COVID-19 epidemiology and demographics: Difference between revisions

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==Overview==
==Overview==
Globally, 3,755,341 cases of COVID-19 have been reported with 263,831 deaths. In the US, more than 1 million cases have been reported with 73,431 deaths in the country. Due to rapidly evolving data at this point, the exact [[Incidence (epidemiology)|incidence rate]] of Coronavirus disease 2019 (COVID-19) can not be approximated. Prevalent in all the continents of the world, [[World Health Organization|World Health Organization (WHO)]] has declared COVID-19 [[outbreak]] a [[pandemic]]. Due to inconsistent reporting and lack of organized data, an exact and universal case-fatality rate of COVID-19 is yet to be established. Middle aged and elderly population seem to be the most commonly affected with a [[median]] age of 49 - 56 years. COVID-19 is affecting males more than females. Majority of the cases of COVID-19 were first reported in China and at this point the disease has spread to all the continents of the world.  
The WHO has declared COVID-19 a pandemic. Due to the lack of broad screening that includes the general population (including asymptomatic patients) and the lack of [[PCR]] and antibody tests with acceptable sensitivity and specificity, an accurate estimate of the [[Incidence (epidemiology)|incidence rate]] of Coronavirus disease 2019 (COVID-19) cannot be accurately estimated. The role of symptomatic and asymptomatic transmission continues to be debated. Due to limited testing of asymptomatic individuals, the potential inaccuracies of early PCR tests and antibody tests, the inconsistent reporting and lack of organized data, an accurate case-fatality rate of COVID-19 has yet to be established. The middle aged and elderly population seem to be the most commonly affected with a [[median]] age of 49 - 56 years. COVID-19 is affects males more often than females. While the majority of COVID-19 cases were first reported in China, at this point the disease has spread to all the continents of the world.  


==Epidemiology and Demorgraphics==
==Epidemiology and Demorgraphics==
===Incidence===
===Incidence===


*Due to the lack of broad screening data at this point, the exact [[Incidence (epidemiology)|incidence rate]] of Coronavirus disease 2019 (COVID-19) can not be approximated.
*Due to the lack of broad screening that includes the general population (including asymptomatic patients) and the lack of [[PCR]] and antibody tests with acceptable sensitivity and specificity, an accurate estimate of the [[Incidence (epidemiology)|incidence rate]] of Coronavirus disease 2019 (COVID-19) cannot be accurately estimated.


