandemic by the World Health Organization (WHO) (WHO). It is affecting more than 180 countries and territories worldwide (WHO, 2020a,b). During the early stages of the coronavirus outbreak in Wuhan, China, the medical resources of the regular healthcare system were quickly drained and infected patients with nonsevere symptoms were suggested to self-quarantine at home, which led to severe cases of family-clustered transmission and fast spread among communities. It is important to evaluate the virological course, clinical features, and outcomes of asymptomatic, and symptomatic patients with COVID-19 treated at cabin hospitals, and share our experience with other countries, and territories that are currently dealing with the infectious disease
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