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Epidemiologic and Clinical Characteristics of Novel Coronavirus Infections Involving 13 Patients Outside Wuhan, China

Educational Objective
Review Epidemiologic and Clinical Characteristics of Novel Coronavirus Infections Involving 13 Patients Outside Wuhan, China.
1 Credit CME

In December 2019, cases of pneumonia appeared in Wuhan, China. The etiology of these infections was a novel coronavirus (2019-nCoV),1,2 possibly connected to zoonotic or environmental exposure from the seafood market in Wuhan. Human-to-human transmission has accounted for most of the infections, including among health care workers.3,4 The virus has spread to different parts of China and at least 26 other countries.1 A high number of men have been infected, and the reported mortality rate has been approximately 2%, which is lower than that reported from other coronavirus epidemics including severe acute respiratory syndrome (SARS; mortality rate, >40% in patients aged >60 years)5 and Middle East respiratory syndrome (MERS; mortality rate, 30%).6 However, little is known about the clinical manifestations of 2019-nCoV in healthy populations or cases outside Wuhan. We report early clinical features of 13 patients with confirmed 2019-nCoV infection admitted to hospitals in Beijing.

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Article Information

Corresponding Authors: Guangfa Zhu, MD, Beijing Institute of Heart, Lung and Blood Vessel Disease, Department of Pulmonary and Critical Care Medicine, Beijing Anzhen Hospital, Capital Medical University, Two Anzhen Road, Chaoyang, Beijing 100029, China (gfzhu6388@sina.com); Lixin Xie, MD, College of Respiratory and Critical Care Medicine, Chinese PLA General Hospital, 28 Fuxing Road, Haidian, Beijing 100853, China (xielx301@126.com).

Published Online: February 7, 2020. doi:10.1001/jama.2020.1623

Author Contributions: Drs Chang and Lin contributed equally. Drs Dela Cruz and Sharma contributed equally as senior authors. Drs Chang and Sharma had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Chang, Wei, Zhu, Sharma.

Acquisition, analysis, or interpretation of data: Chang, Lin, Xie, Dela Cruz.

Drafting of the manuscript: Chang, Wei, Zhu, Dela Cruz, Sharma.

Critical revision of the manuscript for important intellectual content: Chang, Lin, Xie, Dela Cruz, Sharma.

Statistical analysis: Chang, Zhu.

Administrative, technical, or material support: Chang, Lin, Wei, Xie, Zhu.

Supervision: Xie, Dela Cruz, Sharma.

Conflict of Interest Disclosures: None reported.

Funding/Support: This study was supported by funding from China Scholarship Council (Dr Chang; 201809112037), Beijing Nova Program (Dr Chang; Z171100001117012), Beijing Nova Program Interdisciplinary Cooperation Project (Dr Chang; Z191100001119021).

Role of the Funders/Sponsors: The study funders/sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: We thank Xiaohui Wang, MD (Beijing Tsinghua Changgung Hospital), Xuedong Zhang, MD, and Jixiang Chen, MD (Beijing Anzhen Hospital), and Fenfang Zou, MD (Chinese PLA General Hospital), for collecting the data, and Andre Rebaza, MD (Yale School of Medicine), for preparing the Table. None of these individuals received compensation for their contributions.

References
1.
World Health Organization. Novel coronavirus (2019-nCoV) situation report-15. Published February 4, 2020. Accessed February 3, 2020. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200204-sitrep-15-ncov.pdf?sfvrsn=88fe8ad6_2
2.
Paules  CI, Marston  HD, Fauci  AS.  Coronavirus infections—more than just the common cold  [published online January 23, 2020].  JAMA. doi:10.1001/jama.2020.0757Google Scholar
3.
Li  Q, Guan  X, Wu  P,  et al.  Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia  [published online January 29, 2020].  N Engl J Med. doi:10.1056/NEJMoa2001316PubMedGoogle Scholar
4.
Huang  C, Wang  Y, Li  X,  et al.  Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China.  [published online January 24, 2020].  Lancet. doi:10.1016/S0140-6736(20)30183-5PubMedGoogle Scholar
5.
Donnelly  CA, Ghani  AC, Leung  GM,  et al.  Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong.  Lancet. 2003;361(9371):1761-1766. doi:10.1016/S0140-6736(03)13410-1PubMedGoogle ScholarCrossref
6.
Ahmed  AE.  The predictors of 3- and 30-day mortality in 660 MERS-CoV patients.  BMC Infect Dis. 2017;17(1):615. doi:10.1186/s12879-017-2712-2PubMedGoogle ScholarCrossref
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