Clinical characteristics of patients with 2019 coronavirus disease in a non-Wuhan area of Hubei Province, China: a retrospective study

Zhao, Xinying; Xu, Xuanxuan; Yin, Haisen; Hu, Qinming; Xiong, Tingting; Tang, Yuan-Yan; Yang, Ai-Ying; Yu, Baoping; Huang, Zhiping

doi:10.1186/s12879-020-05010-w

Cited by 189 publications

(114 citation statements)

References 14 publications

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“…Results of our study suggest that pneumonia in COVID-19 patients and pneumonia caused by other pathogens (eg, in uenza viruses, adenovirus, and Mycoplasma) are di cult to distinguish based on their clinical manifestations, which included fever, cough, and fatigue in our study. Rarer clinical manifestations, such as expectoration, sore throat, intolerance of cold, shivering, chest tightness, dyspnea, palpitation, and diarrhea, were also common to both COVID-19 and other respiratory pathogens, which was similar to the results from previous studies [8,9].…”

Section: Discussionsupporting

confidence: 89%

Differential diagnosis for suspected cases of coronavirus disease 2019: a retrospective study

Chi

Dai

Jiang

et al. 2020

Preprint

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Background: Since December 2019, the coronavirus disease 2019 (COVID-19) has infected more than 12,310322,000 people and killed over 556,000 people worldwide. However, Differential diagnosis remains difficult for suspected cases of COVID-19 and need to be improved to reduce misdiagnosis.Methods: Sixty-eight cases of suspected COVID-19 treated in Wenzhou Central Hospital from January 21 to February 20, 2020 were divided into confirmed and COVID-19-negative groups based on the results of real-time reverse transcriptase polymerase chain reaction (RT-PCR) nucleic acid testing of the novel coronavirus in throat swab specimens to compare the clinical symptoms and laboratory and imaging results between the groups.Results: Among suspected patients, 17 were confirmed to COVID-19-positive group and 51 were distinguished to COVID-19-negative group. Patients with reduced white blood cell (WBC) count were more common in the COVID-19-positive group than in the COVID-19-negative group (29.4% vs 3.9%, P = 0.003). Subsequently, correlation analysis indicated that there was a significant inverse correlation existed between WBC count and temperature in the COVID-19-positive patients (r=-0.587, P=0.003), instead of the COVID-19-negative group. But reduced lymphocyte count was no different between the two groups (47.1% vs 25.5%, P= 0.096). More common chest imaging characteristics of the confirmed COVID-19 cases by high-resolution computed tomography (HRCT) included ground-glass opacities (GGOs), multiple patchy shadows, and consolidation with bilateral involvement than COVID-19-negative group (82.4% vs 31.4%, P=0.0002; 41.2% vs 17.6% vs P=0.048; 76.5% vs 43.1%, P=0.017; respectively). The rate of clustered infection was higher in COVID-19-positive group than COVID-19-negative group (64.7% vs 7.8%, P=0.001). Through multiplex PCR nucleic acid testing, 2 cases of influenza A, 3 cases of influenza B, 2 cases of adenovirus, 2 cases of Chlamydia pneumonia, and 7 cases of Mycoplasma pneumoniae were diagnosed in the COVID-19-negative group.Conclusions: WBC count inversely correlated with the severity of fever, GGOs, multiple patchy shadows, and consolidation in chest HRCT and clustered infection are common but not specific features in the confirmed COVID-19 group.Reduced WBC count inversely correlating with the severity of fever, GGOs, multiple patchy shadows, and consolidation in chest HRCT and clustered infection are features in the confirmed COVID-19 group but not unique. Multiplex PCR nucleic acid testing helped differential diagnosis for suspected COVID-19 casesexclude pathogenic diagnosis in COVID-19 patients.

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Section: Discussionsupporting

confidence: 89%

Differential diagnosis for suspected cases of coronavirus disease 2019: a retrospective study

Chi

Dai

Jiang

et al. 2020

Preprint

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“…However, the difference between our data and those observed in Chinese cohorts is striking. In fact, in the earliest reports, the mortality among hospitalized patients has been estimated between 2.2% and 3.2% (12,13). The ten-fold higher mortality observed in our cohort is probably related to a more severe clinical picture in our patients at hospital admission.…”

Section: Discussionmentioning

confidence: 44%

Fatality rate and predictors of mortality in a large Italian cohort of hospitalized COVID-19 patients

