8 ms·

Clinical features of patients infected with 2019 novel coronavirus

78 points by SQL2219 7y ago

peter303 7y ago
I am impressed how fast Chinese scientists developed a genetic test distinguish 2019-coronavirus from other kinds of pneumonia. I am old enough to remember biologists flailing around for 4 years to identify the HIV virus and two years more for slow (two week) test.
- chrisco255 7y ago
  I'm not surprised. The Wuhan virology center was studying viruses just like this and probably found this virus years ago.
  - caycep 7y ago
    Granted - this is a Hong Kong U paper...
- bsder 7y ago
  > I am old enough to remember biologists flailing around for 4 years to identify the HIV virus and two years more for slow (two week) test. HIV is rather fragile, no? It only spreads in specific bodily fluids and shows very little viral load when dormant. 2019-nCoV spreads in air. That's a significantly hardier virus that produces quite a lot of virus particles that are way easier to detect. In addition, please remember that molecular biology was just getting started when the AIDS epidemic hit. AIDS (1981) predates PCR (1983). Molecular biology and computing have come a long way in 40 years, and we have a lot more tools at our disposal nowadays.
- Pfhreak 7y ago
  > I am old enough to remember biologists flailing around for 4 years to identify the HIV virus and two years more for slow (two week) test. I suspect that part of this comes from the fact that people thought the disease was thought to target gay men. In fact, AIDS was originally called GRID -- Gay-Related Immune Deficiency. There was plenty of (truly awful) folks out there who felt that it was some sort of cosmic justice.
- crusty 7y ago
  Not all fruits hang the same. Some hang low, some don't, and the tools we use to pick them change as we try.
pbourke 7y ago
It’s interesting to watch the response to this crisis ricochet around the world. Results come from China, the CDC sequences the virus from the Chicago and Seattle patients and releases them, researchers in Seattle process the merged data through their open source tool[0]. Researchers in China then translate these results to Chinese [1] The internet is our immune system. [0] https://twitter.com/nextstrain/status/1221181133884256256?s=20 https://twitter.com/nextstrain/status/1221181133884256256?s=... [1] https://mobile.twitter.com/nextstrain/status/1221548274819178499 https://mobile.twitter.com/nextstrain/status/122154827481917...
caseyf7 7y ago
Of the initial 41 patients, 13 were admitted to ICU and 6 died(15%). This is the data the news has been missing and shows why China is taking this so seriously.
- Geee 7y ago
  And of the dead patients, 5 were in the ICU and one was not.
- mysterypie 7y ago
  A 15% mortality rate is huge, but considering that this is a newly identified disease, the actual mortaility rate might be much less. Inventing some numbers, let's say that 3000 people were already infected when the initial 41 patients were identified -- those 41 being the sickest. The other 2959 people either didn't have symptoms or were assumed to have a cold or flu, and they all recovered. Had there been a reliable way to identify the hypothetical 3000 infected people, the mortaility rate would be only 0.2% if 6 had died.
aaron695 7y ago
We have 2700 confirmed cases, 80 dead. Some also in the West and we are still talking about these initial 41? Are we a pre or post internet civilisation? Honestly 4chan is doing better than this. Reading through their noise is better than the clean data coming out of the officials. For example they have people in pools of blood on the street with people in the bio suits China are using. Maybe it's obvious people will throw up blood with this new SARS, but the officials aren't mentioning it. Sperm may contain the virus for months. Again obvious, not seeing it on official feeds.
- malandrew 7y ago
  Where are you getting the 2700 and 80 numbers from? I couldn’t find a reliable up to date counter. Even the CDC only lists countries.
  - sanxiyn 7y ago
    WHO is now publishing daily situation reports: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/ https://www.who.int/emergencies/diseases/novel-coronavirus-2...
    - adrianmonk 7y ago
      Their "Situation Report - 7" link is broken (points to something, but the wrong document). I managed to guess the correct URL: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200127-sitrep-7-2019--ncov.pdf https://www.who.int/docs/default-source/coronaviruse/situati... This says 2741 confirmed cases in China and 2798 globally.
  - Geee 7y ago
    See the sources on this page: https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6 https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h...
  - cliqueiq 7y ago
    Those are legit numbers. Also 3/5 of the North American cases are new from yesterday.
nnq 7y ago
It would be interesting to see less accurate statistics on the total CURRENT number of cases rather than this OLD NEWS. Cool for whoever published that, but we need more focus on speed of information dissemination, even prioritising it over accurracy, we're moving at pre-Internet pace here or someone is actively hindering the flow of info...
- Geee 7y ago
  There's realtime statistics of non-accurate reports (most cases aren't even diagnosed) https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6 https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h...
- s1artibartfast 7y ago
  one might assume that those who need to know are in response rooms and have more current information. Im not sure that a minor delay to the general public makes any difference whatsoever on outcomes.
- netsharc 7y ago
  > we need more focus on speed of information dissemination I'm curious why you think so. This report is very detailed from a medical point of view, if you want current numbers there are other news sites for that. Besides, why do you need the current numbers, so you can panic faster?
- koalala 7y ago
  BNO News is tracking the numbers and updating every 30 mins or faster it seems. https://bnonews.com/index.php/2020/01/the-latest-coronavirus-cases/ https://bnonews.com/index.php/2020/01/the-latest-coronavirus...
angled 7y ago
