Characteristics and Outcomes of a Sample of Patients With COVID-19 Identified Through Social Media in Wuhan, China: Observational Study.

Dong Liu,Yongjie Yue,Wenjun Liu,Jue Liu,Fuhai Zhang,Ziping Wang,Yuyan Wang,Juan Wang

doi:10.2196/20108

Abstract

BackgroundThe number of deaths worldwide caused by coronavirus disease (COVID-19) is increasing rapidly. Information about the clinical characteristics of patients with COVID-19 who were not admitted to hospital is limited. Some risk factors of mortality associated with COVID-19 are controversial (eg, smoking). Moreover, the impact of city closure on mortality and admission rates is unknown.ObjectiveThe aim of this study was to explore the risk factors of mortality associated with COVID-19 infection among a sample of patients in Wuhan whose conditions were reported on social media.MethodsWe enrolled 599 patients with COVID-19 from 67 hospitals in Wuhan in the study; 117 of the participants (19.5%) were not admitted to hospital. The demographic, epidemiological, clinical, and radiological features of the patients were extracted from their social media posts and coded. Telephone follow-up was conducted 1 month later (between March 15 and 23, 2020) to check the clinical outcomes of the patients and acquire other relevant information.ResultsThe median age of patients with COVID-19 who died (72 years, IQR 66.5-82.0) was significantly higher than that of patients who recovered (61 years, IQR 53-69, P<.001). We found that lack of admission to hospital (odds ratio [OR] 5.82, 95% CI 3.36-10.1; P<.001), older age (OR 1.08, 95% CI 1.06-1.1; P<.001), diffuse distribution (OR 11.09, 95% CI 0.93-132.9; P=.058), and hypoxemia (odds ratio 2.94, 95% CI 1.32-6.6; P=.009) were associated with increasing odds of death. Smoking was not significantly associated with mortality risk (OR 0.9, 95% CI 0.44-1.85; P=.78).ConclusionsOlder age, diffuse distribution, and hypoxemia are factors that can help clinicians identify patients with COVID-19 who have poor prognosis. Our study suggests that aggregated data from social media can also be comprehensive, immediate, and informative in disease prognosis.

Highlights

In December 2019, a novel coronavirus disease (COVID-19) emerged in China and began to spread globally
We present a series of cases reported on the internet with definite clinical outcomes and their early-stage characteristics to explore the early stage risk factors and clinical features of COVID-19 mortality
Our study suggests that use of social media data can be effective to identify patients at high risk for COVID-19, help coordinate appropriate treatment, and lower the mortality rate

Summary

Introduction

In December 2019, a novel coronavirus disease (COVID-19) emerged in China and began to spread globally. Several case series from China and Italy have suggested that male sex, older age, hypertension, kidney disease, and myocardial injury are risk factors for severe COVID-19 [2,3,4,5,6]. Despite these studies, knowledge of the early stage risk factors associated with poor prognosis is still limited. We present a series of cases reported on the internet (from 67 hospitals in Wuhan) with definite clinical outcomes (discharge or death as of March 30, 2020) and their early-stage characteristics (before hospital admission) to explore the early stage risk factors and clinical features of COVID-19 mortality. The impact of city closure on mortality and admission rates is unknown

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