{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T07:19:41Z","timestamp":1768547981791,"version":"3.49.0"},"posted":{"date-parts":[[2020,10,27]]},"group-title":"Infectious Diseases (except HIV\/AIDS)","reference-count":30,"publisher":"openRxiv","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2020,10,27]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:p>Early identification of symptoms and comorbidities most predictive of COVID-19 is critical to identify infection, guide policies to effectively contain the pandemic, and improve health systems\u2019 response. Here, we characterised socio-demographics and comorbidity in 3,316,107persons tested and 219,072 persons tested positive for SARS-CoV-2 since January 2020, and their key health outcomes in the month following the first positive test. Routine care data from primary care electronic health records (EHR) from Spain, hospital EHR from the United States (US), and claims data from South Korea and the US were used. The majority of study participants were women aged 18-65 years old. Positive\/tested ratio varied greatly geographically (2.2:100 to 31.2:100) and over time (from 50:100 in February-April to 6.8:100 in May-June). Fever, cough and dyspnoea were the most common symptoms at presentation. Between 4%-38% required admission and 1-10.5% died within a month from their first positive test. Observed disparity in testing practices led to variable baseline characteristics and outcomes, both nationally (US) and internationally. Our findings highlight the importance of large scale characterization of COVID-19 international cohorts to inform planning and resource allocation including testing as countries face a second wave.<\/jats:p>","DOI":"10.1101\/2020.10.25.20218875","type":"posted-content","created":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T15:40:16Z","timestamp":1603813216000},"source":"Crossref","is-referenced-by-count":6,"title":["Baseline phenotype and 30-day outcomes of people tested for COVID-19: an international network cohort including &gt;3.32 million people tested with real-time PCR and &gt;219,000 tested positive for SARS-CoV-2 in South Korea, Spain and the United States"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4243-155X","authenticated-orcid":false,"given":"Asieh","family":"Golozar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0485-0956","authenticated-orcid":false,"given":"Lana YH","family":"Lai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8630-5347","authenticated-orcid":false,"given":"Anthony G.","family":"Sena","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0248-7636","authenticated-orcid":false,"given":"David","family":"Vizcaya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6878-189X","authenticated-orcid":false,"given":"Lisa M.","family":"Schilling","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0709-6573","authenticated-orcid":false,"given":"Vojtech","family":"Huser","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0892-5668","authenticated-orcid":false,"given":"Fredrik","family":"Nyberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4898-3865","authenticated-orcid":false,"given":"Scott L.","family":"Duvall","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel R.","family":"Morales","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5630-2468","authenticated-orcid":false,"given":"Thamir M","family":"Alshammari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9139-5452","authenticated-orcid":false,"given":"Hamed","family":"Abedtash","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waheed-Ul-Rahman","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6743-803X","authenticated-orcid":false,"given":"Osaid","family":"Alser","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8234-5843","authenticated-orcid":false,"given":"Heba","family":"Alghoul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengchun","family":"Gong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yin","family":"Guan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4668-7069","authenticated-orcid":false,"given":"Carlos","family":"Areia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9912-2344","authenticated-orcid":false,"given":"Jitendra","family":"Jonnagaddala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6219-1653","authenticated-orcid":false,"given":"Karishma","family":"Shah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer C.E.","family":"Lane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert","family":"Prats-Uribe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose D.","family":"Posada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nigam H.","family":"Shah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vignesh","family":"Subbian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Tereza","family":"Fernandes Abrah\u00e3o","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0621-1979","authenticated-orcid":false,"given":"Peter R.","family":"Rijnbeek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seng Chan","family":"You","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula","family":"Casajust","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1964-3546","authenticated-orcid":false,"given":"Elena","family":"Roel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2256-618X","authenticated-orcid":false,"given":"Martina","family":"Recalde","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Fern\u00e1ndez-Bertol\u00edn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Andryc","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason A.","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6305-735X","authenticated-orcid":false,"given":"Adam B.","family":"Wilcox","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Fortin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2570-2124","authenticated-orcid":false,"given":"Clair","family":"Blacketer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5810-8298","authenticated-orcid":false,"given":"Frank","family":"DeFalco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karthik","family":"Natarajan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6904-1394","authenticated-orcid":false,"given":"Thomas","family":"Falconer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Spotnitz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0847-6682","authenticated-orcid":false,"given":"Anna","family":"Ostropolets","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2664-7614","authenticated-orcid":false,"given":"George","family":"Hripcsak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9818-479X","authenticated-orcid":false,"given":"Marc","family":"Suchard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristine E.","family":"Lynch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3217-4147","authenticated-orcid":false,"given":"Michael E.","family":"Matheny","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Williams","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3641-055X","authenticated-orcid":false,"given":"Christian","family":"Reich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8274-0357","authenticated-orcid":false,"given":"Talita","family":"Duarte-Salles","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2595-8736","authenticated-orcid":false,"given":"Kristin","family":"Kostka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick B.","family":"Ryan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3950-6346","authenticated-orcid":false,"given":"Daniel","family":"Prieto-Alhambra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2020103016001135000_2020.10.25.20218875v1.1","unstructured":"John Hopkins University. COVID-19 Dashboard by the Center for Systems Science and Engineering at Johns Hopkins University 2020 [Available from: https:\/\/coronavirus.jhu.edu\/map.html accessed September 26 2020."},{"key":"2020103016001135000_2020.10.25.20218875v1.2","unstructured":"World Health Organization (WHO). Critical preparedness, readiness and response actions for COVID-19: Interim guidance. Updated June 24, 2020. 2020 [Available from: https:\/\/www.who.int\/publications\/i\/item\/critical-preparedness-readiness-and-response-actions-for-covid-19 accessed September 26 2020."},{"key":"2020103016001135000_2020.10.25.20218875v1.3","unstructured":"Max R , Hannah R , Esteban O , et al. COVID-19 testing policies. Published online at OurWorldInData.org 2020 [Available from: https:\/\/ourworldindata.org\/grapher\/covid-19-testing-policy accessed September 24 2020."},{"key":"2020103016001135000_2020.10.25.20218875v1.4","unstructured":"Mailonline. What\u2019s really behind Britain\u2019s testing fiasco? 2020 [Available from: https:\/\/www.dailymail.co.uk\/news\/article-8734923\/Whats-REALLY-Britains-coronavirus-testing-fiasco.html accessed September 24 2020."},{"key":"2020103016001135000_2020.10.25.20218875v1.5","doi-asserted-by":"crossref","unstructured":"Subbian V , Solomonides A , Clarkson M , et al. Ethics and Informatics in the Age of COVID-19: Challenges and Recommendations for Public Health Organization and Public Policy [published Online ahead of print, 2020 Jul 28]. J Am Med Inform Assoc 2020;ocaa188 2020.","DOI":"10.1093\/jamia\/ocaa188"},{"key":"2020103016001135000_2020.10.25.20218875v1.6","unstructured":"Max R , Hannah R , Esteban O , et al. Coronavirus Pandemic (COVID-19). Published online at OurWorldInData.org. 2020 [Available from: https:\/\/ourworldindata.org\/coronavirus accessed September 24 2020."},{"key":"2020103016001135000_2020.10.25.20218875v1.7","unstructured":"Hripcsak G , Duke JD , Shah NH , et al. Observational Health Data Sciences and Informatics (OHDSI): Opportunities for Observational Researchers. Stud Health Technol Inform 2015(216):574\u201378."},{"key":"2020103016001135000_2020.10.25.20218875v1.8","doi-asserted-by":"publisher","DOI":"10.1002\/pds.4722"},{"key":"2020103016001135000_2020.10.25.20218875v1.9","unstructured":"Datta S , Posada J , Olson G , et al. A new paradigm for accelerating clinical data science at Stanford Medicine. arXiv 2020"},{"key":"2020103016001135000_2020.10.25.20218875v1.10","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1697598"},{"key":"2020103016001135000_2020.10.25.20218875v1.11","unstructured":"Burn E , You SC , Sena AG , et al. Deep phenotyping of 34,128 patients hospitalised with COVID-19 and a comparison with 81,596 influenza patients in America, Europe and Asia: an international network study. medRxiv 2020042220074336 2020. (accessed September 24, 2020)."},{"key":"2020103016001135000_2020.10.25.20218875v1.12","unstructured":"Centers for Disease Control and Prevention (CDC). CDC COVID data Tracker. Demographic Trends of COVID-19 cases and deaths in the US reported to CDC. 2020 [Available from: https:\/\/covid.cdc.gov\/covid-data-tracker\/?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fcases-updates%2Fcases-in-us.html#demographics accessed September 24 2020."},{"key":"2020103016001135000_2020.10.25.20218875v1.13","unstructured":"National Epidemiological Centre (Spain). Report No. 37. Situation of COVID-19 in Spain. COVID-19 report. Updated on July 30, 2020 2020 [Available from: https:\/\/www.isciii.es\/QueHacemos\/Servicios\/VigilanciaSaludPublicaRENAVE\/EnfermedadesTransmisibles\/Documents\/INFORMES\/Informes%20COVID-19\/Informe%20n%C2%BA%2037.Situaci%C3%B3n%20de%20COVID-19%20en%20Espa%C3%B1a%20a%2030%20de%20julio%20de%202020.pdf accessed September 24 2020."