=== Prevalence ===
=== Prevalence ===


* To date, 3,755,341 confirmed cases of COVID-19 have emerged globally.
* For details on the real-time [[prevalence]] and spread of COVID-19, click [https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6 '''here'''].<ref name=":0">{{Cite web|url=https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6|title=|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref><ref name="DongDu2020">{{cite journal|last1=Dong|first1=Ensheng|last2=Du|first2=Hongru|last3=Gardner|first3=Lauren|title=An interactive web-based dashboard to track COVID-19 in real time|journal=The Lancet Infectious Diseases|year=2020|issn=14733099|doi=10.1016/S1473-3099(20)30120-1}}</ref><ref name=":1">{{Cite web|url=https://www.who.int/china/news/detail/09-01-2020-who-statement-regarding-cluster-of-pneumonia-cases-in-wuhan-china|title=WHO statement regarding cluster of pneumonia cases in Wuhan, China.|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref><ref name=":2">{{Cite web|url=https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports|title=Coronavirus disease 2019 (COVID-19) situation reports.|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref><ref name=":3">{{Cite web|url=http://weekly.chinacdc.cn/news/TrackingtheEpidemic.htm|title=Tracking the epidemic.|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref>  
*In the US, more than 1 million cases have been reported with 73,431 deaths in the country.
*As it is prevalent in all the continents of the world, [[World Health Organization|World Health Organization (WHO)]] has declared COVID-19 [[outbreak]] a [[pandemic]].
*Epidemiologist Mark Lipsitch has suggested that 40% of the world's population could get infected with coronavirus.<ref>Anoymouis (2020) The latest on the coronavirus. T.H. Chan. Harvard School of Public Health. Avaiable at: https://www.hsph.harvard.edu/news/hsph-in-the-news/the-latest-on-the-coronavirus/ (search the page for instances of '40%')</ref> This assertion may be based on a non-peer-reviewed studies.<ref name="NiehusDe Salazar2020">{{cite journal|last1=Niehus|first1=Rene|last2=De Salazar|first2=Pablo M|last3=Taylor|first3=Aimee|last4=Lipsitch|first4=Marc|year=2020|doi=10.1101/2020.02.13.20022707}}</ref><ref name="De SalazarNiehus2020">{{cite journal|last1=De Salazar|first1=Pablo M|last2=Niehus|first2=Rene|last3=Taylor|first3=Aimee|last4=Buckee|first4=Caroline O|last5=Lipsitch|first5=Marc|year=2020|doi=10.1101/2020.02.04.20020495}}</ref>.
* Among patients with influenza-like-illness and without risk factors for COVID-19, 5% were positive for COVID-19.<ref name="SpellbergHaddix2020">{{cite journal|last1=Spellberg|first1=Brad|last2=Haddix|first2=Meredith|last3=Lee|first3=Rebecca|last4=Butler-Wu|first4=Susan|last5=Holtom|first5=Paul|last6=Yee|first6=Hal|last7=Gounder|first7=Prabhu|title=Community Prevalence of SARS-CoV-2 Among Patients With Influenzalike Illnesses Presenting to a Los Angeles Medical Center in March 2020|journal=JAMA|year=2020|issn=0098-7484|doi=10.1001/jama.2020.4958}}</ref>
*Prevalent in all the continents of the world, [[World Health Organization|World Health Organization (WHO)]] has declared COVID-19 [[outbreak]] a [[pandemic]].
*For details on the real-time [[prevalence]] and spread of COVID-19, click [https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6 '''here'''].<ref name=":0">{{Cite web|url=https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6|title=|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref><ref name="DongDu2020">{{cite journal|last1=Dong|first1=Ensheng|last2=Du|first2=Hongru|last3=Gardner|first3=Lauren|title=An interactive web-based dashboard to track COVID-19 in real time|journal=The Lancet Infectious Diseases|year=2020|issn=14733099|doi=10.1016/S1473-3099(20)30120-1}}</ref><ref name=":1">{{Cite web|url=https://www.who.int/china/news/detail/09-01-2020-who-statement-regarding-cluster-of-pneumonia-cases-in-wuhan-china|title=WHO statement regarding cluster of pneumonia cases in Wuhan, China.|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref><ref name=":2">{{Cite web|url=https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports|title=Coronavirus disease 2019 (COVID-19) situation reports.|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref><ref name=":3">{{Cite web|url=http://weekly.chinacdc.cn/news/TrackingtheEpidemic.htm|title=Tracking the epidemic.|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref>
* Among patients iwth influenza-like-illness and without risk factors for COVID-19, 5% were positive for COVID-19.<ref name="SpellbergHaddix2020">{{cite journal|last1=Spellberg|first1=Brad|last2=Haddix|first2=Meredith|last3=Lee|first3=Rebecca|last4=Butler-Wu|first4=Susan|last5=Holtom|first5=Paul|last6=Yee|first6=Hal|last7=Gounder|first7=Prabhu|title=Community Prevalence of SARS-CoV-2 Among Patients With Influenzalike Illnesses Presenting to a Los Angeles Medical Center in March 2020|journal=JAMA|year=2020|issn=0098-7484|doi=10.1001/jama.2020.4958}}</ref>


