New study offers glimpse of how nCoV spread from ground zero

Published February 9, 2020, 12:00 AM

by manilabulletin_admin

By Martin Sadongdong

Nearly half of the first 138 patients who were admitted at a hospital in Wuhan, China on the early days of the outbreak of the 2019 novel coronavirus acute respiratory disease (2019-nCoV ARD) presumably acquired the virus in the same medical facility, a study recently published in an American peer-reviewed medical journal has disclosed.

In “Clinical Characteristics of 138 Hospitalized Patients with 2019 Novel Coronavirus-infected Pneumonia in Wuhan, China,” a study whose corresponding author was Dr. Zhiyong Peng of the Department of Critical Care Medicine at the Zhongnan Hospital of Wuhan University, it showed that 41.3 percent or 57 of the 138 patients “were presumed to have been infected” at the Zhongnan Hospital where some were admitted for other medical conditions while others were hospitalized due to suspected nCoV infection.

The study was published online in the Journal of the American Medical Association (JAMA) on Friday, February 7, providing insights in what could be regarded as one of the earliest and largest single-center case series of hospitalized patients with nCoV-infected pneumonia (NCIP) that may help shed light on how the deadly disease spread in such an alarming rate.

The clinical outcomes of all 138 patients, who were admitted at Zhongnan Hospital from January 1 – 28, were monitored until February 3. Their medical records were then analyzed by a research team of the Department of Critical Care Medicine.

The Zhongnan Hospital is described as “one of the major tertiary teaching hospitals” and is “responsible for the treatments for NCIP assigned by the [Chinese] government.”

Quick spread

According to the study, 17 patients (12.3 percent) who were “hospitalized for other reasons” and 40 health care workers (29 percent) at Zhongnan Hospital were presumed to have a human-to-human hospital-associated transmission of the virus.

Presumed hospital-related transmission was suspected if a cluster of health professionals or hospitalized patients in the same wards became infected and a possible source of infection could be tracked, it stated.

As of February 3, the last day of the monitoring, the study said 85 of the 138 patients were still hospitalized (61.6 percent), 47 had been discharged (34.1 percent), and six had died (4.3 percent).

Of the patients, 36 required intensive care unit (ICU) treatment (26 percent).

“The data in this study suggest rapid person-to-person transmission of 2019-nCoV may have occurred,” the study said.

“As an infection spreads to new people, it reproduces itself,” it added.

Based on the report, the R0 from nCoV is 2.2 which means that in an average, each patient has been spreading infection to 2.2 other people.

The R0 indicates the average number of additional individuals that one affected case infects during the course of their illness and specifically applies to a population of people who were previously free of infection and have not been vaccinated, the study explained.

“One reason for the rapid spread may be related to the atypical symptoms in the early stage in some patients infected with nCoV,” it said.

The researcher wrote that at present, no specific treatment has been recommended for coronavirus infection except for “meticuluous supportive care.”

“Currently, the approach to this disease is to control the source of infection; use of personal protection precaution to reduce the risk of transmission; and early diagnosis, isolation, and supportive treatments for affected patients,” the study emphasized.

As of Saturday, February 8, the World Health Organization (WHO) said 34,886 confirmed nCoV cases have already been noted in 25 countries and on a cruise ship which was in Japanese territorial waters at the time of detection — 3,419 of which were newly recorded.

In the Philippines, the Department of Health said the number of the persons under investigation (PUIs) along with the confirmed cases (3) has risen to 267 as of Saturday.