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Severity among non-risk groups in Shanghai on Null_China.org.cn

A study on the course of the wave of omicron infection in the Chinese metropolis of Shanghai showed that symptoms are mild in almost all cases. Risk factors are old age and underlying diseases.

Shanghai’s largest makeshift hospital, converted from the National Convention & Exhibition Center, will be delivered on April 9, 2022 and can accommodate up to 50,000 beds. Photo: Xinhua.

A new study is the first to comprehensively describe the symptoms of Covid-19 patients who do not show a severe course of the disease. This group of people accounted for over 95% of all non-serious Covid cases in Shanghai. It demonstrates that a thorough and precise focus of medical resources on vulnerable populations can minimize the risk of overloading the regional health system.

Since the identification of the omicron variant in November 2021, this strain has become the leading cause of infections worldwide, with cases increasing exponentially in several countries. The variant’s high transmissibility has strained health resources, although the vast majority of cases are not serious.

A large cohort study led by leading Chinese epidemiologist Zhang Wenhong, conducted during the omicron outbreak by Fudan University Huashan Hospital National Medical Center for Infectious Diseases and the Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response between on 22 and 28 April 2019. The study, conducted in four hospitals in Shanghai on 11 March and 3 May 2022, describes the spectrum of clinical characteristics, risk factors for disease progression and dynamic changes in viral load in patients with omicron initially not severely infected. The study was published Saturday in the China CDC Weekly.

In Shanghai, 58,104 confirmed patients and 591,506 asymptomatic infections were reported on Sunday. According to the principle that all the needy are tested, those who test positive are quarantined, hospitalized or treated, all asymptomatic carriers, mild cases and medium cases were treated centrally.

All 33,816 study participants were diagnosed with a non-serious Covid-19 infection upon admission to hospital. They had no underlying disease or just one underlying disease, but their health was stable. According to the study, cough and phlegm were the most common symptoms in non-severe cases, followed by fatigue and fever. The mean persistence of symptoms was seven days. The mean time to viral spread (VST) was six days. Old age, comorbidities, and initial symptoms were associated with a longer VST, while full vaccination and booster vaccinations were associated with a shorter VST.

In the entire cohort, 22 patients developed severe or critical infections. All belonged to the high-risk group of patients over the age of 60 with stable underlying diseases (including cardiovascular disease, diabetes mellitus, lung disease, liver disease, cerebrovascular disease, or kidney disease) or an immunodeficiency such as infection with HIV.

The severity rates in all subjects and subjects in the risk group were 0.065% and 0.238%, respectively. The non-risk group severity rate was zero.

The study shows that older age, lack of vaccinations, and multiple underlying diseases increase the risk of serious or critical illness, meaning that even among those with minor infections, there are still people susceptible to the omicron variant.

Therefore, precise prevention and control measures should be implemented for vulnerable groups in order to reduce the mortality rate in these groups and reduce omicron harm to a lower level.

The study provides guidance for refining COVID-19 public health strategies to minimize the risk of overloading regional medical resources by accurately assessing Omicron’s severe disease trajectories in different populations.

The study suggests that the rate of severe disease and death in vulnerable populations can be significantly and gradually reduced if protective measures are taken in a timely manner. These include full vaccination, adequate protection for vulnerable groups, and immediate access to medical care soon after infection.

When medical resources are fully and precisely focused on the vulnerable population and the non-vulnerable group receives adequate primary care, the distribution of medical resources will be optimized and the diagnosis and treatment of other diseases will not be lost due to the outbreaks of Covid-19, according to the study.

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