=== Case-fatality rate ===
=== Case-fatality rate ===


*Due to limited testing of asymptomatic individuals, the potential inaccuracies of early PCR tests and antibody tests, the inconsistent reporting and lack of organized data, an exact and universal case-fatality rate of COVID-19 has yet to be established.
*Due to limited testing of asymptomatic individuals, the potential inaccuracies of early PCR tests and antibody tests, the inconsistent reporting and lack of organized data, an accurate case-fatality rate of COVID-19 has yet to be established.
*The [[Case fatality rate|case fatality-rate]] of COVID-19 in the first 99 [[Patient|patients]] at a Wuhan hospital (the epicenter of the [[outbreak]]) was found to be 11% but this is likely an overestimate as it only included symptomatic cases.<ref name="HuangWang2020">{{cite journal|last1=Huang|first1=Chaolin|last2=Wang|first2=Yeming|last3=Li|first3=Xingwang|last4=Ren|first4=Lili|last5=Zhao|first5=Jianping|last6=Hu|first6=Yi|last7=Zhang|first7=Li|last8=Fan|first8=Guohui|last9=Xu|first9=Jiuyang|last10=Gu|first10=Xiaoying|last11=Cheng|first11=Zhenshun|last12=Yu|first12=Ting|last13=Xia|first13=Jiaan|last14=Wei|first14=Yuan|last15=Wu|first15=Wenjuan|last16=Xie|first16=Xuelei|last17=Yin|first17=Wen|last18=Li|first18=Hui|last19=Liu|first19=Min|last20=Xiao|first20=Yan|last21=Gao|first21=Hong|last22=Guo|first22=Li|last23=Xie|first23=Jungang|last24=Wang|first24=Guangfa|last25=Jiang|first25=Rongmeng|last26=Gao|first26=Zhancheng|last27=Jin|first27=Qi|last28=Wang|first28=Jianwei|last29=Cao|first29=Bin|title=Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China|journal=The Lancet|year=2020|issn=01406736|doi=10.1016/S0140-6736(20)30183-5}}</ref>
*The [[Case fatality rate|case fatality-rate]] of COVID-19 in the first 99 [[Patient|patients]] at a Wuhan hospital (the epicenter of the [[outbreak]]) was found to be 11% but this is likely an overestimate as it only included symptomatic cases.<ref name="HuangWang2020">{{cite journal|last1=Huang|first1=Chaolin|last2=Wang|first2=Yeming|last3=Li|first3=Xingwang|last4=Ren|first4=Lili|last5=Zhao|first5=Jianping|last6=Hu|first6=Yi|last7=Zhang|first7=Li|last8=Fan|first8=Guohui|last9=Xu|first9=Jiuyang|last10=Gu|first10=Xiaoying|last11=Cheng|first11=Zhenshun|last12=Yu|first12=Ting|last13=Xia|first13=Jiaan|last14=Wei|first14=Yuan|last15=Wu|first15=Wenjuan|last16=Xie|first16=Xuelei|last17=Yin|first17=Wen|last18=Li|first18=Hui|last19=Liu|first19=Min|last20=Xiao|first20=Yan|last21=Gao|first21=Hong|last22=Guo|first22=Li|last23=Xie|first23=Jungang|last24=Wang|first24=Guangfa|last25=Jiang|first25=Rongmeng|last26=Gao|first26=Zhancheng|last27=Jin|first27=Qi|last28=Wang|first28=Jianwei|last29=Cao|first29=Bin|title=Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China|journal=The Lancet|year=2020|issn=01406736|doi=10.1016/S0140-6736(20)30183-5}}</ref>
*In a different study comprising of 138 [[Patient|patients]] [[Infection|infected]] with COVID-19, the [[mortality]] was 4.3%, but again this does not include asymptomatic cases.<ref name="WangHu2020">{{cite journal|last1=Wang|first1=Dawei|last2=Hu|first2=Bo|last3=Hu|first3=Chang|last4=Zhu|first4=Fangfang|last5=Liu|first5=Xing|last6=Zhang|first6=Jing|last7=Wang|first7=Binbin|last8=Xiang|first8=Hui|last9=Cheng|first9=Zhenshun|last10=Xiong|first10=Yong|last11=Zhao|first11=Yan|last12=Li|first12=Yirong|last13=Wang|first13=Xinghuan|last14=Peng|first14=Zhiyong|title=Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China|journal=JAMA|year=2020|issn=0098-7484|doi=10.1001/jama.2020.1585}}</ref>
*In a different study comprising of 138 [[Patient|patients]] [[Infection|infected]] with COVID-19, the [[mortality]] was 4.3%, but again this does not include asymptomatic cases.<ref name="WangHu2020">{{cite journal|last1=Wang|first1=Dawei|last2=Hu|first2=Bo|last3=Hu|first3=Chang|last4=Zhu|first4=Fangfang|last5=Liu|first5=Xing|last6=Zhang|first6=Jing|last7=Wang|first7=Binbin|last8=Xiang|first8=Hui|last9=Cheng|first9=Zhenshun|last10=Xiong|first10=Yong|last11=Zhao|first11=Yan|last12=Li|first12=Yirong|last13=Wang|first13=Xinghuan|last14=Peng|first14=Zhiyong|title=Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China|journal=JAMA|year=2020|issn=0098-7484|doi=10.1001/jama.2020.1585}}</ref>
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* COVID-19 can affect individuals of any age.
* COVID-19 can affect individuals of any age.
*Middle aged and elderly population seem to be the most commonly affected.
*The middle aged and elderly population seem to be the most commonly affected.
