Rates of Co-infection Between SARS-CoV-2 and Other Respiratory Pathogens

Abstract

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 di cult 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 con rmed 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 con rmed 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 signi cant 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 con rmed 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 in uenza A, 3 cases of in uenza 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 speci c features in the con rmed 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 con rmed 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. Background Since December 2019, the epidemic of pneumonia caused by novel coronavirus in China, has continued to progress [1], having now infected more than 12,322,000 people and killed over 556,000 people worldwide [2]. On February 11, 2020, The International Committee on Taxonomy of Viruses o cially named this severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the World Health Organization (WHO) named the disease corona...

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