Clinical Characteristics and Prognostic Factors of 148 COVID-19 Cases in a Secondary Epidemic Area

Background: The epidemic characteristic of COVID-19 outside Wuhan was still unclear. We report the epidemiological, clinical, treatment and prognosis of COVID-19 in a secondary epidemic area. Methods: This multi-center cohort study included consecutive laboratory-confirmed COVID-19 cases from January 22 to February 22 in Wenzhou, China. All cases were followed up to discharge, or March 16. Data were extracted with standardized form, and compared between severe and non-severe cases. Logistic regression and Cox regression were used to explore the factors associated with ICU admission and hospital stay, respectively. Findings: The whole epidemic lasted for one month. Of the 148 included cases, 29 were severe, and one died. The median age was 52 years, 62·2% were male and 60·8% were overweight or obese. Fever (81·8%) and cough (61·5%) were the most common symptoms. Importantly, 25·0% had no contact history. The median hospital stay was 20 days, and 5·4% were admitted to ICU. Compared with the non-severe cases, the severe patients were older, had higher proportions of smoking, laboratory abnormalities, and ICU admission. Elevated alanine aminotransferase was independently associated with ICU admission; however, type of antiviral drugs had no significant association with duration of hospital stay. Interpretation: The second-generation cases had atypical symptoms, and one quarter had no clear contact history. The prevalence of overweight was high. Strict prevention and control measures were urgent for controlling the outbreak. Funding Statement: National Natural Science Foundation of China, Provincial Natural Science Foundation of Zhejiang, and Science and Technology Planning Project of Wenzhou. Declaration of Interests: None of the authors have any conflict of interest to declare. Ethics Approval Statement: The ethics committees of the designated hospitals approved this retrospective study. Written informed consent was waived.