Infectious Diseases

Coronavirus symptoms clarified in largest study of virus so far

View 2 Images
A new study analyzed 99 of the earliest patients to be infected with the novel coronavirus
A new study analyzed 99 of the earliest patients to be infected with the novel coronavirus
An infographic depicting the stages of viral infection in a single studied family
The Lancet

A newly published article in the prestigious journal The Lancet is offering the most thorough insights to date into the clinical characteristics of the rapidly spreading novel coronavirus. The study examined 99 of the earliest cases detected, describing the most common symptoms and the types of patients most likely to contract the virus.

Following a wave of unexplained cases of viral pneumonia in the Chinese city of Wuhan across December 2019, a novel coronavirus was detected. Labeled 2019-nCoV, the spread of the virus has been swift. As of January 29, 2020, it has spread to 20 countries with over 6,000 confirmed cases and 133 deaths.

Scientists have been working hard to understand the characteristics of this new virus. While it belongs to the same general family of viruses responsible for the SARS and MERS outbreaks, its unique properties are still unclear. A new Lancet study is presenting the most comprehensive clinical description of the virus published so far, encompassing 99 patients admitted with the virus to a local Wuhan hospital.

The study revealed the average age of infected patients was 55, and the majority (68 percent) were male. Half of the patients studied were suffering from a pre-existing chronic disease and 49 percent had a direct connection to the food market suspected to be the origin of the virus.

Symptomatically, most patients displayed fever and/or cough on admission to hospital. These are the two most prominent and consistent symptoms seen in the virus. Other symptoms seen in some patients included shortness of breath, muscle aches and headaches.

Commenting on an earlier investigation into the clinical characteristics of this new virus, Paul Hunter from the University of East Anglia noted there are key symptomatic differences between this coronavirus and its notorious counterpart, SARS.

“What comes through strongly is that the clinical features and epidemiology of the recent outbreak is very similar to SARS with one big difference – the relative lack of upper respiratory tract symptoms such as runny nose, sore throat and sneezing compared to what was seen in SARS,” says Hunter. “This is very important as sneezes and runny noses are a prime way for people to spread infection.”

By the endpoint of the study, January 25, only 11 patients had died from the virus, while 31 had recovered and been discharged. The scientists behind this new analysis suggest most of the deceased patients were older than 60 years with pre-existing medical conditions. Those patients with the virus that did die primarily did so from acute respiratory distress syndrome, or ARDS, a critical form of respiratory failure.

While the mortality rate in this studied cohort is around 11 percent, the scientists say some patients currently hospitalized may still succumb to the virus. However, it is also noted that this high mortality rate only accounts for acute hospitalized cases and is not indicative of the virus’s general virulence in the real world.

One of the more compelling data points raised in the study is the virus’s tendency to be of a higher infection risk to men rather than women. This resembles one of the stranger traits seen in the earlier SARS and MERS outbreaks.

“The reduced susceptibility of females to viral infections could be attributed to the protection from X chromosome and sex hormones, which play an important role in innate and adaptive immunity,” the scientists hypothesize in the new study.

The ultimate takeaway from this analysis, the scientists claim, is that older males with pre-existing chronic diseases are most at risk from the novel coronavirus.

The outbreak is, of course, still a dynamic and fast-moving global emergency with a variety of questions still unanswered. Particularly unclear is exactly how contagious the virus may be, and whether it is transmissible when a carrier is still asymptomatic.

An infographic depicting the stages of viral infection in a single studied family
The Lancet

Another recently published case study in The Lancet describes how the virus infected a whole family in early January. As well as verifying person-to-person transmission, the case study suggests asymptomatic transmission of the virus is possible. One 10-year-old child in the family was diagnosed with the virus while curiously remaining completely without symptoms. While asymptomatic cases of SARS were detected in the past, they were very rare.

“Because asymptomatic infection appears possible, controlling the epidemic will also rely on isolating patients, tracing and quarantining contacts as early as possible, educating the public on both food and personal hygiene, and ensuring health care workers comply with infection control,” said Kwok-Yung Yuen, lead researcher on the family case study.

The new coronavirus clinical study was published in The Lancet.

  • Facebook
  • Twitter
  • Flipboard
  • LinkedIn
9 comments
KaiserPingo
So it's actually no more dangerous than a normal Influenza virus.
buzzclick
I take umbrage to the way the western media are feeding this wave of paranoia that is consuming people with fear. The Chinese government should be commended for taking quick and decisively constructive action to deal with this new virus.
Worzel
Millions of people are buying and wearing masks, which are probably a complete waste of time and money, as a virus will easily pass through the pores. However, it would seem that China needs to do something serious about food hygiene controls. Far too many nasty diseases seem to originate there. Some years ago, thousands of animals had to be slaughtered in the UK, due to a pig farmer feeding his pigs with swill, obtained from a local Chinese restaurant, containing meat from China, that the farmer had not cooked to sterilising temperature.
christopher
It drives me bananas how so many people cough and sneeze openly in assorted western countries - I fly often, and I can't remember any time recently when someone on my flight has not coughed or sneezed on me. I see it all the time in restaurants too, from both servers and diners. And despite the 24/7 hysteria we now see on the news, not even one time has anyone suggested to all those morons out there that they should stop doing that. The closest we've seen is mask hysteria reports (which are pointless, because almost all masks have exhalation valves, so anyone infected an wearing one of those is still going to spread it...).

MEDIA - IF YOU ARE READING - WAKE UP and tell everyone to cover their mouth when they cough or sneeze, or better still, to NOT GO OUT AND SPREAD IT. I don't want what you've got, whether or not it's coronavirus!!
The deerhunter
So, some (many??) younger people may recover without hospitalization or even declaring it so it may well be much less than potentially 11% fatal. 0.2% to 2% was mentioned in something I read yesterday. Like KaiserPingo says, maybe a storm in a (Chinese) teacup not a fatal pandemic. Let's hope so! Wait & see.
roddy6667
IMHO, more men contract the disease because they are out and about in the world, touching things and breathing germ-laden air. Women are more likely to be at home with children.
And women never say"Hold my beer. Watch this".
Damnielle
@Roddy6667 okay boomer, we’re in the 21st century.
Penny Pattenden
Roddy6667what planet do you live on? Women are more likely to be at home with children. Not these days buddy. Lots of countries have more women in the work force than men. More women are in universities than men (by a ver narrow margin mind you).
roddy6667
Yes, I am a boomer, but I have lived in a large city in China for years. Please confine your criticisms of my comments to adjust for differences between countries and cultures.