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    Full Spectrum of COVID-19 Severity Still Being Depicted

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    This document summarizes a correspondence regarding the clinical features of COVID-19 reported in the initial study by Huang et al. Specifically, it notes that the conclusions of Huang et al. regarding mortality rates and rates of intensive care unit admission were inaccurate and misleading. The correspondence clarifies that case fatality rates should not be confused with overall mortality rates for a population. It also notes that case detection was likely biased toward more severe cases early on. Overall cases appear to range widely in severity, from mild to severe disease resulting in pneumonia, respiratory failure, or in some cases, death.

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    Full Spectrum of COVID-19 Severity Still Being Depicted

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    poop
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    This document summarizes a correspondence regarding the clinical features of COVID-19 reported in the initial study by Huang et al. Specifically, it notes that the conclusions of Huang et al. regarding mortality rates and rates of intensive care unit admission were inaccurate and misleading. The correspondence clarifies that case fatality rates should not be confused with overall mortality rates for a population. It also notes that case detection was likely biased toward more severe cases early on. Overall cases appear to range widely in severity, from mild to severe disease resulting in pneumonia, respiratory failure, or in some cases, death.

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    DOI: 10.1016/S0140-6736(20)30308-1

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    Full spectrum of COVID-19 severity still being depicted

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    This document summarizes a correspondence regarding the clinical features of COVID-19 reported in the initial study by Huang et al. Specifically, it notes that the conclusions of Huang et al. regarding mortality rates and rates of intensive care unit admission were inaccurate and misleading. The correspondence clarifies that case fatality rates should not be confused with overall mortality rates for a population. It also notes that case detection was likely biased toward more severe cases early on. Overall cases appear to range widely in severity, from mild to severe disease resulting in pneumonia, respiratory failure, or in some cases, death.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    14 views1 page

    Full Spectrum of COVID-19 Severity Still Being Depicted

    Uploaded by

    poop
    This document summarizes a correspondence regarding the clinical features of COVID-19 reported in the initial study by Huang et al. Specifically, it notes that the conclusions of Huang et al. regarding mortality rates and rates of intensive care unit admission were inaccurate and misleading. The correspondence clarifies that case fatality rates should not be confused with overall mortality rates for a population. It also notes that case detection was likely biased toward more severe cases early on. Overall cases appear to range widely in severity, from mild to severe disease resulting in pneumonia, respiratory failure, or in some cases, death.

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    of 1

    Correspondence

    Full spectrum of been diagnosed with SARS-CoV-2


    worldwide, and 44 730 of these cases
    COVID-19 severity still are in China.4 Of the confirmed cases Published Online
    being depicted in China, 8204 (18%) cases were February 14, 2020
    https://doi.org/10.1016/
    recorded as severe infections, and S0140-6736(20)30308-1
    Chaolin Huang and colleagues 1 1114 (2%) patients died, which is a
    first reported the clinical features lower case fatality rate than previously
    of patients infected with severe reported.4,5 The case fatality rate for
    acute respiratory syndrome corona COVID-19 reported by Huang and
    virus 2 (SARS-CoV-2; previously colleagues1 could be misunderstood,
    known as 2019-nCoV), which and detection bias should not be
    emerged in Wuhan, China. Their study neglected.
    will contribute to the diagnosis and We declare no competing interests.
    treatment of 2019 novel coronavirus
    Zhou Xu, Shu Li, Shen Tian, Hao Li,
    disease (COVID-19). Meanwhile, the *Ling-quan Kong
    conclusions have caused a certain huihuikp@163.com
    degree of social panic.
    Department of Endocrine and Breast Surgery,
    Huang and colleagues1 only included The First Affiliated Hospital of Chongqing Medical
    59 suspected cases with fever and dry University, Chongqing 400016, China
    cough, and 41 patients were con­firmed 1 Huang C, Wang Y, Li X, et al. Clinical features of
    to be infected with SARS-CoV-2. patients infected with 2019 novel coronavirus
    in Wuhan, China. Lancet 2020; published
    They concluded that SARS-CoV-2 online Jan 24. https://doi.org/10.1016/
    infection was associated with a high S0140-6736(20)30183-5.
    2 Centers for Disease Control and Prevention.
    rate of admission to intensive care Principles of epidemiology in public health
    units (13 [32%] of 41 patients) and practice: lesson 3. May 18, 2012. https://www.
    mortality (six [15%] of 41 patients); cdc.gov/csels/dsepd/ss1978/lesson3/section3.
    html (accessed Feb 4, 2020).
    however, we believe these conclusions 3 Wang C, Horby PW, Hayden FG, Gao GF.
    were inaccurate and misleading. A novel coronavirus outbreak of global health
    concern. Lancet 2020; published online
    Case fatality ratio should not Jan 24. https://doi.org/10.1016/
    be confused with mortality rate. S0140-6736(20)30185-9.
    Case fatality rate is defined as the 4 WHO. Novel coronavirus (2019-nCoV) situation
    reports. Situation report - 23. Feb 12, 2020.
    proportion of people who die of a https://www.who.int/docs/default-source/
    certain disease; however, mortality coronaviruse/situation-reports/20200212-
    sitrep-23-ncov.pdf?sfvrsn=41e9fb78_2
    rate usually reflects the death rate (accessed Feb 12, 2020).
    in an entire population.2 The case 5 National Health Commission of the People’s
    fatality rate is therefore approximately Republic of China. Latest on the novel
    coronavirus outbreak. Feb 12, 2020.
    15% in the study population,1 but this http://www.nhc.gov.cn/xcs/yqtb/202002/
    estimate is also inaccurate since case 395f075a5f3a411f80335766c65b0487.shtml
    (accessed Feb 13, 2020).
    detection is highly biased towards the
    more severe cases in the early stages.3
    In fact, a large number of mild and
    asymptomatic patients might not
    receive timely diagnosis or health care,
    which can conceal the real incidence
    and allow disease progression.
    Patients with SARS-CoV-2 infection
    are presenting with a wide range
    of symptoms. Most patients seem
    to have mild disease, and about
    20% appear to progress to severe
    disease, including pneumonia, Submissions should be
    made via our electronic
    respiratory failure, and, in some cases, submission system at
    even death.4 As of Feb 12, 2020, http://ees.elsevier.com/
    WHO4 reports that 45 171 people have thelancet/

    www.thelancet.com Published online February 14, 2020 https://doi.org/10.1016/S0140-6736(20)30308-1 1

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