Epidemiology and Clinical Outcomes of COVID-19 Patients in Northwestern China Who Had a History of Exposure in Wuhan City: Departure Time-Originated Pinpoint Surveillance

Background: Most COVID-19 patients cannot provide a clear exposure time; therefore, this study was designed to predict the progression of COVID-19 by using the definite departure time from Wuhan. Methods: In this retrospective study, all cases were selected from Northwestern China, which has the lowest population density. As our study endpoints, the incubation period was defined as the date of departure from Wuhan City to the date of symptom onset; we defined the confirmed time as the interval from symptom onset to positive results (samples from the respiratory tract). Both of them were estimated by fitting a Weibull distribution on the departure date and symptom onset. The differences among the variables were analyzed. Results: A total of 139 patients were ultimately enrolled, and similar to 10.1% of patients (14 patients) had no symptoms during their disease course. We estimated the median incubation period to be 4.0 days (interquartile intervals, 2.0-8.0), and the 95th percentile of the distribution was 15.0 days. Moreover, similar to 5.6% of patients (7 patients) experienced symptoms 2 weeks after leaving. Furthermore, the estimation median interval from symptom onset to final diagnosis was 4.0 days (interquartile intervals, 2.0-6.0), and the 95th percentile of the distribution was 12.0 days. Finally, the median hospitalization time was 16.0 days, ranging from 3.0 to 45.0 days. Univariate analysis showed that age (P = 0.021) and severity status (P = 0.001) were correlated significantly with hospitalization time. Conclusions: We provide evidence that departure time can be used to estimate the incubation and confirmed times of patients infected with COVID-19 when they leave an epidemic area.

Automated summary

The study found that the median incubation period for COVID-19 patients was 4.0 days, with a median confirmed time of 4.0 days and a median hospitalization time of 16.0 days. Additionally, a portion of patients did not show symptoms until 2 weeks after departing from the epidemic area.