*In multiple cohorts of [[Patient|patients]] [[Hospitalization|hospitalized]] with confirmed COVID-19, the [[median]] age is established to range from 49 to 56 years.<ref name="pmid31986264">{{cite journal |vauthors=Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B |title=Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China |journal=Lancet |volume=395 |issue=10223 |pages=497–506 |date=February 2020 |pmid=31986264 |doi=10.1016/S0140-6736(20)30183-5 |url=}}</ref><ref name="pmid32007143">{{cite journal |vauthors=Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, Xia J, Yu T, Zhang X, Zhang L |title=Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study |journal=Lancet |volume=395 |issue=10223 |pages=507–513 |date=February 2020 |pmid=32007143 |doi=10.1016/S0140-6736(20)30211-7 |url=}}</ref><ref name="pmid32031570">{{cite journal |vauthors=Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X, Peng Z |title=Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China |journal=JAMA |volume= |issue= |pages= |date=February 2020 |pmid=32031570 |doi=10.1001/jama.2020.1585 |url=}}</ref>
*In multiple cohorts of [[Patient|patients]] [[Hospitalization|hospitalized]] with confirmed COVID-19, the [[median]] age ranges from 49 to 56 years.<ref name="pmid31986264">{{cite journal |vauthors=Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B |title=Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China |journal=Lancet |volume=395 |issue=10223 |pages=497–506 |date=February 2020 |pmid=31986264 |doi=10.1016/S0140-6736(20)30183-5 |url=}}</ref><ref name="pmid32007143">{{cite journal |vauthors=Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, Xia J, Yu T, Zhang X, Zhang L |title=Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study |journal=Lancet |volume=395 |issue=10223 |pages=507–513 |date=February 2020 |pmid=32007143 |doi=10.1016/S0140-6736(20)30211-7 |url=}}</ref><ref name="pmid32031570">{{cite journal |vauthors=Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X, Peng Z |title=Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China |journal=JAMA |volume= |issue= |pages= |date=February 2020 |pmid=32031570 |doi=10.1001/jama.2020.1585 |url=}}</ref>
*In a report including approximately 44,500 cases, 87% of the [[Patient|patients]] were between the ages of 30 and 79 years.<ref name="pmid32091533">{{cite journal |vauthors=Wu Z, McGoogan JM |title=Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention |journal=JAMA |volume= |issue= |pages= |date=February 2020 |pmid=32091533 |doi=10.1001/jama.2020.2648 |url=}}</ref>
*In a report including approximately 44,500 cases, 87% of the [[Patient|patients]] were between the ages of 30 and 79 years.<ref name="pmid32091533">{{cite journal |vauthors=Wu Z, McGoogan JM |title=Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention |journal=JAMA |volume= |issue= |pages= |date=February 2020 |pmid=32091533 |doi=10.1001/jama.2020.2648 |url=}}</ref>
*According to the same report mentioned above, 2% of the [[Patient|patients]] were younger than the age of 20 years.
*According to the same report mentioned above, 2% of the [[Patient|patients]] were younger than the age of 20 years.
*Children account for < 2% of #COVID19 possibly due to lower  expression of angiotensin-converting enzyme 2 (ACE2), the receptor the virus uses for entry into cells.  ACE2 gene expression in the nasal epithelium is now shown to be lower as age decreased. This hypothesis has now found some support in this study showing children have lower ACE2 gene expression in the nasal epithelium, but the causal role has yet to be firmly established. More data is needed but this is provocative<ref name="BunyavanichDo2020">{{cite journal|last1=Bunyavanich|first1=Supinda|last2=Do|first2=Anh|last3=Vicencio|first3=Alfin|title=Nasal Gene Expression of Angiotensin-Converting Enzyme 2 in Children and Adults|journal=JAMA|volume=323|issue=23|year=2020|pages=2427|issn=0098-7484|doi=10.1001/jama.2020.8707}}</ref>
*Children account for < 2% of COVID19 possibly due to lower  expression of angiotensin-converting enzyme 2 (ACE2) in the respiratory system and other organs, the receptor the virus uses for entry into cells.  ACE2 gene expression in the nasal epithelium is now shown to be lower as age decreased. This hypothesis has now found some support in this study showing children have lower ACE2 gene expression in the nasal epithelium, but the causal role has yet to be firmly established. More data is needed but this is provocative<ref name="BunyavanichDo2020">{{cite journal|last1=Bunyavanich|first1=Supinda|last2=Do|first2=Anh|last3=Vicencio|first3=Alfin|title=Nasal Gene Expression of Angiotensin-Converting Enzyme 2 in Children and Adults|journal=JAMA|volume=323|issue=23|year=2020|pages=2427|issn=0098-7484|doi=10.1001/jama.2020.8707}}</ref>