My wife just pointed out what might be a spurious anecdote: no Caucasians died during the SARS epidemic in 2003, and none have died so far in response to this novel virus. Is there any data to back this up? (She was in Beijing during 2003, and saw SARS first hand)
- helloworld 7y ago
  > no Caucasians died during the SARS epidemic in 2003 That's not accurate: 29 March 2003 Dr. Carlo Urbani, an expert on communicable diseases, died today of SARS. Dr. Urbani, worked in public health programs in Cambodia, Laos and Viet Nam. He was based in Hanoi, Viet Nam. Dr. Urbani was 46. https://www.who.int/csr/sars/urbani/en/ https://www.who.int/csr/sars/urbani/en/ https://en.wikipedia.org/wiki/Carlo_Urbani https://en.wikipedia.org/wiki/Carlo_Urbani
- ImaCake 7y ago
  There are a lot of explanations besides Caucasians being less suseptable. Because of monitoring by authorities one could imagine any Caucasians becoming infected are buisness people and wealthy-ish travellers. They would be healthy with few co-morbidities, are identified during initial symptoms (because of screening) and treated at world class facilities and monitored closely (quarantine and research).
- yegle 7y ago
  This is just one of the populor rumors during the 2003 SARS epidemic, that because no Caucasian died from the virus, the whole epidemic is a well organized biological war against China. Like the other comments has pointed out, Dr. Carlo Urbarni is a doctor who died from SARS. He's the one who warned the WHO about the new desease.
  - angled 7y ago
    Thanks for clarifying!
rdtsc 7y ago
> 27 (66%) patients had direct exposure to Huanan seafood market (figure 1B https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext#fig1 https://www.thelancet.com/journals/lancet/article/PIIS0140-6...). Market exposure was similar between the patients with ICU care (nine [69%]) and those with non-ICU care (18 [64%]). The symptom onset date of the first patient identified was Dec 1, 2019. None of his family members developed fever or any respiratory symptoms. No epidemiological link was found between the first patient and later cases. The idea I think was that the strain originated at the market, from people handling and possibly consuming bats. But, the description above and figure 1B indicates the currently known patient 0 was not exposed to the market. Also, what is the chance that a random person in the area has exposure to that market in say a week's time. If it is a central place in the city, and depending on the layout and public transportation, 60% weekly exposure to it might not be unusual for an average citizen there. It maybe be conspiracy at this point but I find it highly suspicious that out of all the markets in the country, this epidemic started just around the corner from China's first (and only?) biosafety level 4 laboratory https://wwwnc.cdc.gov/eid/article/25/5/18-0220_article https://wwwnc.cdc.gov/eid/article/25/5/18-0220_article, which just happened to have been built in response to the 2003 SARS epidemic, and so presumably has been working with those kind of viruses since.
- sanxiyn 7y ago
  Chinese CDC collected environmental samples from the market and some of them tested positive. So it's a little more than "the market happened to be there", although your point about the first patient identified is valid. http://www.xinhuanet.com/english/2020-01/27/c_138735677.htm http://www.xinhuanet.com/english/2020-01/27/c_138735677.htm
  - rdtsc 7y ago
    > Thirty-three of the 585 environmental samples collected from the Wuhan's Huanan Seafood Wholesale Market were found But what’s the chance that sick people would have gone to the market when they were infectious and handled animals, produce, raw meat etc. Having watched footage of some of the wet market I have no doubt it would be place for germs to spread efficiently. But it is still useful to figure out how the whole thing originated.
deleted 7y ago
[deleted]
azalemeth 7y ago
> "Suspected patients were isolated using airborne precautions in the designated hospital, Jin Yin-tan Hospital (Wuhan, China), and fit-tested N95 masks and airborne precautions for aerosol-generating procedures were taken. > This study was approved by the National Health Commission of China and Ethics Commission of Jin Yin-tan Hospital (KY-2020-01.01). > Written informed consent was waived by the Ethics Commission of the designated hospital for emerging infectious diseases." In other words, data from every patient they had is reported in this paper, with or without their consent. That includes radiographic imaging, blood and respiratory specimens, including nasal and pharyngeal swabs, bronchoalveolar lavage fluid, sputum, and/or bronchial aspirates. In a western country, one of the tenants of medical ethics is that, if you have capacity to consent, you can always refuse to give it. In my country, I would be personally liable for assault if I (invasively) collected these samples from patients _without_ their explicit consent. It must be a terrifying situation to be in: sick, in respiratory distress, and isolated from your family and friends in a large hospital, surrounded only by presumably somewhat scared looking medical professionals wearing tightly fitting face masks. I just hope that patients were _verbally_ asked if they consented to the collection of bronchoscopy-obtained samples for research and hopefully their diagnosis and management: it is an unpleasant procedure that, like many things in medicine, carries a small but non-zero risk of serious injury or death.
- ronnie_fr3 7y ago
  and that's why the West is decaying. Who cares about your morals when there's an epidemic ?
  - simongray 7y ago
    > and that's why the West is decaying. Who cares about your morals when there's an epidemic ? This kind of bait is not needed on Hacker News. Keep that on reddit or facebook or whatever.
    - spats1990 7y ago
      In fairness, the GP is bait too. It's just more thoughtful bait with paragraph breaks. It's basically elegant finger wagging. Decay of the west bit aside, the parent has a point. Do you freak patients out by getting them to sign things when they are already in quarantine and fearing for their lives? Or do you prioritise research and response? related: "Conducting Research in Disease Outbreaks" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2669128/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2669128/
deleted 7y ago
[deleted]

