Risk of severe coronavirus disease in imported and secondary cases in Zhejiang province, China

To our knowledge, no previous studies have focused on determining whether the virulence and case fatality rate of the severe acute respiratory coronavirus 2 (SARS-CoV-2) decreases as the virus continues to spread. Hence, our aim was to retrospectively explore the differences in the risk of severe or...

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Bibliographic Details
Published in:Journal of Public Health 2021-04, Vol.43 (1), p.35-41
Main Authors: He, Fan, Shang, Xiaopeng, Fu, Tiehong, Lin, Junfen, Li, Fudong, Qiu, Yinwei, Wu, Chen, Wang, Zhen
Format: Article
Language:English
Subjects:
Adult
Age Factors
Aged
Analysis of Variance
China - epidemiology
COVID-19 - classification
COVID-19 - epidemiology
Disease Progression
Female
Humans
Incidence
Logistic Models
Male
Middle Aged
Original
Retrospective Studies
Risk Factors
SARS-CoV-2
Severity of Illness Index
Sex Factors
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Summary:To our knowledge, no previous studies have focused on determining whether the virulence and case fatality rate of the severe acute respiratory coronavirus 2 (SARS-CoV-2) decreases as the virus continues to spread. Hence, our aim was to retrospectively explore the differences in the risk of severe or critical COVID-19 among imported, secondary and tertiary cases in Zhejiang, China. We categorized COVID-19 cases reported by hospitals in Zhejiang as first-, second- and third-generation cases. Univariate and multivariate logistic regression analyses were performed to compare disease severity and case generation. Of 1187 COVID-19 cases, 227 (19.1%, 95% CI: 16.9-21.4) manifested severe or critical illness. The adjusted risk difference for severe or critical illness was lower for second- (odds ratio (OR) = 0.84, 95% confidence interval (CI): 0.52-1.36) and third-generation (OR = 0.55, 95% CI: 0.37-0.83) cases than for first-generation cases. Compared with hospitalized patients, cases identified at centralized isolation locations (OR = 0.62, 95% CI: 0.40-0.97) and those identified through active search or gateway screening (OR = 0.28, 95% CI: 0.08-1.04) were at a lower risk of severe or critical illness. Second- and third-generation cases of COVID-19 have a lower risk of developing severe or critical illness than first-generation cases.
ISSN:1741-3842
1741-3850
DOI:10.1093/pubmed/fdaa158