Abstract
Objective: To explore those differences and relationships of the initial diagnostic clinical data between confirmed cases of 2019-nCoV and suspected cases of COVID-19, and then to establish prediction models for predicting the probability of the first diagnosis of 2019-nCoV. Methods: A total of 81 suspected cases and 87 confirmed cases of moderate 2019-nCoV diagnosed initially in the isolation wards of the First People’s Hospital of Wuhu and the People’s Hospital of Wuwei and Wuhan Caidian Module Hospital with the help of our hospital doctors were gathered, and retrospectively analyzed. Results: The most common symptoms were fever (76.79%) and cough (64.29%) in the total of 168 cases. The median age was 45 (35 - 56) years old in the 87 confirmed cases of moderate 2019-nCoV, older than the median age 36 (29 - 50) in the 81 suspected cases. There were significant more in the former than in the latter in the incidence of myalgia, ground-glass opacity (GGO), invasions of lesion in the peripheral lobes, vascular thickening and bronchial wall thickening, interlobular septal thicking, and small pulmonary nodules. On the contrary, there were less in the former than in the latter in the total number of leukocytes and neutrophils in blood routine examination and the levels of procalcitonin (PCT). Two groups were statistically significantly different (P P = ex/(1 + ex), x = −6.226 + (0.071 × ages) + (1.720 × fever) + (2.858 × myalgia) + (2.131 × GGO) + (3.000 × vascular thickening and bron-chial wall thickening) + (3.438 × invasions of lesion in the peripheral lobes) + (−0.304 × the number of leukocytes) + (−1.478 × cough) + (−1.830 × pharyngalgia) + (−2.413 × headache), where e is a natural logarithm. The area under the ROC curve (AUC) of this model was calculated to be 0.945 (0.915 - 0.976). The sensitivity is 0.920 and the specificity is 0.827 when the appropriate critical point is 0.360. Conclusions: A mathematical equation prediction model for predicting the probability of the first diagnosis of 2019-nCoV can be established based on the initial diagnostic clinical data of moderate 2019-nCoV. The prediction model is a good assistant diagnostic method for its high accurateness.
Highlights
During this current public health emergency of international concern, screening and diagnosing patients quickly to aid containment is a priority and these limitations make RT-PCR unsuitable for use in the field
Years, The minimum age of patients in the confirmed 87 cases group is 8 years old, the oldest age is 90 years old, and the median age is 45 (35 - 56) years; in the clinical manifestations, 18 (20.69%) patients in the confirmed group have muscle soreness, which is higher than 4 in the suspected group. (4.94%) cases, the difference was significant (P = 0.003); there were no significant differences in the number of cases of fever, cough, sore throat, anorexia, diarrhea, headache, dizziness, chest tightness, and chest pain in the remaining clinical manifestations between the two groups (P > 0.005)
This study compared the general data of 168 patients with common suspected cases of 2019-nCoV and confirmed cases, and found that the median age of common confirmed cases of 2019-nCoV was 45 (35 - 56) years old, which is consistent with literature reports [6], and more than the normal suspected case of 2019-nCoV
Summary
During this current public health emergency of international concern, screening and diagnosing patients quickly to aid containment is a priority and these limitations make RT-PCR unsuitable for use in the field. The sensitivity of the RNA test in the real world is not satisfactory. Scholars found that computed tomography (CT) was associated with a higher rate of diagnostic accuracy than a real-time quantitative polymerase chain reaction (qPCR)-based approach. It is important that clinicians utilize a combination of laboratory and radiological testing where possible in order to ensure that this virus is reliably and quickly detected such that it may be treated and patients may be isolated in a timely fashion, thereby effectively curbing the further progression of this pandemic [2]
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