Abstract
Aim To find the predictors of coronavirus disease 2019 (COVID-19) in hospitalized patients. Methods A prevalence study compared the characteristics of COVID-19 patients with non-COVID-19 patients from January 19, 2020, to February 18, 2020, during the COVID-19 outbreak. Laboratory test results and pulmonary chest imaging of confirmed COVID-19 and non-COVID-19 patients were collected by retrieving medical records in our center. Results 96 COVID-19 patients and 122 non-COVID-19 patients were enrolled in this study. COVID-19 patients were older (53 vs. 39; P < 0.001) and had higher body mass index (BMI) than non-COVID-19 group (24.21 ± 3.51 vs. 23.00 ± 3.27, P = 0.011); however, differences in gender were not observed between the two groups. Logistic regression analysis showed that exposure history (OR: 23.34, P < 0.001), rhinorrhea (odds radio (OR): 0.12, P = 0.006), alanine aminotransferase (ALT) (OR: 1.03, P = 0.049), lactate dehydrogenase (LDH) (OR: 1.01, P = 0.020), lymphocyte (OR: 0.27, P = 0.007), and bilateral involvement on chest CT imaging (OR: 23.01, P < 0.001) were independent risk factors for COVID-19. Moreover, bilateral involvement on chest CT imaging (AUC = 0.904, P < 0.001) had significantly higher AUC than others in predicting COVID-19. Conclusions Exposure history, elevated ALT and LDH, absence of rhinorrhea, lymphopenia, and bilateral involvement on chest CT imaging provide robust evidence for the diagnosis of COVID-19, especially in resource-limited conditions where nucleic acid detection is not readily available.
Highlights
Introduction e2019 novel coronavirus (2019-nCoV), known as the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), is a newly emerging infectious virus that is responsible for the spread of coronavirus disease 2019 (COVID-19) worldwide [1, 2]
Several studies have sought to leverage differences in the inflammatory process and chest CT imaging to differentiate between COVID-19 and non-COVID-19 patients [10, 11]
Only a simple comparison of the clinical characteristics of COVID-19 and non-COVID-19 cases was conducted in the study by Zhou et al, and no attempt was made to analyze which features might be inclined to help in COVID-19 diagnosis with negative PCR results [10]
Summary
Introduction e2019 novel coronavirus (2019-nCoV), known as the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), is a newly emerging infectious virus that is responsible for the spread of coronavirus disease 2019 (COVID-19) worldwide [1, 2]. In the first case series of COVID-19 published on January 24, 2020, it was found that typical SARS-CoV-2 pneumonia shared similar clinical features and radiological manifestations with the severe acute respiratory syndrome (SARS), and a mortality rate of 15% was reported [4]. Laboratory abnormalities, including lymphopenia, prolonged prothrombin time, and elevated lactate dehydrogenase, have been documented in COVID-19 patients [5]. Radiological findings such as focal ground-glass opacities (GGOs) and/or consolidations characteristics have been reported to be common in COVID-19 patients [6]; these findings exhibited poor specificity compared
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