Studies say COVID-19 may have been in the United States as early as December | Nation / World

New data from San Jose, California-Los Angeles medical records suggest that COVID-19 may have spread in the United States even before China notified the World Health Organization of the first outbreak of an unidentified virus. Is shown. University of Washington.

In a study published Thursday at the Journal of Medical Internet Research, a team of nine researchers compared electronic medical records from the UCLA health system from this winter to the last five years to outpatients and emergency rooms. Highly visited, hospitalized for “cough” and acute respiratory failure starting the week of December 22, 2019.

Then until the end of February — a span of 10 weeks — they estimated that there were 1,047 more outpatient visits, 514 emergency clinic visits, and 387 more hospitalizations than their model expected, “SARS-CoV-2 clinical”. To establish awareness and testing capabilities, “the researchers wrote.

The first confirmed case of the virus in the United States was January 21, about three weeks after China first notified WHO of what it called “unexplained pneumonia.” It was revealed that the first American death from the virus this spring occurred in Santa Clara County much earlier than previously known on February 6.

However, no diagnostic tests were performed on patients with UCLA, so it is not possible to know the exact extent to which undiagnosed cases of COVID-19 explain the surge in data.

“Asymptomatic infections and the spread of COVID-19 in the community may be an explanation for the observed excess patient encounters, but other reasons and limitations need to be considered.” The researchers wrote.

Some other reasons are for particularly strong peaks early in the 2019 flu season in Los Angeles, mysterious vaping disease in 2019, or perhaps COVID-like symptoms after getting media coverage in February. Researchers said there could be more people seeking medical advice.

According to the Centers for Disease Control and Prevention, researchers believed that influenza could not explain the pure prevalence of overvisit based on a model of the influenza season over the past few years. The media was also an unlikely explanation, as the coronavirus did not begin to receive serious attention in the United States until February, the researchers said.

Compared to the worst flu season of the last five years, researchers have found hundreds more cases of “cough” reported in clinics and emergency rooms in the city. Outpatient coughs totaled 1,671 in 2016-17, compared to 2,938 in 2019-20.

Acute respiratory failure, a common symptom of COVID-19, has also increased in inpatients from the worst in the last five years, despite a decrease in overall hospitalization. Between December 2018 and February 2019, there were a total of 10,646 hospitalizations, including 996 for acute respiratory failure. During the same period in 2019-20, the number of patients with acute respiratory failure increased to 1,138, despite a reduction in overall hospitalization to 9,903.

“Some of this excess may represent early COVID-19 disease,” the researchers wrote.

They set out to use millions of electronic health records to identify previously undiscovered cases of the virus. The UCLA Health System provided records of 9.5 million outpatients, 575,000 emergency outpatients, and approximately 250,000 inpatients from January 2014 to February 2020.

Researchers used data from the last five years to determine the seasonal average for December-February, compared it to this year’s data, and overvisited outside the 95% interval of what was expected during that period. I checked the number.

We examined data for 13 weeks from the beginning of December to the end of February.

There was no increase in the first three weeks of December, but from the week of December 22, the number of outpatient reports of cough symptoms exceeded that interval for all the next ten weeks. Visits to the emergency room exceeded that interval in 6 out of 10 weeks, but hospitalization was more than 7 weeks.

“A unique feature of this study is the assessment of three different stages of the healthcare environment,” the researchers wrote. “Data from outpatient settings are usually a precursor to what will be brought to the emergency department or intensive care unit of a hospital.”

Their methodology, which focuses on searching for the word “cough” because of a visit on an electronic medical record, may seem inaccurate, but the researchers found COVID-19 patients.

The term “cough” may be more specific to COVID-19 than other symptoms such as “fever” or “pain”, but this search method does not include a complete spectrum of COVID-19 symptoms. Incomplete specificity and sensitivity. “Researchers wrote.

This study does not capture asymptomatic patients, which are said to account for 40% of all cases, but only represent images of a single medical system.

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