Team

Sainaghi

2020

Preprint

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Substantial discrepancies are evident in the clinical features and natural history of coronavirus disease 2019 (COVID-19), among different countries, so we aimed to evaluate the fatality rate and to identify predictors of mortality in a cohort of hospitalized patients. We performed a retrospective multicenter cohort study on medical records of patients admitted between 1st March and 28th April 2020, involving three hospitals in Northern Italy. We included 1697 patients older than 18 years of age and with a confirmed diagnosis of SARS-CoV-2 infection by reverse-transcriptase polymerase chain reaction (RT-PCR). During the study period we observed 504 deaths, with a CFR of 29.7%. We further looked for predictors of mortality in a subset of 486 patients (239 males, 59%); the median age of the study population was 71 [58-80] years. Among demographic and clinical variables considered, age, a diagnosis of cancer, obesity and current smoking independently predicted mortality. When laboratory data were added to the model, age, the diagnosis of cancer, and the baseline PaO2/FiO2 ratio were independent predictors of mortality. During the COVID-19 outbreak, the CFR of hospitalized patients in Northern Italy was high, approaching 30%. The identification of mortality predictors might contribute to better stratification of individual patient risk.

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“…Among the selected studies for symptom analysis, 9 were from China [7][8][9][10][11][12][13] , one study per each country included from Netherlands 14 , India 15 , Korea 16 and Italy 17 . Another article by Spiteri G et.al was included which represented the rst 38 cases in Europe 18 .…”

Section: Articles Published In English Languagementioning

confidence: 99%

Symptomatology of Coronavirus Disease 2019 (COVID-19) - Lessons from A Meta-Analysis Across 13 Countries

Gamakaranage

Hettiarachchi

Ediriweera

et al. 2020

Preprint

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Abstract Background: COVID-19 pandemic has resulted in varying clinical manifestations and mortality rates. There is no consensus on the symptomatology that would guide researchers and clinicians.Objective: The objective of the study was to identify symptoms and their frequencies of coronavirus disease 2019 with a meta-analysis of studies from several countries. Data sources: A systematic review using PubMed and Google Scholar data sources and reference tracing were used to identify 7176 relevant articles. Eligibility criteria: Suitable articles were selected manually with selection criteria and 14 original articles included for meta-analysis. Data abstraction analysis: PRISMA guideline was used for abstracting data. Then a table was generated by feeding it with numbers and proportions of each symptom described in original studies. A meta-analysis was carried out using random effect models on each symptom separately across the studies and their prevalence rates and 95% confident intervals calculated.Results: We identified 14 relevant scientific papers, either cross-sectional or cohort studies and analyzed. There were 2,660 cases of COVID-19. he majority were from China (n=2,439, 91.7%) and remainder from the Netherlands, Italy, Korea and India and one article from Europe. There was a total of 32 symptoms (i.e. present in >50% of patients): fever (79.56%, 95% CI: 72.17-86.09%), malaise (63.3%, 95% CI: 53.1 – 73.0%), cough (56.7. %, 95% CI: 48.6 - 64.6 %) and cold (55.6%, 95% CI: 45.2 – 65.7%). Symptoms of intermediate incidence (5-49%) were; anosmia, sneezing, ocular pain, fatigue, sputum production, arthralgia, tachypnea, palpitation, headache, chest tightness, shortness of breath, chills, myalgia, sore throat, anorexia, weakness, diarrhea, rhinorrhea, dizziness, nausea, altered level of consciousness, vomiting and abdominal pain. Rare symptoms (<5% of patients) were: tonsil swelling, haemoptysis, conjunctival injection, lymphadenopathy and rash were uncommon symptoms of coronavirus disease (<5%).Conclusion and implications of key findings: We found (25/32) symptoms to be present in =>5% of cases which could be considered as “typical” symptoms of COVID-19. The list of symptoms we identified are different from those documents released by the WHO, CDC, NHS, Chinese CDC, Institute Pasteur and Mayo Clinic. The compiled list would be useful for future researchers to document a comprehensive picture of the illness.

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Clinical characteristics of patients with 2019 coronavirus disease in a non-Wuhan area of Hubei Province, China: a retrospective study

Cited by 189 publications

References 14 publications

Differential diagnosis for suspected cases of coronavirus disease 2019: a retrospective study

Differential diagnosis for suspected cases of coronavirus disease 2019: a retrospective study

Fatality rate and predictors of mortality in a large Italian cohort of hospitalized COVID-19 patients

Symptomatology of Coronavirus Disease 2019 (COVID-19) - Lessons from A Meta-Analysis Across 13 Countries

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