78 points by SQL2219 7y ago

I am impressed how fast Chinese scientists developed a genetic test distinguish 2019-coronavirus from other kinds of pneumonia. I am old enough to remember biologists flailing around for 4 years to identify the HIV virus and two years more for slow (two week) test.

chrisco255 7y ago
I'm not surprised. The Wuhan virology center was studying viruses just like this and probably found this virus years ago.
- caycep 7y ago
  Granted - this is a Hong Kong U paper...
bsder 7y ago
> I am old enough to remember biologists flailing around for 4 years to identify the HIV virus and two years more for slow (two week) test. HIV is rather fragile, no? It only spreads in specific bodily fluids and shows very little viral load when dormant. 2019-nCoV spreads in air. That's a significantly hardier virus that produces quite a lot of virus particles that are way easier to detect. In addition, please remember that molecular biology was just getting started when the AIDS epidemic hit. AIDS (1981) predates PCR (1983). Molecular biology and computing have come a long way in 40 years, and we have a lot more tools at our disposal nowadays.
Pfhreak 7y ago
> I am old enough to remember biologists flailing around for 4 years to identify the HIV virus and two years more for slow (two week) test. I suspect that part of this comes from the fact that people thought the disease was thought to target gay men. In fact, AIDS was originally called GRID -- Gay-Related Immune Deficiency. There was plenty of (truly awful) folks out there who felt that it was some sort of cosmic justice.
crusty 7y ago
Not all fruits hang the same. Some hang low, some don't, and the tools we use to pick them change as we try.

pbourke 7y ago

It’s interesting to watch the response to this crisis ricochet around the world. Results come from China, the CDC sequences the virus from the Chicago and Seattle patients and releases them, researchers in Seattle process the merged data through their open source tool[0]. Researchers in China then translate these results to Chinese [1] The internet is our immune system. [0] https://twitter.com/nextstrain/status/1221181133884256256?s=20 https://twitter.com/nextstrain/status/1221181133884256256?s=... [1] https://mobile.twitter.com/nextstrain/status/1221548274819178499 https://mobile.twitter.com/nextstrain/status/122154827481917...

caseyf7 7y ago

Of the initial 41 patients, 13 were admitted to ICU and 6 died(15%). This is the data the news has been missing and shows why China is taking this so seriously.

