key: cord-0754407-0229ziyn authors: Deng, Kebin; Li, Hui; Ma, Xin; Yu, Bianbian; Yi, Xinlin; Chen, Ying; Tian, Bo; Zhang, Qing title: Analysis of the positive rate of 4254 cases of COVID‐19 nucleic acid tests in different aites in Wuhan, China date: 2020-07-27 journal: J Med Virol DOI: 10.1002/jmv.26323 sha: 4084a627f52512be94e21a26bcb87d0449e29998 doc_id: 754407 cord_uid: 0229ziyn There's an outbreak of coronavirus diesase 2019 (COVID‐19) since December 2019, first in Wuhan. It has caused huge medical challenges to Hubei Province with currently more than 67 thousand confirmed cases till 8th March 2020. Identification, there is no clinically effective drug. Isolation and masks are essential to limit human‐to‐human transmission initially. The nucleic acid test (NAT) of COVID‐19 currently was the most reliable established laboratory diagnosis method in clinical. From 8th February to 7th March 2020, 4254 cases were collected for analysis at six nucleic acid collection sites in the community medical team of Hubei Provincial Hospital of Traditional Chinese Medicine, which cover almost all groups who need NAT in Wuhan. Distribution of positive rates in different sites by genders, ages, or occupations were compared. The positive rates of different sites from high to low were: hospital wards (24.71%) > fever clinics (16.57%) > nursing homes (5.51%) > isolation hotels (5.30%) > rehabilitation stations (1.36%) >close contact sites (0.17%). The confirmed patients in isolation hotels, hospital ward, and fever clinical were mainly middle‐aged and elderly, and most of them were women. The positive rate in isolation hotels and fever clinics gradually decreased over time. There were no significant differences between genders among those six nucleic acid collection sites (P < .05). The hospital wards have the highest positive rate; however, close contact sites have lowest one. Patients who are discharged from hospitals may still have potential risks. Middle‐aged and older people remain the focus of epidemic prevention and control. (NAT) of COVID-19 currently was the most reliable established laboratory diagnosis method in clinical. From 8th February to 7th March 2020, 4254 cases were collected for analysis at six nucleic acid collection sites in the community medical team of Hubei Provincial Hospital of Traditional Chinese Medicine, which cover almost all groups who need NAT in Wuhan. Distribution of positive rates in different sites by genders, ages, or occupations were compared. The positive rates of different sites from high to low were: hospital wards (24.71%) > fever clinics (16.57%) > nursing homes (5.51%) > isolation hotels (5.30%) > rehabilitation stations (1.36%) >close contact sites (0.17%). The confirmed patients in isolation hotels, hospital ward, and fever clinical were mainly middle-aged and elderly, and most of them were women. The positive rate in isolation hotels and fever clinics gradually decreased over time. There were no significant differences between genders among those six nucleic acid collection sites (P < .05). The hospital wards have the highest positive rate; however, close contact sites have lowest one. Patients who are discharged from hospitals may still have potential risks. Middle-aged and older people remain the focus of epidemic prevention and control. Chinese Medicine, it has been mainly responsible for the NAT of multiple isolation hotels (suspected cases) in Hongshan District, Wuhan City. Later, it also took charge of close contact sites (direct contact with COVID-19), nursing homes, rehabilitation stations (discharged from the hospital), hospital wards (confirmed patients), and fever clinics. Almost all groups who be asked to do NAT are included in those six nucleic acid collection sites. In this paper, our medical team will analyze the RT-PCR results of the six nucleic acid collection sites to discuss the distribution of positive rates of COVID-19. 2 | DATA AND METHODS Four thousand two-hundred and fifty-four cases from 8th February to 7th March were tested at different nucleic acid collection sites in the Hongshan District of Wuhan. Cases information, including name, gender, age, ID, etc, was collected after NAT with oropharyngeal swabs. Close contact sites were the cases that contact with confirmed patients with COVID-19 directly. Isolation hotels mainly receive suspected cases. Rehabilitation stations accept patients with COVID-19 who discharged from the hospital, and needed to be isolated for 2 weeks before returning home. Nursing homes, as a special place, are paid attention to people gradually in the later period since the first infected patient was confirmed in prison. Hospital wards are the patients who confirmed. Fever clinics are patients with fever as the main complaint. This study was approved by the Ethics Committee of the Hubei University of Traditional Chinese Medicine (HBZY2020-C25-01), the need for informed consent was waived. All of cases collect oropharyngeal secretions. The nurse checks information carefully under the third-level protection. Afterwards, the doctor holds an oropharynx swab to scrape the patient's secretion, and puts it into a nucleic acid kit for storage. We will send all specimens for inspection on the same day. The nucleic acid kit of hospital Thermal cycling was performed at 55°C for 10 minutes for reverse transcription, followed by 95°C for 3 minutes and then 45 cycles of 95°C for 15 seconds, 58°C for 30 seconds. SPSS 18.0 was used for statistical analysis. The count data were expressed in terms of cases and percentages. The χ 2 test and rank analysis were used to compare intergroup differences. Statistical significance was defined as P < .05. A total of 4254 effective nucleic acid detection specimens were collected within 1 month (4 weeks) from six nucleic acid collection sites (Table 1) . Among them, there were 1997 males and 2257 females. The age of patients was from 2 days to 99 years with the average age of 54.98 years. The positive rate of close contact sites is the lowest (0.17%), however, which of hospital ward is the highest one (24.71%). Only 1 positive case was confirmed in close contact sites, while 2 out of 288 were single positive. Both of them were women ( Table 2) . Comparing the differences in nucleic