Full spectrum of COVID-19 severity still being depicted – Authors' reply
Xiaoying Gu, Bin Cao, Jianwei Wang
Abstract
Zhou Xu and colleagues point out that mortality, which should be referred correctly and more clearly as case fatality ratio, among the first 41 cases with laboratory-confirmed 2019 novel coronavirus disease (COVID-19; previously known as 2019-nCoV) was misleading in our Article.1Huang C Wang Y Li X et al.Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China.Lancet. 2020; (published online Jan 24.)https://doi.org/10.1016/S0140-6736(20)30183-5Summary Full Text Full Text PDF Scopus (33292) Google Scholar We definitely agree that the case fatality ratio among the first 41 cases cannot represent the case fatality ratio of the full disease spectrum during the outbreak of COVID-19. From the perspective of case detection, the reasons for the inconsistency between the case fatality ratio reported in our Article1Huang C Wang Y Li X et al.Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China.Lancet. 2020; (published online Jan 24.)https://doi.org/10.1016/S0140-6736(20)30183-5Summary Full Text Full Text PDF Scopus (33292) Google Scholar and data that have become available since publication of our Article1Huang C Wang Y Li X et al.Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China.Lancet. 2020; (published online Jan 24.)https://doi.org/10.1016/S0140-6736(20)30183-5Summary Full Text Full Text PDF Scopus (33292) Google Scholar were clearly clarified in advance in the comment by Chen Wang and colleagues.2Wang C Horby PW Hayden FG Gao GF A novel coronavirus outbreak of global health concern.Lancet. 2020; (published online Jan 24.)https://doi.org/10.1016/S0140-6736(20)30185-9Summary Full Text Full Text PDF Scopus (5092) Google Scholar Patients with the most severe symptoms were paid attention to during the early stages of the outbreak because of limited resources to detect severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infection. From the perspective of treatment, even the most up-to-date case fatality ratio is expected to decrease as diagnosis and treatment procedure for patients with pneumonia who are infected with SARS-CoV-2 is improving,3China National Health CommissionNotice on the issuance of diagnosis and treatment procedure for pneumonia patients infected with the 2019-nCoV (version 5).http://www.nhc.gov.cn/yzygj/s7653p/202002/3b09b894ac9b4204a79db5b8912d4440.shtmlDate: Feb 5, 2020Date accessed: February 7, 2020Google Scholar potential drugs to treat COVID-19 are being evaluated for efficacy and safety in ongoing clinical trials,4US National Library of Medicine-ClinicalTrials.govMild/Moderate 2019-nCoV Remdesivir RCT.https://clinicaltrials.gov/ct2/show/NCT04252664?term=bin+cao&draw=2&rank=10Date: Feb 5, 2020Date accessed: February 7, 2020Google Scholar, 5US National Library of Medicine-ClinicalTrials.govSevere 2019-nCoV Remdesivir RCT.https://clinicaltrials.gov/ct2/show/NCT04257656?term=bin+cao&draw=2&rank=4Date: Feb 6, 2020Date accessed: February 7, 2020Google Scholar and management is becoming more intense, not only for patients with severe infection but also for those with moderate, mild, or even asymptomatic infection. Without denying the limitations of our study1Huang C Wang Y Li X et al.Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China.Lancet. 2020; (published online Jan 24.)https://doi.org/10.1016/S0140-6736(20)30183-5Summary Full Text Full Text PDF Scopus (33292) Google Scholar at the time of publication, we still hope our results provided a useful depiction of clinical features of SARS-CoV-2 infection at the very early stage of the outbreak and during progression of disease. Intense and continuous efforts are indeed needed for medical workers and researchers all over the world to get the full picture of the spectrum of disease severity of COVID-19 and to overcome the huge health challenge. We declare funding by the Special Project for Emergency of the Ministry of Science and Technology (2020YFC0841300), Chinese Academy of Medical Sciences (CAMS) Innovation Fund for Medical Sciences (CIFMS 2018-I2M-1-003), National Science Grant for Distinguished Young Scholars (81425001/H0104), the National Key Research and Development Program of China (2018YFC1200102), and The Beijing Science and Technology Project (Z19110700660000). Full spectrum of COVID-19 severity still being depictedChaolin Huang and colleagues1 first reported the clinical features of patients infected with severe acute respiratory syndrome corona virus 2 (SARS-CoV-2; previously known as 2019-nCoV), which emerged in Wuhan, China. Their study will contribute to the diagnosis and treatment of 2019 novel coronavirus disease (COVID-19). Meanwhile, the conclusions have caused a certain degree of social panic. Full-Text PDF Clinical features of patients infected with 2019 novel coronavirus in Wuhan, ChinaThe 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Full-Text PDF