=== Race ===
=== Racial predilection to COVID-19 ===


* At this point, there seems to be no racial predilection to COVID-19.
*In Baltimore/DC area, the COVID19 positivity rate for Latino patients was 42.6%, significantly higher than the rate for white patients (8.8%), black patients (17.6%), or those of other race/ethnicity (17.2%) (P < .001 for each pairwise comparison)<ref name="MartinezHinson2020">{{cite journal|last1=Martinez|first1=Diego A.|last2=Hinson|first2=Jeremiah S.|last3=Klein|first3=Eili Y.|last4=Irvin|first4=Nathan A.|last5=Saheed|first5=Mustapha|last6=Page|first6=Kathleen R.|last7=Levin|first7=Scott R.|title=SARS-CoV-2 Positivity Rate for Latinos in the Baltimore-Washington, DC Region|journal=JAMA|year=2020|issn=0098-7484|doi=10.1001/jama.2020.11374}}</ref>
*In Baltimore/DC area, the #COVID19 positivity rate for Latino patients was 42.6%, significantly higher than the rate for white patients (8.8%), black patients (17.6%), or those of other race/ethnicity (17.2%) (P < .001 for each pairwise comparison)<ref name="MartinezHinson2020">{{cite journal|last1=Martinez|first1=Diego A.|last2=Hinson|first2=Jeremiah S.|last3=Klein|first3=Eili Y.|last4=Irvin|first4=Nathan A.|last5=Saheed|first5=Mustapha|last6=Page|first6=Kathleen R.|last7=Levin|first7=Scott R.|title=SARS-CoV-2 Positivity Rate for Latinos in the Baltimore-Washington, DC Region|journal=JAMA|year=2020|issn=0098-7484|doi=10.1001/jama.2020.11374}}</ref>


