Xiaoying Gu1, Bin Cao2, Jianwei Wang3. 1. Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China; Department of Pulmonary and Critical Care Medicine, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, Beijing 100029, China; Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing 100029, China. 2. Department of Pulmonary and Critical Care Medicine, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, Beijing 100029, China; Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing 100029, China; Department of Respiratory Medicine, Capital Medical University, Beijing, China; Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, China. Electronic address: caobin_ben@163.com. 3. NHC Key Laboratory of Systems Biology of Pathogens and Christophe Merieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Zhou Xu and colleagues point out that mortality, which should be referred correctly and more clearly as case fatality ratio, among the first 41 cases with laboratory-confirmed 2019 novel coronavirus disease (COVID-19; previously known as 2019-nCoV) was misleading in our Article.We definitely agree that the case fatality ratio among the first 41 cases cannot represent the case fatality ratio of the full disease spectrum during the outbreak of COVID-19. From the perspective of case detection, the reasons for the inconsistency between the case fatality ratio reported in our Article and data that have become available since publication of our Article were clearly clarified in advance in the comment by Chen Wang and colleagues. Patients with the most severe symptoms were paid attention to during the early stages of the outbreak because of limited resources to detect severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infection. From the perspective of treatment, even the most up-to-date case fatality ratio is expected to decrease as diagnosis and treatment procedure for patients with pneumonia who are infected with SARS-CoV-2 is improving, potential drugs to treat COVID-19 are being evaluated for efficacy and safety in ongoing clinical trials,4, 5 and management is becoming more intense, not only for patients with severe infection but also for those with moderate, mild, or even asymptomatic infection.Without denying the limitations of our study at the time of publication, we still hope our results provided a useful depiction of clinical features of SARS-CoV-2 infection at the very early stage of the outbreak and during progression of disease. Intense and continuous efforts are indeed needed for medical workers and researchers all over the world to get the full picture of the spectrum of disease severity of COVID-19 and to overcome the huge health challenge.