• Yifei Nie, Jitian Li, Xueyong Huang, Wanshen Guo, Xiaobai Zhang, Yan Ma, Haifeng Wang, Muge Qi, Xiaoyan Tang, Xiaojing Shen, and Xiaofeng Dai.
• Henan Center for Disease Control and Prevention/Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China.
• Int J Epidemiol. 2020 Aug 1; 49 (4): 1085-1095.

BackgroundDespite many reports on the characteristics of coronavirus disease 2019 (COVID-19) in Wuhan, China, relatively little is known about the transmission features of COVID-19 outside Wuhan, especially at the provincial level.MethodsWe collected epidemiological, demographic, clinical, laboratory, radiological and occupation information, along with contact history, of 671 patients with laboratory-confirmed COVID-19 reported from January 23 to February 5, 2020, in Henan province, China. We described characteristics of these cases, compared the diagnostic accuracy and features of blood testing, computed tomography (CT) scans and X-rays, and analysed SARS-CoV-2 transmission sources and patients' occupations in Henan province.ResultsThe mean age of patients in this case series was 43 years, 56.2% were male and 22.4% had coexisting medical disorders. The death rate was 0.3%. Fourteen patients did not show any symptoms. Lymphocyte percentage was associated with disease severity (χ2 = 6.71, P = 0.035) but had a large variation in each sample group. The mean time from illness onset to diagnosis was 5.6 days. A total of 330 patients had ever lived in or visited Wuhan, 150 had contact with confirmed cases, 323 had been to a hospital and 119 had been to a wet market. There were 33 patients who did not have a traceable transmission source, with 21.2% of these being farmers and 15.2% being workmen.ConclusionsLymphocyte percentage was a sign of severe COVID-19 in general but was not a good diagnostic index. Longer time from illness onset to diagnosis was associated with higher COVID-19 severity, older age, higher likelihood of having coexisting cardiovascular diseases including hypertension, and being male. Farming was found to be a high-risk occupation in Henan province, China.© The Author(s) 2020; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

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