=== Gender ===
=== Gender ===


* COVID-19 is affecting males more than females.<ref name="LiGuan20202">{{cite journal|last1=Li|first1=Qun|last2=Guan|first2=Xuhua|last3=Wu|first3=Peng|last4=Wang|first4=Xiaoye|last5=Zhou|first5=Lei|last6=Tong|first6=Yeqing|last7=Ren|first7=Ruiqi|last8=Leung|first8=Kathy S.M.|last9=Lau|first9=Eric H.Y.|last10=Wong|first10=Jessica Y.|last11=Xing|first11=Xuesen|last12=Xiang|first12=Nijuan|last13=Wu|first13=Yang|last14=Li|first14=Chao|last15=Chen|first15=Qi|last16=Li|first16=Dan|last17=Liu|first17=Tian|last18=Zhao|first18=Jing|last19=Liu|first19=Man|last20=Tu|first20=Wenxiao|last21=Chen|first21=Chuding|last22=Jin|first22=Lianmei|last23=Yang|first23=Rui|last24=Wang|first24=Qi|last25=Zhou|first25=Suhua|last26=Wang|first26=Rui|last27=Liu|first27=Hui|last28=Luo|first28=Yinbo|last29=Liu|first29=Yuan|last30=Shao|first30=Ge|last31=Li|first31=Huan|last32=Tao|first32=Zhongfa|last33=Yang|first33=Yang|last34=Deng|first34=Zhiqiang|last35=Liu|first35=Boxi|last36=Ma|first36=Zhitao|last37=Zhang|first37=Yanping|last38=Shi|first38=Guoqing|last39=Lam|first39=Tommy T.Y.|last40=Wu|first40=Joseph T.|last41=Gao|first41=George F.|last42=Cowling|first42=Benjamin J.|last43=Yang|first43=Bo|last44=Leung|first44=Gabriel M.|last45=Feng|first45=Zijian|title=Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia|journal=New England Journal of Medicine|year=2020|issn=0028-4793|doi=10.1056/NEJMoa2001316}}</ref><ref name="YangPeng2020">{{cite journal|last1=Yang|first1=Yongshi|last2=Peng|first2=Fujun|last3=Wang|first3=Runsheng|last4=Guan|first4=Kai|last5=Jiang|first5=Taijiao|last6=Xu|first6=Guogang|last7=Sun|first7=Jinlyu|last8=Chang|first8=Christopher|title=The deadly coronaviruses: The 2003 SARS pandemic and the 2020 novel coronavirus epidemic in China|journal=Journal of Autoimmunity|year=2020|pages=102434|issn=08968411|doi=10.1016/j.jaut.2020.102434}}</ref>
* COVID-19 affects males more often than females.<ref name="LiGuan20202">{{cite journal|last1=Li|first1=Qun|last2=Guan|first2=Xuhua|last3=Wu|first3=Peng|last4=Wang|first4=Xiaoye|last5=Zhou|first5=Lei|last6=Tong|first6=Yeqing|last7=Ren|first7=Ruiqi|last8=Leung|first8=Kathy S.M.|last9=Lau|first9=Eric H.Y.|last10=Wong|first10=Jessica Y.|last11=Xing|first11=Xuesen|last12=Xiang|first12=Nijuan|last13=Wu|first13=Yang|last14=Li|first14=Chao|last15=Chen|first15=Qi|last16=Li|first16=Dan|last17=Liu|first17=Tian|last18=Zhao|first18=Jing|last19=Liu|first19=Man|last20=Tu|first20=Wenxiao|last21=Chen|first21=Chuding|last22=Jin|first22=Lianmei|last23=Yang|first23=Rui|last24=Wang|first24=Qi|last25=Zhou|first25=Suhua|last26=Wang|first26=Rui|last27=Liu|first27=Hui|last28=Luo|first28=Yinbo|last29=Liu|first29=Yuan|last30=Shao|first30=Ge|last31=Li|first31=Huan|last32=Tao|first32=Zhongfa|last33=Yang|first33=Yang|last34=Deng|first34=Zhiqiang|last35=Liu|first35=Boxi|last36=Ma|first36=Zhitao|last37=Zhang|first37=Yanping|last38=Shi|first38=Guoqing|last39=Lam|first39=Tommy T.Y.|last40=Wu|first40=Joseph T.|last41=Gao|first41=George F.|last42=Cowling|first42=Benjamin J.|last43=Yang|first43=Bo|last44=Leung|first44=Gabriel M.|last45=Feng|first45=Zijian|title=Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia|journal=New England Journal of Medicine|year=2020|issn=0028-4793|doi=10.1056/NEJMoa2001316}}</ref><ref name="YangPeng2020">{{cite journal|last1=Yang|first1=Yongshi|last2=Peng|first2=Fujun|last3=Wang|first3=Runsheng|last4=Guan|first4=Kai|last5=Jiang|first5=Taijiao|last6=Xu|first6=Guogang|last7=Sun|first7=Jinlyu|last8=Chang|first8=Christopher|title=The deadly coronaviruses: The 2003 SARS pandemic and the 2020 novel coronavirus epidemic in China|journal=Journal of Autoimmunity|year=2020|pages=102434|issn=08968411|doi=10.1016/j.jaut.2020.102434}}</ref>


=== Region ===
=== Region ===


* Majority of the cases of COVID-19 were first reported in China and at this point the disease has spread to all the continents of the world.
* The majority of the early cases of COVID-19 were first reported in China and at this point the disease has spread to all the continents of the world.
*In the United States, confirmed cases of COVID-19 have been reported in all of the 50 States.<ref>{{Cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html|title=|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref>
*In the United States, confirmed cases of COVID-19 have been reported in all of the 50 States.<ref>{{Cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html|title=|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref>
*For real-time details regarding the worldwide spread of COVID-19, click [https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6 '''here'''].<ref name=":0" /><ref name="DongDu2020" /><ref name=":1" /><ref name=":2" /><ref name=":3" />
*For real-time details regarding the worldwide spread of COVID-19, click [https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6 '''here'''].<ref name=":0" /><ref name="DongDu2020" /><ref name=":1" /><ref name=":2" /><ref name=":3" />

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sabawoon Mirwais, M.B.B.S, M.D.[2]

Overview

The WHO has declared COVID-19 a pandemic. Due to the lack of broad screening that includes the general population (including asymptomatic patients) and the lack of PCR and antibody tests with acceptable sensitivity and specificity, an accurate estimate of the incidence rate of Coronavirus disease 2019 (COVID-19) cannot be accurately estimated. The role of symptomatic and asymptomatic transmission continues to be debated. Due to limited testing of asymptomatic individuals, the potential inaccuracies of early PCR tests and antibody tests, the inconsistent reporting and lack of organized data, an accurate case-fatality rate of COVID-19 has yet to be established. The middle aged and elderly population seem to be the most commonly affected with a median age of 49 - 56 years. COVID-19 is affects males more often than females. While the majority of COVID-19 cases were first reported in China, at this point the disease has spread to all the continents of the world.

