Laboratory results showed that there were significant differences in white blood cell counts, absolute values of lymphocytes, platelets, albumin, total bilirubin, blood urea nitrogen, blood creatinine, myoglobin, cardiac troponin, C-reactive protein (CRP) and interleukin-6 (IL-6) between those who died from COVID-19 and those who survived.

Laboratory Results of COVID-19 Patients in Wuhan, China

The distribution of survival time from disease onset to death showed two peaks, with the first one at approximately 14 days (22 cases) and the second one at approximately 22 days (17 cases).

Survival Times of Patients with COVID-19 in Wuhan, China

- Of the 228 cases with known outcomes, the estimated median time to recovery was 20.8 days (95% CI: 20.1-21.5).
 - The estimated median time to recovery of cases aged 50-59 years was 22.4 days (95% CI: 20.8-24.1).
- Cases that presented with severe symptoms were had a 41% (95% CI: 24-60) longer time of recovery when compared to those presenting with mild symptoms.


Time to Recovery for COVID-19 Cases in Shenzhen, China

Laboratory tests were performed on hospital admission of healthcare workers, 19 of  80 (23.75%) COVID-19 patients showed reduced white blood cells and 38 (47.5%) showed reduced lymphocytes.
The platelet and D-dimer levels were within normal range. 
12 (15%) healthcare workers with COVID-19 showed prolonged prothrombin time, and 13 (26.53%) showed shortened activated partial thromboplastin time.
19 (23.75%) patients showed increased serum creatinine level, and 30 (37.5%) had decreased creatine kinase (CK)
Levels of lactate dehydrogenase (LDH), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were increased in 37 (46.25%), 14 (17.5%), and 21 (26.25%) patients respectively.

Laboratory Results of Healthcare Workers with COVID-19 in Wuhan, China

- Journal of Hospital Infection
- The Lancet
- medRxiv
- Journal of the American Medical Association (JAMA)
- MMWR
- Journal of Medical Virology 

Laboratory Result of COVID-19 Patient References by Journal

In order to determine prior infection with SARS-CoV-2, the virus that causes COVID-19, some testing locations have offered testing for SARS-CoV-2 antibodies. A positive test result indicates you may have antibodies from an infection with the virus that causes COVID-19, or from infection with a related virus from the same family of viruses.

It is not yet known if having antibodies to the virus that causes COVID-19 can protect someone from getting infected again or, if they do, how long this protection might last.

SARS-CoV-2 Antibody Testing

Correctional and detention facilities are disproportionately burdened by the COVID-19 pandemic. Early detection and proper care for persons with SARS-Cov-2 is essential to slow transmission within these facilities. This study conducted in partnership with the Louisiana Department of Health and CDC, evaluated the effectiveness of serial testing to identify people with SARS-CoV-2 infection. This MMWR report investigated the serial laboratory testing following a staff member in a facility in Louisiana who developed symptoms on March 29, 2020. Two additional staff members tested positive in early April, and the first case in an incarcerated person was detected on April 7. From May 7-21, 98 incarcerated and detained people were tested for SARS-CoV-2, of which 71 tested positive. 

Serial Laboratory Testing for SARS-CoV-2 Infection Among Incarcerated and Detained Persons in a Correctional and Detention Facility — Louisiana, April–May 2020

Cured COVID-19 patients are testing positive again for SARS‐CoV‐2 RNA in China. Discharged patients who are asymptomatic end up testing positive. Often times, it is unclear whether a person who has tested positive again is contagious or not. Testing positive twice does not specifically show the presence of virus replicating or being transmissible.

COVID-19 Patients in China Testing Positive Twice

COVID-19 patients have gone through laboratory testing to determine the impact and extent of SARS-CoV-2 on the body.

University of Michigan - Ann Arbor

- Case Demographics of Patients
- Categorized by Geographic Location
- Communicable Period
- Control Strategies
- Disparate COVID-19 Outcomes
- Fatality
- Interventions
- Patient Comorbidities
- Patient Laboratory Results
- Psychological effects
- Recovery & Rehabilitation
- Re-opening of Childcare/ Educational Environments
- Secondary Infections
- Signs
- Symptomology
- Time from Onset to Reporting
- Telehealth (telemedicine)
- Transmission
- Risk Factors
- COVID-19 Vaccination Uptake

Focuses of Epidemiological studies on COVID-19

Due to differences in testing and case definitions, as well as how new COVID-19 is, the fatality of the virus is not well-defined yet.

Fatality of COVID-19

Countries have implemented multiple control strategies for reducing the spread of COVID-19, such as closing schools and businesses to enforce social distancing.

Struggle pertaining to controlling the virus:
The epidemiology of the respiratory virus changes rapidly. Reponses have to be nimble. Given that everyone is susceptible to for which we lack effective biologic interventions, the response has required large-scale behavior change, including social distancing and public masking.

