OBJECTIVE To reveal more data on the epidemiologic and clinical characteristics of coronavirus disease 2019 (COVID-19) patients outside of Wuhan, from five hospitals in east of Zhejiang province, China. DESIGN Retrospective case series. SETTING Five hospitals in east of Zhejiang province, China. PARTICIPANTS 88 cases of laboratory-confirmed and 3 cases of clinical-confirmed COVID-19 were : medRxiv preprint RESULTSOf all 91 patients, 88 (96.70%) were laboratory-confirmed COVID-19 pneumonia with throat swab samples that tested positive for SARS-Cov-2 while 3 (3.30%) were clinical-diagnosed COVID-19 pneumonia cases. The median age of the patients was 50 (36.5-57) years, and female accounted for 59.34%. In this sample 40 (43.96%) patients had contracted the diseases from local cases, 31 (34.07%) patients had been to Wuhan/Hubei, 8 (8.79%) cases had contacted with people from Wuhan, 11 (12.09%) cases were confirmed aircraft transmission.In particular within the city of Ningbo, 60.52% cases can be traced back to an event held in a temple.The most common symptoms were fever (71.43%), cough (60.44%) and fatigue (43.96%).The median of incubation period was 6 (IQR, 3-8) days and the median time from first visit to a doctor to confirmed diagnosis was 1 (1-2) days. According to the Chest computed tomography scans, 67.03% cases had bilateral pneumonia, and 27.47% cases showed unilateral pneumonia. CONCLUSIONSocial activity cluster, family cluster and travel by airplane were how COVID-19 patients get transmitted and could be rapidly diagnosed COVID-19 in Zhejiang.
We report the dynamic change process of target genes by RT-PCR testing of SARS-Cov-2 during the course of a COVID-19 patient: from successive negative results to successive single positive nucleocapsid gene, to two positive target genes (orf1ab and nucleocapsid) by RT-PCR testing of SARS-Cov-2, and describe the diagnosis, clinical course, and management of the case. In this case, negative results of RT-PCR testing was not excluded to diagnose a suspected COVID-19 patient, clinical signs and symptoms, other laboratory findings, and chest CT images should be taken into account for the absence of enough positive evidence. This case highlights the importance of successive sampling and testing SARS-Cov-2 by RT-PCR as well as the increased value of single positive target gene from pending to positive in two specimens to diagnose laboratory-confirmed COVID-19.
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