Analysis of Symptom Spectra and Associated Factors Among 536 Respondents During the COVID-19 Epidemic in China: A Cross-Sectional Study

Ye Wang,1,* Fenxiang Li,1,* Jian Liu,2 Jing Liu,3 Pei Qin,4 Jiayi Zhang,5 Yingtao Zhang,5 Shuning Wu6 1Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, People’s Republic of China; 2Department of General Surgery, Maternal and Child Health Hospital, Qingyuan, Guangdong, People’s Republic of China; 3Intensive Care Unit 1, The First Affiliated Hospital, Jinan University, Guangdong, Guangzhou, People’s Republic of China; 4Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, People’s Republic of China; 5Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, People’s Republic of China; 6Department of Thyroid and Breast Surgery, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yingtao Zhang, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 510000, People’s Republic of China, Tel +86 15918805867, Email zhangyt9@mail2.sysu.edu.cn Shuning Wu, Thyroid and Breast Surgical Department, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, 518067, People’s Republic of China, Tel +86 13480209989, Email jessica540wu@outlook.comPurpose: This study aims to identify common COVID-19 symptoms and asymptomatic infection rates during the epidemic in China. We also introduce the concepts of “Time-point asymptomatic rate” and “Period asymptomatic rate”.Object and Methods: A questionnaire survey was conducted online from December 2022 to January 5, 2023, collecting demographic characteristics, laboratory results, clinical symptoms, lifestyle and vaccination history. Statistical methods were used to analyze symptom characteristics, associated factors, and patterns during an 8-day observation period. Numerical variables were described by median M (Q1-Q3) or mean and standard deviation (). Categorical variables are described by frequency (N), ratio (%) or rate (%). The influencing factors were studied by Wilcoxon or Kruskal-Willis H rank sum test or logistic regression analysis, and the trend of symptom incidence by Spearman rank correlation. P value being ≤ 0.05 was statistically significant.Results: Out of 536 participants, 493 (91.98%) were infected, with 3 asymptomatic cases and 490 symptomatic cases within 8 days. The time-point asymptomatic rate increased from 0.61% on day 1 to 15.42% on day 8. Fever, cough, and fatigue were the main symptoms, with additional symptoms such as vomiting, diarrhea, and hyposmia reported. Symptom durations varied, with cough and expectoration lasting longer and vomiting and diarrhea lasting shorter. Several symptoms showed a downward trend over time.Conclusion: Our online survey highlighted that most COVID-19 patients experienced symptoms, and the time-point asymptomatic rate showed a dynamic change among the infected population. Onset patterns and demographic factors influence symptom occurrence and duration. These findings have implications for clinical practitioners and decision-makers in public health measures and strategies.Keywords: Novel coronavirus infection, onset patterns, clinical features, associated factors, time-point asymptomatic, period asymptomatic rate