Analysis of Imported Cases of COVID-19 in Taiwan: A Nationwide Study

Abstract

In the early stages of the 2019 novel coronavirus disease (COVID-19) pandemic, containment of disease importation from epidemic areas was essential for outbreak control. This study is based on publicly accessible data on confirmed COVID-19 cases in Taiwan extracted from the Taiwan Centers for Disease Control website. We analysed the characteristics, infection source, symptom presentation, and route of identification of the 321 imported cases that were identified from 21 January to 6 April 2020. They were mostly returned Taiwanese citizens who had travelled to one or more of 37 countries for tourism, business, work, or study. Half of these cases developed symptoms before arrival, most of the remainder developed symptoms 1-13 days (mean 4.0 days) after arrival, and 3.4% never developed symptoms. Three-quarters of the cases had respiratory symptoms, 44.9% had fever, 13.1% lost smell or taste, and 7.2% had diarrhoea. Body temperature and symptom screening at airports identified 32.7% of the cases. Of the remainder, 27.7% were identified during home quarantining, 16.2% were identified via contact tracing, and 23.4% were reported by hospitals. Under the strict enforcement of these measures, the incidence of locally acquired COVID-19 cases in Taiwan remains sporadic. In conclusion, proactive border control measures are effective for preventing community transmission of this disease.

COVID-19: interim guidance on rehabilitation in the hospital and post-hospital phase from a European Respiratory Society- and American Thoracic Society-coordinated international task force

“…It is well established that optimising caloric and protein intake is important to support recovery of functional muscle mass. The post-ICU COVID-19 survivor will face commonly reported problems with nutrition (e.g., loss of appetite, swallowing disorders) and the additional symptom of loss of taste (ageusia) and smell (anosmia) are now recognised symptom of COVID-19 (37). In general, for those with chronic respiratory disease weight loss and wasting of muscle and bone tissue may be induced or accelerated during severe acute exacerbations of respiratory disease requiring hospitalisation, due to the combination of malnutrition, physical inactivity, hypoxia, systemic inflammation and/or systemic glucocorticoids (38), this is likely to be mirrored in the COVID patient.…”

Systematic Review and Meta‐analysis of Smell and Taste Disorders in COVID‐19

“…The estimated prevalence of COVID-19 in the 13 studies ranged from 7.96% by Lee et al 17 to 75.74% Yan et al 31 The estimated pooled prevalence of combined loss of smell and taste in COVID-19 patients was 35.04% (95% CI, 22.03%-49.26%). Both loss of smell and taste were reported in 5 publications each from Asia 7,17,20,23,45 and Europe 5,27,40,48,49 and 3 from North America. 8,9,31 The estimated pooled prevalence of loss of smell and taste in the populations of Europe, North America, and Asia regions was 31.26% (95% CI, 13.64%-52.22%), 66.84% (95% CI, 56.18%-76.70%), and 15.89% (95% CI, 8.15%-25.42%), respectively (Figure 4).…”

“…Several studies from the United States, China, South Korea, Iran, Australia, France, Spain, Italy, United Kingdom, and Germany strongly confirmed different degrees of loss of smell (anosmia/hyposmia/dysosmia) and loss of taste (ageusia/hypogeusia/dysgeusia) as early symptoms of COVID-19. 4 - 32 It was observed that sudden loss in smell and taste could be the only features in asymptomatic newly infected individuals and could also serve as early symptoms of the disease. In fact, the American Academy of Otolaryngology–Head and Neck Surgery Foundation and Ear, Nose, and Throat Society of the United Kingdom (ENTUK) recommended that patients presenting with these clinical features should commence self-isolation before alerting the health authorities.…”

Emergency department response to coronavirus disease 2019 outbreak with a fever screening station and “graded approach” for isolation and testing

“…6 A study of 321 imported COVID-19 cases to Taiwan revealed only 44.9% had fever, three-quarters of had respiratory symptoms, 13.1% had loss of smell or taste, and 7.2% had diarrhea. 11 This signifies that body temperature screening at the ED door does not ensure detection of all cases and can miss those without obvious symptoms. A graded approach in testing allows testing of even low-risk patients, who may not have been eligible for testing.…”