Geee 7y ago
And of the dead patients, 5 were in the ICU and one was not.
mysterypie 7y ago
A 15% mortality rate is huge, but considering that this is a newly identified disease, the actual mortaility rate might be much less. Inventing some numbers, let's say that 3000 people were already infected when the initial 41 patients were identified -- those 41 being the sickest. The other 2959 people either didn't have symptoms or were assumed to have a cold or flu, and they all recovered. Had there been a reliable way to identify the hypothetical 3000 infected people, the mortaility rate would be only 0.2% if 6 had died.

aaron695 7y ago

We have 2700 confirmed cases, 80 dead. Some also in the West and we are still talking about these initial 41? Are we a pre or post internet civilisation? Honestly 4chan is doing better than this. Reading through their noise is better than the clean data coming out of the officials. For example they have people in pools of blood on the street with people in the bio suits China are using. Maybe it's obvious people will throw up blood with this new SARS, but the officials aren't mentioning it. Sperm may contain the virus for months. Again obvious, not seeing it on official feeds.

malandrew 7y ago
Where are you getting the 2700 and 80 numbers from? I couldn’t find a reliable up to date counter. Even the CDC only lists countries.
- sanxiyn 7y ago
  WHO is now publishing daily situation reports: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/ https://www.who.int/emergencies/diseases/novel-coronavirus-2...
  - adrianmonk 7y ago
    Their "Situation Report - 7" link is broken (points to something, but the wrong document). I managed to guess the correct URL: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200127-sitrep-7-2019--ncov.pdf https://www.who.int/docs/default-source/coronaviruse/situati... This says 2741 confirmed cases in China and 2798 globally.
- Geee 7y ago
  See the sources on this page: https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6 https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h...
- cliqueiq 7y ago
  Those are legit numbers. Also 3/5 of the North American cases are new from yesterday.

nnq 7y ago

It would be interesting to see less accurate statistics on the total CURRENT number of cases rather than this OLD NEWS. Cool for whoever published that, but we need more focus on speed of information dissemination, even prioritising it over accurracy, we're moving at pre-Internet pace here or someone is actively hindering the flow of info...

Geee 7y ago
There's realtime statistics of non-accurate reports (most cases aren't even diagnosed) https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6 https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h...
s1artibartfast 7y ago
one might assume that those who need to know are in response rooms and have more current information. Im not sure that a minor delay to the general public makes any difference whatsoever on outcomes.
netsharc 7y ago
> we need more focus on speed of information dissemination I'm curious why you think so. This report is very detailed from a medical point of view, if you want current numbers there are other news sites for that. Besides, why do you need the current numbers, so you can panic faster?
koalala 7y ago
BNO News is tracking the numbers and updating every 30 mins or faster it seems. https://bnonews.com/index.php/2020/01/the-latest-coronavirus-cases/ https://bnonews.com/index.php/2020/01/the-latest-coronavirus...

angled 7y ago

My wife just pointed out what might be a spurious anecdote: no Caucasians died during the SARS epidemic in 2003, and none have died so far in response to this novel virus. Is there any data to back this up? (She was in Beijing during 2003, and saw SARS first hand)

helloworld 7y ago
> no Caucasians died during the SARS epidemic in 2003 That's not accurate: 29 March 2003 Dr. Carlo Urbani, an expert on communicable diseases, died today of SARS. Dr. Urbani, worked in public health programs in Cambodia, Laos and Viet Nam. He was based in Hanoi, Viet Nam. Dr. Urbani was 46. https://www.who.int/csr/sars/urbani/en/ https://www.who.int/csr/sars/urbani/en/ https://en.wikipedia.org/wiki/Carlo_Urbani https://en.wikipedia.org/wiki/Carlo_Urbani
ImaCake 7y ago
There are a lot of explanations besides Caucasians being less suseptable. Because of monitoring by authorities one could imagine any Caucasians becoming infected are buisness people and wealthy-ish travellers. They would be healthy with few co-morbidities, are identified during initial symptoms (because of screening) and treated at world class facilities and monitored closely (quarantine and research).
yegle 7y ago
This is just one of the populor rumors during the 2003 SARS epidemic, that because no Caucasian died from the virus, the whole epidemic is a well organized biological war against China. Like the other comments has pointed out, Dr. Carlo Urbarni is a doctor who died from SARS. He's the one who warned the WHO about the new desease.
- angled 7y ago
  Thanks for clarifying!