Control Strategies for COVID-19

- Age
- Education
- Employment
- Ethnicity
- Gender
- Income
- Marital status
- Race





Case Demographics of Patients with COVID-19

- Asia
- Africa 
- North America
- South America
- Europe
- Australia & Oceania 

Epidemiological studies on COVID-19 Categorized by Continents

The progression of COVID-19 varies greatly by individual and demographic, as do many of the factors related to the disease. Studies have been analyzing the disease progression timeline, or the time frames before patients feel symptoms, are admitted to the hospital, are admitted to the ICU, are put on a mechanical ventilator, experience acute respiratory distress syndrome, etc. Not every COVID-19 case will reach each of these events.

COVID-19 Clinical Disease Progression Timeline

- 0-19 (n=123): 0%
- 20-44 (n=705): 0.1–0.2%
- 45-54 (n=429): 0.5–0.8%
- 55-64 (n=429): 1.4–2.6%
- 65-74 (n=409): 2.7–4.9%
- 75-84 (n=210): 4.3–10.5%
- greater than or equal to 85 (n=144): 10.4–27.3%
- Total (n=2,449): 1.8–3.4%

Case-Fatality Among COVID-19 Patients in the United States by Age

Following a primary infection of SARS-CoV-2, some patients acquire a secondary infection of SARS-CoV-2, or a co-infection with a different bacteria or virus

Secondary/Co-Infections of COVID-19

COVID-19 Laboratory Results

The spread of the SARS-CoV-2 virus has produced or highlighted disparate outcomes of different types between population groups all over the world. Health disparities can highlight inequitable access, treatment, etc. within a country or state and often indicate the need for public health intervention.

Disparate COVID-19 Outcomes

Due to the varying experiences for those with COVID-19, recovery and rehabilitation look different for many individuals. As a baseline, "for persons recovered from COVID-19 illness, CDC recommends that isolation be maintained for at least 10 days after illness onset and at least 3 days (72 hours) after recovery. Illness onset is defined as the date symptoms begin. Recovery is defined as resolution of fever without the use of fever-reducing medications with progressive improvement or resolution of other symptoms. Ideally, isolation should be maintained for this full period to the extent that it is practicable under rapidly changing circumstances."

COVID-19 Recovery & Rehabilitation

- Resuscitation
- Convalescent Plasma (CP) Transfusion

COVID-19 Patient Interventions

The seroprevalence of COVID-19 is the measurement of the level of the pathogen in a population. There have been difficulties with estimating the seroprevalence in large populations because of the unknown qualities of COVID-19, expense in widespread population collection, asymptomatic infection, etc.

Seroprevalence of SARS-CoV-2 (COVID-19) 

A communicable period is defined as the interval from the first day of positive ribonucleic acid test to the first day of continuous negative test. For COVID-19, the communicable period has been established as two days before onset of symptoms until three days of symptom relief and no fever. 

Communicable Period of COVID-19

- Fever (when high temperature is measured)
- Laboratory confirmation of illness via viral testing
- Radiological lung abnormalities such as ground-glass chest and stripe shadowing


Clinical Characteristics of Asymptomatic COVID-19 Patients

Telehealth are health-related services and information through electronic communication technologies to help patients with or people influenced by COVID-19. It allows long-distance patient and clinician care, education, and monitoring. Telemedicine is sometimes used as a synonym, or is used in a more limited sense to describe remote clinical services, such as diagnosis and monitoring. 

Telehealth (telemedicine) and COVID-19

Presence and severity of symptoms of COVID-19 depend largely on individual characteristics. COVID-19 produces both symptomatic and asymptomatic infection.

Symptomology of COVID-19 

The psychological effect COVID-19 is having on the populations affected by the pandemic

Psychological Effects of COVID-19 Pandemic

COVID-19 comorbidities are high risk conditions that put patients at greater risk for infection and negative outcomes. Some COVID-19 comorbidities have been found to be: 
- Cancer 
- Cardiovascular Disease
- Diabetes
- Digestive Diseases
- HIV
- Hypertension
- Immunological Disease
- Liver Injury
- Obesity
- Renal disease
- Respiratory System Disease

COVID-19 Patient Comorbidities

- Schools (K-12)

- Universities/Colleges

- Summer Camps

- Daycares

- Nurseries

Re-opening Childcare/ Educational Environments

COVID-19 is spread through person-to-person transmission. The virus spreads mainly through close personal contact (such as when people are within 6 feet of one another) and through the respiratory droplets of someone infected with COVID-19.  Aerosol transmission is also likely, but the relative contribution of these smaller respiratory particles is not completely understood. While less common, spreading can also occur when people touch contaminated objects or surfaces and then their faces, eyes, or mouth. 

Transmission of COVID-19

- smoking
- high BMI
- old age
- congregate housing
- environmental conditions
- Immune system conditions

Risk Factors For COVID-19

We can explore factors that affect the uptake of established adult vaccinations to inform efforts of COVID-19 vaccine acceptance. 

- Social Factors 
- Knowledge, Attitudes, and Beliefs
- Racial Factors
- Age

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