KARACHI: A Chinese study on the clinical features of coronavirus has found that the majority of patients hospitalised in mainland China initially presented without fever and many had no abnormal radiologic findings.

Titled ‘Clinical characteristics of coronavirus disease 2019 in China’, the study has recently been published online in The New England Journal of Medicine and funded by the National Health Commission of China, among others.

It is based on the data of 1,099 patients with laboratory-confirmed coronavirus disease from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China.

The study’s findings show that the most common symptom was cough (67.8 per cent). Fever was present in 43.8pc of the patients on admission but developed in 88.7pc during hospitalisation.

“In concert with recent studies, we found that the clinical characteristics of Covid-19 (the ongoing coronavirus outbreak) mimic those of SARS-CoV.

“The absence of fever in Covid-19 is more frequent than in SARS-CoV (1%) and MERS-CoV infection (2pc), so afebrile patients may be missed if the surveillance case definition focuses on fever detection,” it says.

Nausea or vomiting and diarrhoea were uncommon. Among the overall population, 23.7pc had at least one coexisting illness (example, hypertension and chronic obstructive pulmonary disease).

The median incubation period (of the virus) was four days. The median age of the patients was 47 years. A total of 41.9pc were female.

The study points out that most patients at the time of hospital admission were classified as having non-severe disease. Patients with severe disease were older and that coexisting illness was more common among them as compared to those with non-severe disease.

However, the exposure history between the two groups of disease severity was similar.

Only 1.9pc of the patients had a history of direct contact with wildlife. Among non-residents of Wuhan, the Chinese city which first reported the virus outbreak, 72.3pc had contact with residents of Wuhan, including 31.3pc who had visited the city.

“We found a lower case fatality rate (1.4%) than the rate that was recently reportedly, 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.

“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, the southern Chinese province affected by the disease,” it says.

Published in Dawn, March 5th, 2020