rdtsc 7y ago

> 27 (66%) patients had direct exposure to Huanan seafood market (figure 1B https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext#fig1 https://www.thelancet.com/journals/lancet/article/PIIS0140-6...). Market exposure was similar between the patients with ICU care (nine [69%]) and those with non-ICU care (18 [64%]). The symptom onset date of the first patient identified was Dec 1, 2019. None of his family members developed fever or any respiratory symptoms. No epidemiological link was found between the first patient and later cases. The idea I think was that the strain originated at the market, from people handling and possibly consuming bats. But, the description above and figure 1B indicates the currently known patient 0 was not exposed to the market. Also, what is the chance that a random person in the area has exposure to that market in say a week's time. If it is a central place in the city, and depending on the layout and public transportation, 60% weekly exposure to it might not be unusual for an average citizen there. It maybe be conspiracy at this point but I find it highly suspicious that out of all the markets in the country, this epidemic started just around the corner from China's first (and only?) biosafety level 4 laboratory https://wwwnc.cdc.gov/eid/article/25/5/18-0220_article https://wwwnc.cdc.gov/eid/article/25/5/18-0220_article, which just happened to have been built in response to the 2003 SARS epidemic, and so presumably has been working with those kind of viruses since.

sanxiyn 7y ago
Chinese CDC collected environmental samples from the market and some of them tested positive. So it's a little more than "the market happened to be there", although your point about the first patient identified is valid. http://www.xinhuanet.com/english/2020-01/27/c_138735677.htm http://www.xinhuanet.com/english/2020-01/27/c_138735677.htm
- rdtsc 7y ago
  > Thirty-three of the 585 environmental samples collected from the Wuhan's Huanan Seafood Wholesale Market were found But what’s the chance that sick people would have gone to the market when they were infectious and handled animals, produce, raw meat etc. Having watched footage of some of the wet market I have no doubt it would be place for germs to spread efficiently. But it is still useful to figure out how the whole thing originated.

deleted 7y ago

[deleted]

azalemeth 7y ago

> "Suspected patients were isolated using airborne precautions in the designated hospital, Jin Yin-tan Hospital (Wuhan, China), and fit-tested N95 masks and airborne precautions for aerosol-generating procedures were taken. > This study was approved by the National Health Commission of China and Ethics Commission of Jin Yin-tan Hospital (KY-2020-01.01). > Written informed consent was waived by the Ethics Commission of the designated hospital for emerging infectious diseases." In other words, data from every patient they had is reported in this paper, with or without their consent. That includes radiographic imaging, blood and respiratory specimens, including nasal and pharyngeal swabs, bronchoalveolar lavage fluid, sputum, and/or bronchial aspirates. In a western country, one of the tenants of medical ethics is that, if you have capacity to consent, you can always refuse to give it. In my country, I would be personally liable for assault if I (invasively) collected these samples from patients _without_ their explicit consent. It must be a terrifying situation to be in: sick, in respiratory distress, and isolated from your family and friends in a large hospital, surrounded only by presumably somewhat scared looking medical professionals wearing tightly fitting face masks. I just hope that patients were _verbally_ asked if they consented to the collection of bronchoscopy-obtained samples for research and hopefully their diagnosis and management: it is an unpleasant procedure that, like many things in medicine, carries a small but non-zero risk of serious injury or death.

ronnie_fr3 7y ago
and that's why the West is decaying. Who cares about your morals when there's an epidemic ?
- simongray 7y ago
  > and that's why the West is decaying. Who cares about your morals when there's an epidemic ? This kind of bait is not needed on Hacker News. Keep that on reddit or facebook or whatever.
  - spats1990 7y ago
    In fairness, the GP is bait too. It's just more thoughtful bait with paragraph breaks. It's basically elegant finger wagging. Decay of the west bit aside, the parent has a point. Do you freak patients out by getting them to sign things when they are already in quarantine and fearing for their lives? Or do you prioritise research and response? related: "Conducting Research in Disease Outbreaks" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2669128/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2669128/

deleted 7y ago

[deleted]