Duration of symptom onset to hospital admission and admission to discharge or death in SARS in mainland China: a descriptive study.
OBJECTIVE
To describe and analyse factors associated with the duration of disease onset to hospital admission, admission to discharge and admission to death for severe acute respiratory syndrome (SARS), using the recently developed comprehensive database covering all regions of mainland China, and compare the results within and outside China.


METHODS
The database included all probable 5327 SARS cases, of whom 343 died. Linear regression (uni- and multivariate analysis) was performed for all three durations to test the impact of the following variables: sex, age, occupation, geographic location and period of the SARS epidemic (time since the first case, i.e. 16 November 2002).


RESULTS
The average duration of onset of symptoms to hospital admission was 3.8 days, of admission to discharge for those who survived was 29.7 days, while admission to death for casualties was 17.4 days. Health care workers, patients from Tianjin and patients infected towards the end of the epidemic had the shortest duration of onset to admission. Regarding admission to discharge, particularly young patients and patients from Guangdong had the shortest duration. Older age was the sole factor associated with shorter duration of admission to death.


CONCLUSIONS
The average duration and pattern (with time of epidemic and age) of onset of symptoms to hospital admission of SARS patients in mainland China were comparable to other affected areas. The duration of hospital admission to discharge was shorter than elsewhere, possibly because of different hospitalisation policies. The duration of hospital admission to death in mainland China, however, appeared to be shorter than in other areas, which is in striking contrast to the much lower case fatality in mainland China.
Feng
Dan
D
Beijing Institute of Microbiology and Epidemiology, State Key Laboratory of Pathogen and Biosecurity, Beijing, P.R. China.
Jia
Na
N
Fang
Li-Qun
LQ
Richardus
Jan Hendrik
JH
Han
Xiao-Na
XN
Cao
Wu-Chun
WC
de Vlas
Sake J
SJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002681:China; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010351:Patient Discharge / Q000706:statistics & numerical data*; D040442:Public Health Informatics; D045169:Severe Acute Respiratory Syndrome / Q000401:mortality*; D013997:Time Factors; D055815:Young Adult