J Korean Med Sci.  2020 Aug;35(30):e280. 10.3346/jkms.2020.35.e280.

Clinical Course and Outcomes of 3,060 Patients with Coronavirus Disease 2019 in Korea, January–May 2020

Affiliations
  • 1National Emergency Medical Center, National Medical Center, Seoul, Korea
  • 2Division of Infectious Diseases, Department of Internal Medicine, Incheon Medical Center, Incheon, Korea
  • 3Department of Pulmonology, Busan Medical Center, Busan, Korea
  • 4Department of Tuberculosis, Seoul Metropolitan Seobuk Hospital, Seoul, Korea
  • 5Department of Orthopedic Surgery, Seoul Metropolitan Seonam Hospital, Seoul, Korea
  • 6Department of Laboratory Medicine, Chungju Medical Center, Chungju, Korea
  • 7Department of Internal Medicine, Gyeonggi Provincial Medical Center Ansung Hospital, Anseong, Korea
  • 8Department of Infection Control, Chungcheongnam-do Gongju Medical Center, Gongju, Korea
  • 9Division of Infectious Disease, Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Korea
  • 10Department of Infection Control, Chungcheongnam-do Seosan Medical Center, Seosan, Korea
  • 11Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea
  • 12Department of Nursing, Yeongju Red Cross Hospital, Yeongju, Korea
  • 13Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
  • 14Department of Surgery, Gyeonggi Provincial Medical Center Uijeongbu Hospital, Uijeongbu, Korea
  • 15Division of Infectious Disease, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
  • 16Department of Internal Medicine, Korea Workers’ Compensation & Welfare Services Daegu Hospital, Daegu, Korea
  • 17Division of Infectious Diseases, Department of Internal Medicine, Myongji Hospital, Goyang, Korea
  • 18Department of Internal Medicine, Chungcheongnam-do Cheonan Medical Center, Cheonan, Korea
  • 19Division of Infectious Diseases, Department of Internal Medicine, Seoul Medical Center, Seoul, Korea
  • 20Department of Internal Medicine, Jeonllanam-do Suncheon Medical Center, Suncheon, Korea
  • 21Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
  • 22Infection Control Team, Cheongju Medical Center, Cheongju, Korea
  • 23Division of Infectious Diseases, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
  • 24Division of Infectious Diseases, Department of Internal Medicine, Keimyung University Dongsan Hospital, Daegu, Korea
  • 25Intensive Care Team, Gyeonggi Provincial Medical Center Paju Hospital, Paju, Korea
  • 26Infection Control Team, Gyeonggi Provincial Medical Center Icheon Hospital, Icheon, Korea
  • 27Infection Control Team, Korea Worker's Compensation & Welfare Service Changwon Hospital, Changwon, Korea
  • 28National Medical Center, Seoul, Korea
  • 29Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea

Abstract

Background
The fatality rate of patients with coronavirus disease 2019 (COVID-19) varies among countries owing to demographics, patient comorbidities, surge capacity of healthcare systems, and the quality of medical care. We assessed the clinical outcomes of patients with COVID-19 during the first wave of the epidemic in Korea.
Methods
Using a modified World Health Organization clinical record form, we obtained clinical data for 3,060 patients with COVID-19 treated at 55 hospitals in Korea. Disease severity scores were defined as: 1) no limitation of daily activities; 2) limitation of daily activities but no need for supplemental oxygen; 3) supplemental oxygen via nasal cannula; 4) supplemental oxygen via facial mask; 5) non-invasive mechanical ventilation; 6) invasive mechanical ventilation; 7) multi-organ failure or extracorporeal membrane oxygenation therapy; and 8) death. Recovery was defined as a severity score of 1 or 2, or discharge and release from isolation.
Results
The median age of the patients was 43 years of age; 43.6% were male. The median time from illness onset to admission was 5 days. Of the patients with a disease severity score of 3–4 on admission, 65 (71.5%) of the 91 patients recovered, and 7 (7.7%) died due to illness by day 28. Of the patients with disease severity scores of 5–7, 7 (19.5%) of the 36 patients recovered, and 8 (22.2%) died due to illness by day 28. None of the 1,324 patients who were < 50 years of age died; in contrast, the fatality rate due to illness by day 28 was 0.5% (2/375), 0.9% (2/215), 5.8% (6/104), and 14.0% (7/50) for the patients aged 50–59, 60–69, 70–79, and ≥ 80 years of age, respectively.
Conclusion
In Korea, almost all patients of < 50 years of age with COVID-19 recovered without supplemental oxygen. In patients of ≥ 50 years of age, the fatality rate increased with age, reaching 14% in patients of ≥ 80 years of age.

Keyword

COVID-19; SARS-CoV-2; Prognosis; Cohort Study; Korea
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