key: cord-0733336-e7xt6pck authors: Wang, Guan; Chen, Wenhu; Jin, Xian; Chen, Yi‐Peng title: Description of COVID‐19 cases along with the measures taken on prevention and control in Zhejiang, China date: 2020-05-22 journal: J Med Virol DOI: 10.1002/jmv.25906 sha: 2a345deebde0b990a940147a23a61b678803ce0b doc_id: 733336 cord_uid: e7xt6pck Under the outbreak of COVID‐19, it was urgent to analyze the cases from clinical features and epidemiological factors, as well as understand the effectiveness of measures taken on disease prevent and control. A retrospective study was applied for descriptive analysis of clinical features and epidemiological factors of confirmed cases in four cities of Zhejiang. The Onset‐admission interval was calculated and plotted as well. The provincial measures regarding the response of COVID‐19 were summed up and sorted out. The distribution and sex and age were under normality distribution, and the age of 20 to 80 were all in risk of developing the disease. Clinical features of fever and cough were found mostly happen on patients. More than half of the patients had image changed on chest from reported data. The factor of closely contacted with confirmed cases was the most cause to the disease. The median onset‐admission interval was 6 days in Zhejiang province. As of the efficient health system, COVID‐19 had been successfully prevented and controlled in Zhejiang. Males and females were all vulnerable to COVID‐19. Preventing contact with confirmed cases could largely avoid the disease to happen. The government should take emergent and effective measures to prevent and treatment of the pandemic disease. In December 2019, cases of pneumonia with unknown causes were reported in Wuhan, China. Epidemiological evidence suggested that most of these patients had visited the Huanan seafood market in Wuhan and Proved to be caused by SARS-CoV-2, which had not been found in humans before. 1 The infectious disease was officially named as COVID-19 and this disease outbreak was declared as a Public Health Emergency of International Concern by World Health Organization (WHO) on 30 January 2020. 2 So far, more than 1 million cases of COVID-19 have been confirmed globally. 3 In China, 83 597 confirmed cases have been reported and 78 145 patients have been cured to the date of 13 April 2020. 4 Analyzing of the genome of SARS-CoV-2 isolated from human airway epithelial cells, revealed that this new virus formed another clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. 5 Different from both SARS-CoV and MERS-CoV, SARS-CoV-2 is the seventh member of the family of coronaviruses that infect humans. 6, 7 Some researchers have found that SARS-CoV-2 has a strong affinity to a human respiratory receptor and determined the phenomenon of human to human transmission in family homes and hospitals, which suggested a potential threat to the global public health. 8 Research found that the incubation period is 3 to 7 days in general, and days of 14 has been suggested as a quarantine period to ensure the absence of disease from healthy. [9] [10] [11] Guan Wang and Wenhu Chen are co-first authors of the article. Zhejiang Province, ranked as the third place of COVID-19 cumulative cases in China, has been suffering a lot for the disease. 12 Based on the official data, four cities had the most cases among a total of 11 cities in Zhejiang, which were Wenzhou, Hangzhou, Ningbo, and Taizhou, respectively. 3, 12 Along with national actions against the disease, the Zhejiang government has also taken emergency measures to control the outbreak of disease, such as application of big data for monitoring the health status of citizens, 13 and development of nucleic acid detection kit for the early detection of COVID-19 cases. Since most of the studies were performed based on Wuhan or Hubei Province. Seldom information on novel coronavirus cases was known in other places of China. Therefore, it is necessary to explore the epidemiological and clinical characteristics of COVID-19 patients in addition to related measures taken in non-Hubei areas. 14 Days, median (IQR) 6 (4-9) 7 (4-10) 5 (3-9) 6 (4-9) 6 (4-9) In Wenzhou, we found a factor of shopping in Yintai market took up for 4% of its cases, pointing out accessed to a public occasion could be a risk factor of the disease transmission. In addition, a factor of got in touch with returnees from Wuhan was also identified as an epidemiological factor especially when patients were asymptomatic, without obvious clinical symptoms. In December of 2019, Wuhan started the outbreak of COVID- 19. 15 Since then, the first case in Zhejiang was reported on 21st January. 12 Zhejiang, where is a province with large floating population, due to its specificity, the province soon ranked as the third place of cumulative confirmed cases in China. 3, 12 In this study, we did a retrospective study analysis for the confirmed cases diagnosed from 27th January to F I G U R E 2 Epidemiological analysis for COVID-19 exposure in four major cities Table 1 presented a descriptive analysis of novel coronavirus pneumonia cases from four major cities in Zhejiang. Our study found males and females were all vulnerable to the disease, indicating gender may not be a risk factor of developing the disease. The infected patients could be found at all ages, and most patients were found at the age of 20 to 80. Research showed the infection of COVID-19 is self-limited, people whom could recover in a strong immune system. 16 And the younger would be in a lower likelihood of infection because of a faster immune response mechanism. 17 Elder population were in a higher risk to be infected owning to lack of knowledge of disease prevention or having chronic conditions. 18, 19 Cough and fatigue were mostly found among patients, which were consistent with the findings of Shi et al and Wu et al 20, 21 It is also important to carry out differential diagnosis from patients with common cold, especially when they had epidemiological exposure history. 22 We noticed that asymptomatic infection took up a small proportion among patients, although it varied from each city. The discrimination of asymptomatic patients was mostly from imaging screening in light of epidemiological exposure history. 23, 24 As the asymptomatic did not present any clinical signs or symptoms but still excrete coronavirus and could become a source of infection, 25, 26 it is necessary to detect the inapparent infection from population and prevent the disease from further spread. Due to the unreported information on image change, the proportion for radiology "Changed" and "Unchanged" varied a lot between each city. Since chest CT could identify the early phrase of the disease infection, it has been recommended as one of major evidence for COVID-19 diagnosis and public health surveillance. 27 Yang et al 28 has proved chest CT could be used to quickly assess patients with severity of the novel coronavirus. Research found the disease is mainly transmitted through respiratory tract and interpersonal contact. 10, 22 Since closely contact with confirmed cases was the leading cause to COVID-19 in Zhejiang Province, it is of great importance to quarantine the population with epidemiological exposure to prevent disease transmission. 29, 30 In the meanwhile, public space as well as transportation could be closed or suspended for the spread of infectious disease. In this study, pregnant cases have not been found, however, we still need to pay attention to this special group, relevant guidelines should be made for the management of this group. 31 The day of onset-admission interval was shorter than the initially reported cases in Wuhan, 9 while was a bit longer than days in Shanghai. 32 This indictor was supposed to reflect the effectiveness and capacity of public health emergency system, and it is regarded as a better health system with a shorter interval for admission. 33 As of the quick response to the COVID-19 treatment, the local government has provided the effective detecting device such as the kit for reverse transcription polymerase chain reaction as well as taken strictly measures to control the disease, which shortened the diagnostic time significantly. 12 We found in Males and females were all vulnerable to COVID-19, and the disease occurred at all age groups. 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Description of COVID-19 cases along with the measures taken on prevention The authors declare that there are no conflict of interests. GW and WC collected the data and together developed the draft.