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Epidemiological and Clinical Characteristics of Suspected COVID-19 Patients in the Isolation Ward in Guangzhou, China: A Retrospective Study
30 Pages Posted: 4 Jun 2020
More...Abstract
Background: The recent outbreak of coronavirus disease 2019 (COVID-19) coincided with the epidemic periods of other seasonal diseases. We are thus faced with the challenge of identifying COVID-19 cases among febrile patients.
Methods: Suspected COVID-19 patients from the isolation ward of the First Affiliated Hospital of Guangzhou Medical University were recruited. Epidemiological and clinical information were collected and analyzed.
Findings: From January 25 to March 3, 2020, 87 suspected COVID-19 patients were admitted to our isolation ward. Among them, pathogens were identified in only 59 patients (67·8%), including 11 (12·6%) with SARS-CoV-2, 21 (24·1%) with other viruses, and 24 (27·6%) with other pathogens and 3(3·5%) mixed infection. The most common symptoms of COVID-19 patients were fever, cough, fatigue and muscle ache, which were significant difference comparing with non-viral infection (p<0.05), but not with other virus-infected patients (p>0.05). Furthermore, lactate dehydrogenase and neutrophil/lymphocyte ratio were significantly increased in COVID-19 patients comparing to non-COVID-19 patients (p<0.05). Ground-glass changes were the most common manifestations of COVID-19 (91%) and other virus-infected patients (52%), but COVID-19 patients often showed involvement of both lungs and more lobes (p<0.05). Due to the clear differential diagnosis, the overall antibiotic use rate was 35·6% (31/87).
Interpretation: When diagnosing COVID-19, infections with other pathogens should not be ignored. Successful pathogen identification and differential diagnosis will be conducive to accurate treatment with antivirals and antibiotics.
Funding Statement: This work was funded by the emergency project of COVID-19 clinical research on prevention and treatment with traditional Chinese medicine (TCM) in the Guangdong Bureau of TCM (Grant number: 2020ZYYJ05); the National Natural Science Foundation of China (Grant number: 62043102) and the Innovative and Strategic Program of Guangdong's Scientific and Technological Policy (Grant number: 2020B111126005); Guangzhou Science and Technology Innovation Development Special Fund (Grant number: 2060901); and by the Guangzhou Institute of Respiratory Health.
Declaration of Interests: All authors declare no competing interests.
Ethics Approval Statement: This study was approved by the ethics committee of the First Affiliated Hospital of Guangzhou Medical University.
Keywords: COVID-19; non-COVID-19; pathogens; differential diagnosis
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