• Eu Suk Kim, Bum Sik Chin, Chang Kyung Kang, Nam Joong Kim, Yu Min Kang, Jae Phil Choi, Dong Hyun Oh, Jeong Han Kim, Boram Koh, Seong Eun Kim, Na Ra Yun, Jae Hoon Lee, Jin Yong Kim, Yeonjae Kim, Ji Hwan Bang, Kyoung Ho Song, Hong Bin Kim, Ki Hyun Chung, Myoung Don Oh, and Korea National Committee for Clinical Management of COVID-19.
• Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
• J. Korean Med. Sci. 2020 Apr 6; 35 (13): e142e142.

BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected pneumonia emerged in Wuhan, China in December 2019. In this retrospective multicenter study, we investigated the clinical course and outcomes of novel coronavirus disease 2019 (COVID-19) from early cases in Republic of Korea.MethodsAll of the cases confirmed by real time polymerase chain reaction were enrolled from the 1st to the 28th patient nationwide. Clinical data were collected and analyzed for changes in clinical severity including laboratory, radiological, and virologic dynamics during the progression of illness.ResultsThe median age was 40 years (range, 20-73 years) and 15 (53.6%) patients were male. The most common symptoms were cough (28.6%) and sore throat (28.6%), followed by fever (25.0%). Diarrhea was not common (10.7%). Two patients had no symptoms. Initial chest X-ray (CXR) showed infiltration in 46.4% of the patients, but computed tomography scan confirmed pneumonia in 88.9% (16/18) of the patients. Six patients (21.4%) required supplemental oxygen therapy, but no one needed mechanical ventilation. Lymphopenia was more common in severe cases. Higher level of C-reactive protein and worsening of chest radiographic score was observed during the 5-7 day period after symptom onset. Viral shedding was high from day 1 of illness, especially from the upper respiratory tract (URT).ConclusionThe prodromal symptoms of COVID-19 were mild and most patients did not have limitations of daily activity. Viral shedding from URT was high from the prodromal phase. Radiological pneumonia was common from the early days of illness, but it was frequently not evident in simple CXR. These findings could be plausible explanations for the easy and rapid spread of SARS-CoV-2 in the community.© 2020 The Korean Academy of Medical Sciences.

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