Characteristics of Adult Outpatients and Inpatients with COVID-19 — 11 Academic Medical Centers, United States, March–May 2020: Early Release

Details

• Journal Article:
  Morbidity and Mortality Weekly Report (MMWR)
• Personal Author:
  Tenforde, Mark W. ; Rose, Erica Billig ; Lindsell, Christopher J. ; Shapiro, Nathan I. ; Files, D. Clark ; Gibbs, Kevin W. ; Prekker, Matthew E. ; Steingrub, Jay S. ; Smithline, Howard A. ; Gong, Michelle N. ; Aboodi, Michael S. ; Exline, Matthew C. ; Henning, Daniel J. ; Wilson, Jennifer G. ; Khan, Akram ; Qadir, Nida ; Stubblefield, William B. ; Patel, Manish M. ; Self, Wesley H. ; Feldstein, Leora R.
• Corporate Authors:
  Vanderbilt University Medical Center,. ; Beth Israel Deaconess Medical Center. ; Wake Forest University Baptist Medical Center. ; Hennepin County Medical Center. ; Baystate Medical Center, Springfield, Massachusetts ; Montefiore Medical Center and Albert Einstein College of Medicine. ; Ohio State University. Wexner Medical Center. ; University of Washington Medical Center. ; Stanford University Medical Center. ; Oregon Health & Sciences University. ; UCLA Medical Center, Los Angeles, California. ; CDC COVID-19 Response Team.
• Description:
  What is already known about this topic?: Exposures to SARS-CoV-2 have commonly been described in congregate settings rather than broader community settings.
  
  What is added by this report?: In a multistate telephone survey of 350 adult inpatients and outpatients who tested positive for SARS-CoV-2 infection, only 46% reported recent contact with a COVID-19 patient. Most participants’ contacts were a family member (45%) or a work colleague (34%). Two thirds of participants were employed; only 17% were able to telework.
  
  What are the implications for public health practice?: Case investigation, contact tracing, and isolation of infected persons are needed to prevent ongoing community transmission, given the frequent lack of a known contact. Enhanced measures to ensure workplace safety, including social distancing and more widespread use of cloth face coverings, are warranted.
  
  Descriptions of coronavirus disease 2019 (COVID-19) in the United States have focused primarily on hospitalized patients. Reports documenting exposures to SARS-CoV-2, the virus that causes COVID-19, have generally been described within congregate settings, such as meat and poultry processing plants (1) and long-term care facilities (2). Understanding individual behaviors and demographic characteristics of patients with COVID-19 and risks for severe illness requiring hospitalization can inform efforts to reduce transmission. During April 15–May 24, 2020, telephone interviews were conducted with a random sample of adults aged ≥18 years who had positive reverse transcription–polymerase chain reaction (RT-PCR) test results for SARS-CoV-2 in outpatient and inpatient settings at 11 U.S. academic medical centers in nine states. Respondents were contacted 14–21 days after SARS-CoV-2 testing and asked about their demographic characteristics, underlying chronic conditions, symptoms experienced on the date of testing, and potential exposures to SARS-CoV-2 during the 2 weeks before illness onset (or the date of testing among those who did not report symptoms at the time of testing). Among 350 interviewed patients (271 [77%] outpatients and 79 [23%] inpatients), inpatients were older, more likely to be Hispanic and to report dyspnea than outpatients. Fewer inpatients (39%, 20 of 51) reported a return to baseline level of health at 14–21 days than did outpatients (64%, 150 of 233) (p = 0.001). Overall, approximately one half (46%) of patients reported known close contact with someone with COVID-19 during the preceding 2 weeks. This was most commonly a family member (45%) or a work colleague (34%). Approximately two thirds (64%, 212 of 333) of participants were employed; only 35 of 209 (17%) were able to telework. These findings highlight the need for screening, case investigation, contact tracing, and isolation of infected persons to control transmission of SARS-CoV-2 infection during periods of community transmission. The need for enhanced measures to ensure workplace safety, including ensuring social distancing and more widespread use of cloth face coverings, are warranted (3).
  
  Suggested citation for this article: Tenforde MW, Rose EB, Lindsell CJ, et al. Characteristics of Adult Outpatients and Inpatients with COVID-19 — 11 Academic Medical Centers, United States, March–May 2020. MMWR Morb Mortal Wkly Rep. ePub: 30 June 2020.
  
  mm6926e3-H.pdf
  
  mm6926e3.htm?s_cid=mm6926e3_w
  
  
• Content Notes:
  Demographic and Baseline Health Characteristics -- Reported Symptoms -- Exposures -- Discussion -- Acknowledgments -- Table 1 -- Table 2 -- Table 3.
• Subjects:
  Communicable Disease Control Coronavirus Infections/prevention & Control COVID-19 Humans Pandemics/prevention & Control Pneumonia, Viral/prevention & Control Social Distance
• Source:
  MMWR: Morbidity and Mortality Weekly Report 2020; v. 69 Early Release
• Series:
  Weekly Report: Morbidity and Mortality Weekly Report (MMWR)
• ISSN:
  0149-2195 (print) ; 1545-861X (digital)
• Document Type:
  Journal Article
• Place as Subject:
  United States
• Pages in Document:
  7 pdf pages
• Volume:
  69
• Collection(s):
  Morbidity and Mortality Weekly Report (MMWR)
• Main Document Checksum:
  urn:sha-512:9d3d8d4ab175885e251eea6d3e14db73269d10e4718ce89062a483586ddbc38a1497c53b080ec67865ac49edd1d0d8068d173be2a466063bb6a8c84fd349f7f8
• Download URL:
  https://stacks.cdc.gov/view/cdc/90017/cdc_90017_DS1.pdf
• File Type:
  [PDF - 237.86 KB ]