Abstract

The coronavirus disease 2019 (COVID-19) has become a pandemic. Rapidly distinguishing COVID-19 from other respiratory infections is a challenge for first-line health care providers. This retrospective study was conducted at the Taipei Medical University Hospital, Taiwan. Patients who visited the outdoor epidemic prevention screening station for respiratory infection from February 19 to April 30, 2020, were evaluated for blood biomarkers to distinguish COVID-19 from other respiratory infections. Monocyte distribution width (MDW) ≥ 20 (odds ratio [OR]: 8.39, p = 0.0110, area under curve [AUC]: 0.703) and neutrophil-to-lymphocyte ratio (NLR) < 3.2 (OR: 4.23, p = 0.0494, AUC: 0.673) could independently distinguish COVID-19 from common upper respiratory tract infections (URIs). Combining MDW ≥ 20 and NLR < 3.2 was more efficient in identifying COVID-19 (AUC: 0.840). Moreover, MDW ≥ 20 and NLR > 5 effectively identified influenza infection (AUC: 0.7055). Thus, MDW and NLR can distinguish COVID-19 from influenza and URIs.

Highlights

  • The novel coronavirus disease 2019 (COVID-19) is a highly contagious viral infection

  • Radiologic studies could improve the early diagnosis of COVID-19; 18%–56% patients with nonsevere symptoms had nonspecific findings in chest radiography and computed tomography, with a lower rate observed in the early phase of the disease [8,9,10]

  • 9 were confirmed as COVID-19 positive through nasal swab reverse transcription polymerase chain reaction (RT-PCR) screening, 24 patients were confirmed to have influenza using the rapid-test for influenza, and 141 patients were diagnosed as having a common upper respiratory tract infections (URIs) clinically

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Summary

Introduction

The novel coronavirus disease 2019 (COVID-19) is a highly contagious viral infection. Severe acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2), isolated from the bronchoalveolar lavage of patients, is transmitted through respiratory droplets and contact [2, 3]. Radiologic studies could improve the early diagnosis of COVID-19; 18%–56% patients with nonsevere symptoms had nonspecific findings in chest radiography and computed tomography, with a lower rate observed in the early phase of the disease [8,9,10]. MDW and other blood biomarkers were used to evaluate the likelihood of COVID-19 and distinguish the disease from other respiratory infections in the early phase

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