Epidemiology and Demorgraphics

Incidence

  • Due to the lack of broad screening that includes the general population (including asymptomatic patients) and the lack of PCR and antibody tests with acceptable sensitivity and specificity, an accurate estimate of the incidence rate of Coronavirus disease 2019 (COVID-19) cannot be accurately estimated.

Prevalence

Case-fatality rate

  • Due to limited testing of asymptomatic individuals, the potential inaccuracies of early PCR tests and antibody tests, the inconsistent reporting and lack of organized data, an accurate case-fatality rate of COVID-19 has yet to be established.
  • The case fatality-rate of COVID-19 in the first 99 patients at a Wuhan hospital (the epicenter of the outbreak) was found to be 11% but this is likely an overestimate as it only included symptomatic cases.[7]
  • In a different study comprising of 138 patients infected with COVID-19, the mortality was 4.3%, but again this does not include asymptomatic cases.[8]
  • In Wuhan, the case-fatality was 5.8% while in the rest of China it was 0.7%.[9] Again these numbers do not include asymptomatic cases.
  • The CDC states "Lower estimates [0.6%] might be closest to the true value, but a broad range of 0.25%–3.0% probably should be considered."[10]

Age

  • COVID-19 can affect individuals of any age.
  • The middle aged and elderly population seem to be the most commonly affected.
  • In multiple cohorts of patients hospitalized with confirmed COVID-19, the median age ranges from 49 to 56 years.[11][12][13]
  • In a report including approximately 44,500 cases, 87% of the patients were between the ages of 30 and 79 years.[14]
  • According to the same report mentioned above, 2% of the patients were younger than the age of 20 years.
  • Children account for < 2% of COVID19 possibly due to lower expression of angiotensin-converting enzyme 2 (ACE2) in the respiratory system and other organs, the receptor the virus uses for entry into cells. ACE2 gene expression in the nasal epithelium is now shown to be lower as age decreased. This hypothesis has now found some support in this study showing children have lower ACE2 gene expression in the nasal epithelium, but the causal role has yet to be firmly established. More data is needed but this is provocative[15]

Racial predilection to COVID-19

  • In Baltimore/DC area, the COVID19 positivity rate for Latino patients was 42.6%, significantly higher than the rate for white patients (8.8%), black patients (17.6%), or those of other race/ethnicity (17.2%) (P < .001 for each pairwise comparison)[16]

Gender

  • COVID-19 affects males more often than females.[17][18]

Region

  • The majority of the early cases of COVID-19 were first reported in China and at this point the disease has spread to all the continents of the world.
  • In the United States, confirmed cases of COVID-19 have been reported in all of the 50 States.[19]
  • For real-time details regarding the worldwide spread of COVID-19, click here.[1][2][3][4][5]
  • For real-time details regarding the spread of COVID-19 in the US, click here.[20]

