Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, People's Republic of China.
State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, People's Republic of China.
BMC Infect Dis. 2022 Aug 5;22(1):674. doi: 10.1186/s12879-022-07660-4.
To quantitatively assess the impact of the onset-to-diagnosis interval (ODI) on severity and death for coronavirus disease 2019 (COVID-19) patients.
This retrospective study was conducted based on the data on COVID-19 cases of China over the age of 40 years reported through China's National Notifiable Infectious Disease Surveillance System from February 5, 2020 to October 8, 2020. The impacts of ODI on severe rate (SR) and case fatality rate (CFR) were evaluated at individual and population levels, which was further disaggregated by sex, age and geographic origin.
As the rapid decline of ODI from around 40 days in early January to < 3 days in early March, both CFR and SR of COVID-19 largely dropped below 5% in China. After adjusting for age, sex, and region, an effect of ODI on SR was observed with the highest OR of 2.95 (95% CI 2.37‒3.66) at Day 10-11 and attributable fraction (AF) of 29.1% (95% CI 22.2‒36.1%) at Day 8-9. However, little effect of ODI on CFR was observed. Moreover, discrepancy of effect magnitude was found, showing a greater effect from ODI on SR among patients of male sex, younger age, and those cases in Wuhan.
The ODI was significantly associated with the severity of COVID-19, highlighting the importance of timely diagnosis, especially for patients who were confirmed to gain increased benefit from early diagnosis to some extent.
定量评估发病至诊断间隔（ODI）对 2019 年冠状病毒病（COVID-19）患者严重程度和死亡的影响。
本回顾性研究基于中国国家法定传染病监测系统报告的 2020 年 2 月 5 日至 2020 年 10 月 8 日年龄在 40 岁以上的 COVID-19 病例数据。在个体和人群水平上评估 ODI 对严重率（SR）和病死率（CFR）的影响，并按性别、年龄和地理来源进行细分。
随着 ODI 从 1 月初的约 40 天迅速下降到 3 月初的<3 天，中国的 CFR 和 SR 均大幅下降到 5%以下。在调整年龄、性别和地区后，观察到 ODI 对 SR 有影响，第 10-11 天的最高比值比（OR）为 2.95（95%CI 2.37-3.66），第 8-9 天的归因分数（AF）为 29.1%（95%CI 22.2-36.1%）。然而，ODI 对 CFR 的影响较小。此外，还发现影响幅度的差异，表明 ODI 对男性、年轻患者和武汉病例的 SR 影响更大。
ODI 与 COVID-19 的严重程度显著相关，强调了及时诊断的重要性，特别是对那些在一定程度上从早期诊断中获得更多益处的患者。
