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.
  More +
• 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.
  More +
• 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:
  • COVID-19
  • Communicable Disease Control
  • Coronavirus Infections/prevention & control
  • 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
• Download URL:
  https://stacks.cdc.gov/view/cdc/90017/cdc_90017_DS1.pdf
• File Type:
  [PDF - 237.86 KB]
• Collection(s):
  Morbidity and Mortality Weekly Report (MMWR)
• Main Document Checksum:
  urn:sha-512:9d3d8d4ab175885e251eea6d3e14db73269d10e4718ce89062a483586ddbc38a1497c53b080ec67865ac49edd1d0d8068d173be2a466063bb6a8c84fd349f7f8