},{"key":"2020103016001135000_2020.10.25.20218875v1.14","unstructured":"Korea Disease Control and Prevention Agency (KDCA). Coronavirus Infectious Disease-19 Outbreak in Korea: Domestic Occurrence Status 2020 [Available from: http:\/\/ncov.mohw.go.kr\/bdBoardList_Real.do?brdId=1&brdGubun=11&ncvContSeq=&contSeq=&board_id=&gubun= accessed September 24 2020."},{"key":"2020103016001135000_2020.10.25.20218875v1.15","unstructured":"Boniol M , McIsaac M , Xu L , et al. Gender equity in the health workforce: analysis of 104 countries. Geneva: World Health Organization 2020 [Available from: https:\/\/apps.who.int\/iris\/handle\/10665\/311314 accessed September 24 2020."},{"key":"2020103016001135000_2020.10.25.20218875v1.16","unstructured":"World Health Organization (WHO). Delivered by women, led by men: a gender and equity analysis of the global health and social workforce. 2019 [accessed September 24 2020."},{"key":"2020103016001135000_2020.10.25.20218875v1.17","unstructured":"World Health Organization (WHO). Gender and COVID-19 2020 [Available from: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/332080\/WHO-2019-nCoV-Advocacy_brief-Gender-2020.1-eng.pdf?sequence=1&isAllowed=y accessed September 24 2020."},{"key":"2020103016001135000_2020.10.25.20218875v1.18","doi-asserted-by":"crossref","unstructured":"Alsan M , Stantcheva S , Yang D , et al. Disparities in Coronavirus 2019 Reported Incidence, Knowledge, and Behavior Among US Adults. JAMA Netw Open 2020; 3(6). http:\/\/europepmc.org\/abstract\/MED\/32556260 (accessed September 24, 2020).","DOI":"10.1001\/jamanetworkopen.2020.12403"},{"key":"2020103016001135000_2020.10.25.20218875v1.19","doi-asserted-by":"crossref","unstructured":"Yang J , Zheng Y , Gou X , et al. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis 2020; 94.","DOI":"10.1016\/j.ijid.2020.03.017"},{"key":"2020103016001135000_2020.10.25.20218875v1.20","unstructured":"Morgan SG , Daniel Sehayek , Sofianne Gabrielli , et al. COVID-19 and comorbidities: a systematic review and meta-analysis. Postgraduate Medicine 2020. (accessed September 24, 2020)."},{"key":"2020103016001135000_2020.10.25.20218875v1.21","unstructured":"Centers for Disease Control and Prevention (CDC). COVIDView: a weekly surveillance summary of US COVID-19 activity. Key updates for week 40, ending October 3rd, 2020 2020 [Available from: https:\/\/gis.cdc.gov\/grasp\/COVIDNet\/COVID19_5.html accessed October 12 2020."},{"key":"2020103016001135000_2020.10.25.20218875v1.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.medj.2020.06.005"},{"key":"2020103016001135000_2020.10.25.20218875v1.23","doi-asserted-by":"publisher","DOI":"10.1161\/hypertensionaha.120.15353"},{"key":"2020103016001135000_2020.10.25.20218875v1.24","doi-asserted-by":"crossref","unstructured":"Burke RM , Killerby ME , Newton S , et al. Symptom Profiles of a Convenience Sample of Patients with COVID-19 \u2014 United States, January\u2013 April 2020. 2020; 69. (accessed September 24, 2020).","DOI":"10.15585\/mmwr.mm6928a2"},{"key":"2020103016001135000_2020.10.25.20218875v1.25","unstructured":"World Health Organization (WHO). Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19) 2020 [Available from: https:\/\/www.who.int\/docs\/default-source\/coronaviruse\/who-china-joint-mission-on-covid-19-final-report.pdf accessed September 24 2020."},{"key":"2020103016001135000_2020.10.25.20218875v1.26","doi-asserted-by":"crossref","unstructured":"Centers for Disease Control and Prevention (CDC). Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) \u2014 United States, February 12\u2013March 16, 2020. MMWR Morb Mortal Wkly Rep 2020; (69).","DOI":"10.15585\/mmwr.mm6912e2"},{"key":"2020103016001135000_2020.10.25.20218875v1.27","unstructured":"European Centre for Disease Prevention and Control (ECDC). Coronavirus disease 2019 (COVID-19) in the EU\/EEA and the UK - eighth update. 2020 [Available from: https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/documents\/covid-19-rapid-risk-assessment-coronavirus-disease-2019-eighth-update-8-april-2020.pdf accessed September 24 2020."},{"key":"2020103016001135000_2020.10.25.20218875v1.28","unstructured":"John Hopkins Coronavirus Resource Center. Mortality Analyses 2020 [Available from: https:\/\/coronavirus.jhu.edu\/data\/mortality accessed October 11 2020."},{"key":"2020103016001135000_2020.10.25.20218875v1.29","unstructured":"Centers for Disease Control and Prevention (CDC). COVIDView: a weekly surveillance summary of US COVID-19 activity. COVIDView summary ending on May 30, 2020 2020 [Available from: https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/covid-data\/covidview\/past-reports\/06052020.html accessed September 24 2020."},{"key":"2020103016001135000_2020.10.25.20218875v1.30","unstructured":"World Health Organization (WHO). Laboratory testing strategy recommendations for COVID-19: Interim guidance 21 March 2020 2020 [Available from: https:\/\/apps.who.int\/iris\/rest\/bitstreams\/1272560\/retrieve accessed October 2020."}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1101\/2020.10.25.20218875","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T13:57:19Z","timestamp":1768485439000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.1101\/2020.10.25.20218875"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,27]]},"references-count":30,"URL":"https:\/\/doi.org\/10.1101\/2020.10.25.20218875","relation":{},"subject":[],"published":{"date-parts":[[2020,10,27]]},"subtype":"preprint"}}