Abstract
Abstract Objectives The clinical implications of different blood indices in patients with coronavirus disease-2019 (COVID-19) were analyzed at different stages. Methods We compared blood test results of 17 COVID-19 patients treated in Jinhua Central Hospital between January 1 and March 5, 2020 at different stages. We also compared the initial blood results of 17 COVID-19 patients with 115 influenza virus A/B (Flu A/B)-positive patients, 19 Mycoplasma pneumonia (MP)-positive patients and 50 healthy subjects (HSs). Results (1) The white blood cell count (WBC) and absolute neutrophil count (NEU#) were lower in the SARS-CoV-2 group than in the MP and Flu A/B groups; the eosinophil percentage (EO%) and absolute eosinophil count (EO#) were lower in the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) group than in the MP group (p<0.05). (2) Aspartate aminotransferase (AST) levels were significantly lower when patients were discharged from the hospital (p<0.05), EO% and EO# recovered at discharge, and returned to normal levels during follow-up (p<0.05). (3) When the throat swab was nucleic acid-negative but the stool was still positive, lymphocyte percentage (LY%) and absolute lymphocyte count (LY#) decreased (p<0.05). (4) As the cycle threshold (Ct) value of the nucleic acid increased or decreased, EO# showed a consistent trend. Conclusions Blood cell count indices upon hospital admission could be helpful to give some tips of diagnosis of SARS-CoV-2-infection, Flu A/B-infection and MP-infection; AST and EO# could be used to predict the outcome of patients. Feces turned negative for nucleic acid more slowly than throat swabs; LY# was lower during the fecal-positive period and low Ct values of fecal nucleic acid were negatively associated with the patient’s recovery level.
Highlights
In December 2019, a coronavirus disease-2019 (COVID-19) epidemic broke out in Wuhan, which quickly spread worldwide [1]
Blood cell count indices upon hospital admission could be helpful to give some tips of diagnosis of SARS-CoV-2-infection, Flu A/B-infection and Mycoplasma pneumonia (MP)-infection; AST and EO# could be used to predict the outcome of patients
Feces turned negative for nucleic acid more slowly than throat swabs; LY# was lower during the fecalpositive period and low cycle threshold (Ct) values of fecal nucleic acid were negatively associated with the patient’s recovery level
Summary
In December 2019, a coronavirus disease-2019 (COVID-19) epidemic broke out in Wuhan, which quickly spread worldwide [1]. Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is a single-stranded positive-strand RNA virus and is the seventh member of the coronavirus family. SARS-CoV-2 can be detected in nasal swabs, throat swabs, sputum specimens, alveolar lavage fluid, serum/ plasma and fecal of infected persons by nucleic acid amplification [3, 4]. Alveolar lavage fluid sampling is likely to cause aerosol transmission, and early concentrations of viral nucleic acids in the blood are too low. According to the latest treatment guidelines of the Ministry of Health for COVID-19, pharyngeal swab nucleic acid tests must be negative for two consecutive times (24 h interval) to confirm patient recovery. Some patients had nucleic acidpositive feces that lasted for a long time. During this period, the patient’s condition basically recovered. Fecal samples should be tested to exclude a potential alternative
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