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expert reaction to study looking at the clinical characteristics of 139 patients with the novel coronavirus in Wuhan

Research, published in JAMA, reports on the clinical characteristics of 139 patients with the novel coronavirus in Wuhan.

 

Prof William Keevil, Professor of Environmental Healthcare, University of Southampton, said:

“This is a really important study by Wang and colleagues of the clinical symptoms of some of the first patients suffering 2019-nCoV infection and their age and medical status. Of concern, the authors stated ‘hospital-related transmission/infection could not be definitively proven but was suspected and presumed based on timing and patterns of exposure to infected patients and subsequent development of infection’. They have reported 41% hospital-related transmission/infection which is high and appeared to affect both patients and staff in different wards: 7 patients were from the surgical department, 5 were from internal medicine, and 5 were from the oncology department; of the infected health care workers, 31 (77.5%) worked on general wards, 7 (17.5%) in the emergency department, and 2 (5%) in the ICU.

“Also, one patient in the current study presented with abdominal symptoms and was admitted to the surgical department. More than 10 health care workers in this department were presumed to have been infected by this patient and at least 4 hospitalized patients in the same ward were infected, and all presented with atypical abdominal symptoms. Importantly, 2019-nCoV has been reported elsewhere in the faeces of patients with atypical abdominal symptoms, similar to SARS which was also shed in urine, suggesting a faecal transmission route which is highly transmissible.

“If true then it seems that under very demanding working conditions there were inadequate hygiene arrangements e.g. not completely removing protective equipment before moving from an infected to an uninfected area, not washing hands correctly, not effectively and regularly decontaminating the patient environment and surrounding areas. This report re-emphasize the difficulties of keeping healthcare facilities clean and protecting not only vulnerable patients but also healthy staff.” 

 

Dr Michael Head, Senior Research Fellow in Global Health, University of Southampton, said:

“The paper by Dawei Wang and colleagues shows that 40 healthcare workers were infected with the coronavirus. This highlights the risks to frontline healthcare workers who are looking after patients in very difficult circumstances. The authors also indicate that one patient may have infected 10 healthcare workers. If true, then this confirms that some patients are likely to be far more infectious than others, and this poses further difficulties in managing their cases.”

 

‘Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China’ by Wang et al. was published in JAMA on Friday 7th February.

DOI: 10.1001/jama.2020.1585

 

Declared interests

None received. 

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