References

  1. ↑ 1.0 1.1 https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6. Missing or empty |title= (help)
  2. ↑ 2.0 2.1 Dong, Ensheng; Du, Hongru; Gardner, Lauren (2020). "An interactive web-based dashboard to track COVID-19 in real time". The Lancet Infectious Diseases. doi:10.1016/S1473-3099(20)30120-1. ISSN 1473-3099.
  3. ↑ 3.0 3.1 "WHO statement regarding cluster of pneumonia cases in Wuhan, China".
  4. ↑ 4.0 4.1 "Coronavirus disease 2019 (COVID-19) situation reports".
  5. ↑ 5.0 5.1 "Tracking the epidemic".
  6. ↑ Spellberg, Brad; Haddix, Meredith; Lee, Rebecca; Butler-Wu, Susan; Holtom, Paul; Yee, Hal; Gounder, Prabhu (2020). "Community Prevalence of SARS-CoV-2 Among Patients With Influenzalike Illnesses Presenting to a Los Angeles Medical Center in March 2020". JAMA. doi:10.1001/jama.2020.4958. ISSN 0098-7484.
  7. ↑ Huang, Chaolin; Wang, Yeming; Li, Xingwang; Ren, Lili; Zhao, Jianping; Hu, Yi; Zhang, Li; Fan, Guohui; Xu, Jiuyang; Gu, Xiaoying; Cheng, Zhenshun; Yu, Ting; Xia, Jiaan; Wei, Yuan; Wu, Wenjuan; Xie, Xuelei; Yin, Wen; Li, Hui; Liu, Min; Xiao, Yan; Gao, Hong; Guo, Li; Xie, Jungang; Wang, Guangfa; Jiang, Rongmeng; Gao, Zhancheng; Jin, Qi; Wang, Jianwei; Cao, Bin (2020). "Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China". The Lancet. doi:10.1016/S0140-6736(20)30183-5. ISSN 0140-6736.
  8. ↑ Wang, Dawei; Hu, Bo; Hu, Chang; Zhu, Fangfang; Liu, Xing; Zhang, Jing; Wang, Binbin; Xiang, Hui; Cheng, Zhenshun; Xiong, Yong; Zhao, Yan; Li, Yirong; Wang, Xinghuan; Peng, Zhiyong (2020). "Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China". JAMA. doi:10.1001/jama.2020.1585. ISSN 0098-7484.
  9. ↑ (PDF) https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf. Missing or empty |title= (help)
  10. ↑ Wilson, Nick; Kvalsvig, Amanda; Barnard, Lucy Telfar; Baker, Michael G. (2020). "Case-Fatality Risk Estimates for COVID-19 Calculated by Using a Lag Time for Fatality". Emerging Infectious Diseases. 26 (6). doi:10.3201/eid2606.200320. ISSN 1080-6040.
  11. ↑ Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B (February 2020). "Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China". Lancet. 395 (10223): 497–506. doi:10.1016/S0140-6736(20)30183-5. PMID 31986264.
  12. ↑ Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, Xia J, Yu T, Zhang X, Zhang L (February 2020). "Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study". Lancet. 395 (10223): 507–513. doi:10.1016/S0140-6736(20)30211-7. PMID 32007143 Check |pmid= value (help).
  13. ↑ Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X, Peng Z (February 2020). "Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China". JAMA. doi:10.1001/jama.2020.1585. PMID 32031570 Check |pmid= value (help).
  14. ↑ Wu Z, McGoogan JM (February 2020). "Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention". JAMA. doi:10.1001/jama.2020.2648. PMID 32091533 Check |pmid= value (help).
  15. ↑ Bunyavanich, Supinda; Do, Anh; Vicencio, Alfin (2020). "Nasal Gene Expression of Angiotensin-Converting Enzyme 2 in Children and Adults". JAMA. 323 (23): 2427. doi:10.1001/jama.2020.8707. ISSN 0098-7484.
  16. ↑ Martinez, Diego A.; Hinson, Jeremiah S.; Klein, Eili Y.; Irvin, Nathan A.; Saheed, Mustapha; Page, Kathleen R.; Levin, Scott R. (2020). "SARS-CoV-2 Positivity Rate for Latinos in the Baltimore-Washington, DC Region". JAMA. doi:10.1001/jama.2020.11374. ISSN 0098-7484.
  17. ↑ Li, Qun; Guan, Xuhua; Wu, Peng; Wang, Xiaoye; Zhou, Lei; Tong, Yeqing; Ren, Ruiqi; Leung, Kathy S.M.; Lau, Eric H.Y.; Wong, Jessica Y.; Xing, Xuesen; Xiang, Nijuan; Wu, Yang; Li, Chao; Chen, Qi; Li, Dan; Liu, Tian; Zhao, Jing; Liu, Man; Tu, Wenxiao; Chen, Chuding; Jin, Lianmei; Yang, Rui; Wang, Qi; Zhou, Suhua; Wang, Rui; Liu, Hui; Luo, Yinbo; Liu, Yuan; Shao, Ge; Li, Huan; Tao, Zhongfa; Yang, Yang; Deng, Zhiqiang; Liu, Boxi; Ma, Zhitao; Zhang, Yanping; Shi, Guoqing; Lam, Tommy T.Y.; Wu, Joseph T.; Gao, George F.; Cowling, Benjamin J.; Yang, Bo; Leung, Gabriel M.; Feng, Zijian (2020). "Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia". New England Journal of Medicine. doi:10.1056/NEJMoa2001316. ISSN 0028-4793.
  18. ↑ Yang, Yongshi; Peng, Fujun; Wang, Runsheng; Guan, Kai; Jiang, Taijiao; Xu, Guogang; Sun, Jinlyu; Chang, Christopher (2020). "The deadly coronaviruses: The 2003 SARS pandemic and the 2020 novel coronavirus epidemic in China". Journal of Autoimmunity: 102434. doi:10.1016/j.jaut.2020.102434. ISSN 0896-8411.
  19. ↑ https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html. Missing or empty |title= (help)
  20. ↑ https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html. Missing or empty |title= (help)
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