Public Health England, 61 Colindale Avenue, London, NW9 5EQ, England.
Public Health England, Liverpool, England.
Bull World Health Organ. 2021 Mar 1;99(3):178-189. doi: 10.2471/BLT.20.265603. Epub 2020 Nov 30.
To describe the clinical presentation, course of disease and health-care seeking behaviour of the first few hundred cases of coronavirus disease 2019 (COVID-19) in the United Kingdom of Great Britain and Northern Ireland.
We implemented the World Health Organization's First Few X cases and contacts investigation protocol for COVID-19. Trained public health professionals collected information on 381 virologically confirmed COVID-19 cases from 31 January 2020 to 9 April 2020. We actively followed up cases to identify exposure to infection, symptoms and outcomes. We also collected limited data on 752 symptomatic people testing negative for COVID-19, as a control group for analyses of the sensitivity, specificity and predictive value of symptoms.
Approximately half of the COVID-19 cases were imported (196 cases; 51.4%), of whom the majority had recent travel to Italy (140 cases; 71.4%). Of the 94 (24.7%) secondary cases, almost all reported close contact with a confirmed case (93 cases; 98.9%), many through household contact (37 cases; 39.8%). By age, a lower proportion of children had COVID-19. Most cases presented with cough, fever and fatigue. The sensitivity and specificity of symptoms varied by age, with nonlinear relationships with age. Although the proportion of COVID-19 cases with fever increased with age, for those with other respiratory infections the occurrence of fever decreased with age. The occurrence of shortness of breath also increased with age in a greater proportion of COVID-19 cases.
The study has provided useful evidence for generating case definitions and has informed modelling studies of the likely burden of COVID-19.
描述英国首批数百例 2019 年冠状病毒病（COVID-19）病例的临床表现、病程和就医行为。
我们实施了世界卫生组织针对 COVID-19 的首批数例病例和接触者调查方案。经过培训的公共卫生专业人员从 2020 年 1 月 31 日至 2020 年 4 月 9 日期间收集了 381 例经病毒学确诊的 COVID-19 病例的信息。我们积极对病例进行随访，以确定感染暴露、症状和结局。我们还对 752 例症状检测为 COVID-19 阴性的症状性人群收集了有限的数据，作为对症状的敏感性、特异性和预测值进行分析的对照组。
大约一半的 COVID-19 病例为输入性病例（196 例；51.4%），其中大多数有近期意大利旅行史（140 例；71.4%）。在 94 例（24.7%）继发性病例中，几乎所有病例都报告与确诊病例有密切接触（93 例；98.9%），许多是通过家庭接触（37 例；39.8%）。按年龄来看，儿童的 COVID-19 比例较低。大多数病例表现为咳嗽、发热和乏力。症状的敏感性和特异性因年龄而异，与年龄呈非线性关系。尽管 COVID-19 病例发热的比例随年龄增加而增加，但对于其他呼吸道感染，发热的发生率随年龄降低。呼吸急促的发生也随 COVID-19 病例年龄的增加而增加。
本研究为制定病例定义提供了有用的证据，并为 COVID-19 可能负担的建模研究提供了信息。
