Discussion
During the initial phase of the Covid-19 outbreak, the diagnosis of the disease was complicated by the diversity in symptoms and imaging findings and in the severity of disease at the time of presentation. Fever was identified in 43.8% of the patients on presentation but developed in 88.7% after hospitalization. Severe illness occurred in 15.7% of the patients after admission to a hospital. No radiologic abnormalities were noted on initial presentation in 2.9% of the patients with severe disease and in 17.9% of those with nonsevere disease. Despite the number of deaths associated with Covid-19, SARS-CoV-2 appears to have a lower case fatality rate than either SARS-CoV or Middle East respiratory syndrome–related coronavirus (MERS-CoV). Compromised respiratory status on admission (the primary driver of disease severity) was associated with worse outcomes.
Approximately 2% of the patients had a history of direct contact with wildlife, whereas more than three quarters were either residents of Wuhan, had visited the city, or had contact with city residents. These findings echo the latest reports, including the outbreak of a family cluster,4 transmission from an asymptomatic patient,6 and the three-phase outbreak patterns.8 Our study cannot preclude the presence of patients who have been termed “super-spreaders.”
Conventional routes of transmission of SARS-CoV, MERS-CoV, and highly pathogenic influenza consist of respiratory droplets and direct contact,18-20 mechanisms that probably occur with SARS-CoV-2 as well. Because SARS-CoV-2 can be detected in the gastrointestinal tract, saliva, and urine, these routes of potential transmission need to be investigated21 (Tables S1 and S2).
The term Covid-19 has been applied to patients who have laboratory-confirmed symptomatic cases without apparent radiologic manifestations. A better understanding of the spectrum of the disease is needed, since in 8.9% of the patients, SARS-CoV-2 infection was detected before the development of viral pneumonia or viral pneumonia did not develop.
In concert with recent studies,1,8,12 we found that the clinical characteristics of Covid-19 mimic those of SARS-CoV. Fever and cough were the dominant symptoms and gastrointestinal symptoms were uncommon, which suggests a difference in viral tropism as compared with SARS-CoV, MERS-CoV, and seasonal influenza.22,23 The absence of fever in Covid-19 is more frequent than in SARS-CoV (1%) and MERS-CoV infection (2%),20 so afebrile patients may be missed if the surveillance case definition focuses on fever detection.14 Lymphocytopenia was common and, in some cases, severe, a finding that was consistent with the results of two recent reports.1,12 We found a lower case fatality rate (1.4%) than the rate that was recently reportedly,1,12 probably because of the difference in sample sizes and case inclusion criteria. Our findings were more similar to the national official statistics, which showed a rate of death of 3.2% among 51,857 cases of Covid-19 as of February 16, 2020.11,24 Since patients who were mildly ill and who did not seek medical attention were not included in our study, the case fatality rate in a real-world scenario might be even lower. Early isolation, early diagnosis, and early management might have collectively contributed to the reduction in mortality in Guangdong.
Despite the phylogenetic homogeneity between SARS-CoV-2 and SARS-CoV, there are some clinical characteristics that differentiate Covid-19 from SARS-CoV, MERS-CoV, and seasonal influenza infections. (For example, seasonal influenza has been more common in respiratory outpatient clinics and wards.) Some additional characteristics that are unique to Covid-19 are detailed in Table S3.
We may never know.
For the naysayers who say people die from the flu, do you know someone who has? Can you name a notable person who has?
i didn’t realize that FR allowed non-alarmist articles about coronavirus to be posted here ...
Which is why I bought 22 day call options at the bottom of the market yesterday.
An engineered hoax designed to take down the economy and then Trump? You have to remember that the ChiComs and the globalists will do ANYTHING to get the USA to drop tariffs. But even a fake medical scare? Maybe. Free Traitors™ are fanatics.
This article confirms what I have been saying: We don’t know what the true mortality rate is. I think it’s substantially lower than 2%. This article cites a 2% mortality rate in people who were HOSPITALIZED. That’s a different kettle of fish than claiming that 2% of those infected are going to die. Asians are notoriously germ phobes and freak out at any infectious diseases. I predict this whole thing blows over by the end of this week.
Flu quarantines?
.
Next they will criticize this because it is an opinion piece and not peer reviewed.
Sick of reading and hearing bout this panic borne disease.
Never let a crisis go to waste.