HealthDay News – Patients with coronavirus disease 2019 (COVID-19) often have fever and cough on presentation, according to research published online February 28 in the New England Journal of Medicine.

Wei-jie Guan, PhD, from the First Affiliated Hospital of Guangzhou Medical University in China, and colleagues extracted data for 1099 patients with laboratory-confirmed COVID-19 from 552 hospitals in China through January 29, 2020.

The researchers found that the primary composite end point occurred in 6.1% of patients, including 5.0, 2.3, and 1.4% who were admitted to the intensive care unit, underwent invasive mechanical ventilation, and died, respectively. Of the patients, only 1.9% had a history of direct contact with wildlife. Almost three-quarters (72.3%) of nonresidents of Wuhan had contact with residents of Wuhan, including 31.3% who had visited the city. Fever (43.8% on admission, 88.7% during hospitalization) and cough (67.8%) were the most common symptoms, while diarrhea was uncommon (3.8%). There was a four-day median incubation period. Ground-glass opacity was the most common radiologic finding with chest computed tomography (CT) on admission (56.4%); 17.9% of patients with nonsevere disease and 2.9% with severe disease had no radiologic or CT abnormality. In 83.2% of the patients, lymphocytopenia was present on admission.

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“Some patients with COVID-19 do not have fever or radiologic abnormalities on initial presentation, which has complicated the diagnosis,” the authors write.

Abstract/Full Text