acid detection results between males and females, the χ 2 test (put SP and DP as a group) showed P = .236 > .05. There was no statistically significant difference. Isolation hotels are the suspected patients of fever, fatigue, or dry cough, but have not been detected nucleic acid or NAT results were negative. A total of 1716 cases were collected, including 767 males and 949 females ( Table 3 ). The double-positive rate is 5.22% for males, while the female is 5.37%. Comparison of the nucleic acid detection results of the differences between genders. There is no obvious gender difference statistically during sample collection (P < .05). All personnel in the isolation hotels are classified according to the testing date (by weeks), and the number of specimens and positive rate are shown in Table 4 The results of the rank-sum test showed that Z = −9.487, P < .0001 < .05. There was a significant difference between genders, indicating that female has a higher DP rate than male. The total rate of age from 30 to 69 years is 83.52%, especially in 50 to 59 years old (24.18%) (Figure 1 ). People who less than 20 or more than 80 years old absolutely has a lower positive rate. Rehabilitation stations mainly accepted patients with COVID-19 who have been diagnosed and cured in hospital. A total of 661 cases were collected, including 342 males and 319 females (Table 5) . the χ 2 test (put SP and DP as a group) showed P = .958 > .05, there was no statistically significant difference. As a special concentration place, nursing homes are the most elder people, also included nursing home staff and accompanying family members. A total of 272 cases were collected, including 95 males and 177 females (Table 6) , with an average age of 70.9 ± 14.45 years. Comparing the differences between males and females, the results of the rank-sum test showed that Z = −1.191, P = .234 > .05, no statistically significant. Hospital wards treat patients who meet the diagnosis and treatment plan for the new coronavirus pneumonia (5th and 6th editions). 5 A total of 340 cases were collected, including 158 males and 182 females. Comparing the differences between genders with the χ 2 test (N and DP) showed P = .908 > .05, there was no statistically significant difference ( Table 7) . were showed in Figure 2 and Workers and retirees have a major rate (24% and 23%) in occupational distribution. However, medical personnel has a lowest rate (4%) (Figure 4 ). A total of 682 cases came to our fever clinic during these 4 weeks. The DP rate of COVID-19 is 16.57% (113 out of 682). There was no statistically significant difference between genders with χ 2 testing. The same statistical method was used among those 4 weeks showed that the P value is less than .0001 (Table 8) . Therefore, a pairwise comparison was made between these 4 weeks (α = .007). All of the P value is less than .007 except 1st to 2nd week. That means the positive rate of NAT gradually decreased over time. people, although they have better immunity, more contact opportunities will increase the risk of infection. For the elderly, the source of epidemic information is relatively backward, the awareness of prevention is also insufficient. Besides, the major organism and body's immunity also decline gradually. What's more, many chronic diseases are often combined to make it difficult to resist the invasion of diseases. Therefore they are belonging to the high-risk population. The positive rate of the NAT in this study is lower than in other studies. [14] [15] [16] The In this study, the collection of nucleic acids was mostly out-ofhospital, the basic information of the cases that could be collected was limited, and there was a lack of epidemiological history, clinical symptoms, imaging examinations, laboratory examinations, and other data. Our medical team will try to increase sample size and improve epidemiological data to provide more reference for the clinical diagnosis and treatment of COVID-19. This work was supported by Ministry of Science and Technology of the People's Republic of China (2020YFC0845000). A novel coronavirus from patients with pneumonia in China The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health The latest 2019 novel coronavirus outbreak in Wuhan, China The General Office of the National Health Commission, the National Science and Technology Education Office The General Office of the National Health Commission. Notice of the General Office of the National Health Commission on printing and distributing biosafety guidelines for new coronavirus laboratories The General Office of the National Health Commission. Notice on the issuance of a new coronavirus infection pneumonia diagnosis and treatment plan On the issuance of pneumonia treatment programs novel coronavirus infection Coronavirus infections-more than just the common cold Qing-wu J. β-Coronavirus epidemic and control of human disease Identification of a novel coronavirus in patients with severe acute respiratory syndrome Middle East respiratory syndrome coronavirus (MERS CoV): announcement of the coronavirus study group Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study A novel coronavirus outbreak of global health concern Clinical features of patients infected with 2019 novel coronavirus in Wuhan Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes Comparative study of two sampling methods of nasal and pharyngeal swabs in the screening of novel coronavirus nucleic acid Positive rate of RT-PCR detection of SARS-CoV-2 infection in 4880 cases from one hospital in Notice about the issuance of a new coronavirus pneumonia diagnosis and treatment plan (for trial implementation of the seventh edition) The authors declare that there are no conflict of interests. KD and HL: Conceptualization, methodology, data curation, writing original draft, writing review and editing. XM, BY, and BT: Conceptualization, methodology, investigation. XY, YC, and QZ: Methodology, data curation, software. KBD, HL, and XM designed the study and analyzed the data. XLY and BBY collected and analyzed the data.KBD and HL wrote the paper. YC, BT, and QZ read and approved the final manuscript. All data generated or analyzed during this study are included in this article. http://orcid.org/0000-0003-4635-8385