Clinical Course
The CDC reports a summary of “multiple early studies from Wuhan, China who had severe COVID-19 illness”1 showing these median timeframes:
- 5-8 days – onset of illness to dyspnea
- 8-12 days – onset of illness to acute respiratory distress syndrome (ARDS)
- 9.5-12 days – onset of illness to ICU admission
- 10-13 days – length of hospitalization among survivors
The CDC also notes “Clinicians should be aware of the potential for some patients with COVID-19 to rapidly deteriorate about one week after illness onset.”1
Case Distribution
The largest published data set comes from a Chinese study of 72 314 cases, published in JAMA in February 2020.2 Summary of the data provides the following:
72 314 Cases (as of February 11, 2020)2
- Confirmed cases: 44 672 (62%)
- Suspected cases: 16 186 (22%)
- Diagnosed cases: 10 567 (15%)
- Asymptomatic cases: 889 (1%)
Spectrum of disease (N = 44 415)2
- Mild: 81% (36 160 cases)
- Severe: 14% (6168 cases)
- Critical: 5% (2087 cases)
Age distribution (N = 44 672)2
- ≥80 years: 3% (1408 cases)
- 30-79 years: 87% (38 680 cases)
- 20-29 years: 8% (3619 cases)
- 10-19 years: 1% (549 cases)
- <10 years: 1% (416 cases)
Case-fatality rate2
- 2.3% (1023 of 44 672 confirmed cases)
- 14.8% in patients aged ≥80 years (208 of 1408)
- 8.0% in patients aged 70-79 years (312 of 3918)
- 49.0% in critical cases (1023 of 2087)
Health care personnel infected2
- 3.8% (1716 of 44 672)
- 63% in Wuhan (1080 of 1716)
- 14.8% cases classified as severe or critical (247 of 1668)
- 5 deaths
Pediatric distribution3
- 728 (34.1%) laboratory-confirmed cases and 1407 (65.9%) suspected cases
- 94% asymptomatic, mild, or moderate disease
- 5% severe disease
- <1% critical disease
The CDC reports “Among U.S. COVID-19 cases reported January 22–May 30, 2020, overall the proportion of people who were hospitalized was 14%, including 2% admitted to the intensive care unit (ICU). Overall 5% of patients died.”1
Sources
- CDC https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html
- Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020 Feb 24;323(13):1239–42. doi:10.1001/jama.2020.2648external icon.
- Dong Y, Mo X, Hu Y, et al. Epidemiology of COVID-19 Among Children in China. Pediatrics. 2020 Jun;145(6): e20200702. doi:10.1542/peds.2020-0702external icon.