The Impact of Active Screening and Management on COVID-19 in Plateau Region of Sichuan, China

Jia-Jie Lu; Guo-Guo Jiang; Xiang He; Kai-Ju Xu; Hong Yang; Rui Shi; Ying Chen; Yu-Yao Tan; Lang Bai; Hong Tang; Guo-Ping Li

doi:10.3389/fmed.2022.850736

The Impact of Active Screening and Management on COVID-19 in Plateau Region of Sichuan, China

Front Med (Lausanne). 2022 May 10:9:850736. doi: 10.3389/fmed.2022.850736. eCollection 2022.

Authors

Jia-Jie Lu¹, Guo-Guo Jiang², Xiang He^{3

4}, Kai-Ju Xu⁵, Hong Yang⁶, Rui Shi^{1

6}, Ying Chen⁶, Yu-Yao Tan⁶, Lang Bai¹, Hong Tang¹, Guo-Ping Li^{3

4}

Affiliations

¹ Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, China.
² Department of Hospital Infection Management, Chengdu Second People Hospital, Chengdu, China.
³ Laboratory of Allergy and Precision Medicine, Chengdu Institute of Respiratory Health, the Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China.
⁴ Department of Pulmonary and Critical Care Medicine, Chengdu Third People's Hospital Branch of National Clinical Research Center for Respiratory Disease, Affiliated Hospital of ChongQing Medical University, Chengdu, China.
⁵ Department of Infectious Diseases, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China.
⁶ People's Hospital of Ganzi Tibetan Autonomous Prefecture, Ganzi Tibetan Autonomous Prefecture, Kangding, China.

Abstract

Background: In December 2019, the cases of pneumonia of unknown etiology emerged in Wuhan, China, and rapidly spread throughout the country. The disease was later designated by the World Health Organization (WHO) as Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS CoV-2). Few studies have assessed the clinical characteristics of COVID-19 and control strategies used to mitigate disease spread in high-altitude plateau regions of China.

Study objective: To assess the impact of real-world strategies to control COVID-19 spread in remote plateau regions.

Methods: A retrospective study was performed to assess the epidemiology of COVID-19 and strategies used to control disease spread in the high-altitude plateau of Sichuan, China from 24 January 2020 to 19 March 2020.

Results: COVID-19 spread and outbreaks in Sichuan were attributed to mass gatherings. A total of 70 patients and 20 asymptomatic individuals were found in the hypoxic plateau region of Sichuan. Twelve patients were admitted after the onset of symptoms, while 58 patients and 20 asymptomatic individuals were found by active screening. The symptomatic patients included those with uncomplicated illness (16/70, 22.9%), mild pneumonia (44/70, 62.9%), and severe pneumonia (10/70, 14.3%). Most patients in the study area showed relatively mild and atypical symptoms such as low or no fever and dyspnea. The incidence of severe pneumonia, fever, dyspnea, and interstitial abnormalities identified by chest CT were all significantly lower in screened patients than those admitted after symptom onset (P < 0.05). Severe pneumonia was noted in patients with chronic conditions like hypertension, diabetes etc. as compared to less severe pneumonia in healthy subjects (P <0.05). No patients died and all were eventually discharged.

Conclusion: Mass gatherings increased risk of spread of SARS-CoV-2 responsible for COVID-19. Active screening and early management have collectively contributed to reduced incidence of severe pneumonia and satisfactory prognoses of infections with COVID-19 in this hypoxic plateau region.

Keywords: COVID-19; clinical characteristics; control strategies; hypoxic plateau area; severe pneumonia.