Differential diagnosis of coronavirus disease 2019 from pneumonias caused by other etiologies in a fever clinic in Beijing.
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ABSTRACT:
SUBMITTER: Liang Y
PROVIDER: S-EPMC7575191 | biostudies-literature | 2020 Oct
REPOSITORIES: biostudies-literature
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Differential diagnosis of coronavirus disease 2019 from pneumonias caused by other etiologies in a fever clinic in Beijing.
Liang Ying Y Liang Jing-Jin JJ Zhou Qing-Tao QT Li Xiao-Guang XG Lin Fei F Deng Zhong-Hua ZH Zhang Bi-Ying BY Li Lu L Wang Xiao-Hua XH Zhu Hong H Ma Qing-Bian QB Tong Xiao-Mei XM Xu Jie J Sun Yong-Chang YC
Chinese medical journal 20201001 20
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Project description:BackgroundA new coronavirus pneumonia caused by 2019 new coronavirus (2019-nCoV) is spreading in China. Here we summarized the patients we accepted in the fever outpatient department.MethodsPatients with epidemiologic history, respiratory symptoms or fever were required to go to the fever clinic for screening. Patients were finally laboratory-confirmed 2019-nCoV infection by real-time reverse transcription-polymerase chain reaction (RT-PCR) using nasal and pharyngeal swabs. Epidemiologic features, clinical presentation, laboratory findings and image features were collected and analyzed.ResultsTotally, 16 patients were diagnosed as 2019-nCoV infection. The median age of the patients was 39.00 (35.25-55.75) years old, and the ratio of men and women was 9:7. Fifteen (93.75%) patients had clear epidemiologic history. The most common symptoms of the patients were fever (87.50%) and cough (n=8, 50.00%). The mean white blood cell count in the patients was (4.97±1.71) ×109/L, and it was lower than 4.00×109/L in 4 (25.00%) patients. The median neutrophil and lymphocyte count were 2.70 (1.84-3.27) ×109/L and (1.52±0.53) ×109/L respectively. The mean C-reactive protein level was 19.11±17.39 mg/L. Patients were likely had normal procalcitonin, creatinine, alanine aminotransferase, creatine kinase and lactate dehydrogenase levels at diagnosis. Fourteen (87.50%) patients had pneumonia in chest CT scan.ConclusionsNo specific symptom was helpful in the diagnosis of 2019-nCoV infection, but relatively low WBC and lymphocyte level might be suggestive to diagnosis. Most patients had fever and pneumonia, however, there were indeed some patients without fever and pneumonia. Screening procedure should not only focus on fever patients. The origin, transmission route, key targets of the virus and mechanism of infection deserved more studies.
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