Early-Stage Vigilance of Novel Coronavirus Pneumonia

Background: Early-stage novel coronavirus pneumonia (NCP) cases with atypical symptoms are prone to misdiagnose. Methods: Epidemiological, clinical, laboratory, radiological, treatment and prognosis information of suspected early-stage cases admitted to the isolation wards of the Southeast Hospital of Xiaogan Central Hospital were collected and analyzed retrospectively. Characteristics of the patients with positive and negative nucleic acid tests were compared and analyzed with a multivariate regression model for predictive factors for positive nucleic acid tests. Findings: 517 consecutive patients hospitalized for suspected early-stage NCP were enrolled, with 335 cases (64.80%) positive for nucleic acid testing and 182 cases (35.20%) negative. The proportion of males and smoking population were 47.8% and 14.37% in the confirmed patients. Compared to the patients with negative nucleic acid tests, the patients’ age, the proportion of familial clusters, cardiovascular comorbidities and the time from the onset of illness to the first admission were significantly higher in confirmed cases (50.7 ± 13.4ys, 42.02%,18.18%, 4.55%, 4.8 ± 2.8d to 46.3 ± 13.9 ys, 22.86%, 10.06%, 1.12%, 4.2 ± 3.1d, p<0.05). The proportion of severe and critical cases in confirmed patients was 4.20% from onset to follow-up (average, 15 ± 3.2 days), and only one patient died (0.35%). Symptoms of the two groups are mostly identical except for fatigue and headache. Confirmed patients exhibited significantly higher white blood cell count, AST and CK-MB compared to negative cases (p<0.05). Patients’ age, time from onset to first admission, presence of familial cluster, white blood cell count and AST were the risk factors for positive nucleic acid tests (p<0.05). The area under the ROC curve was 0.7577. Interpretation: There is no clinical difference between female and male patients with early-stage NCP, and most patients were never-smoker. Suspected patients with the older age, longer time from onset to admission, presence of familial clusters, lower white blood cell count and increased AST at screening should raise concern on NCP. Timely identification and treatment are crucial in order to decrease incidence of severe and critical cases and fatality rate of the disease. Funding Statement: The First Affiliated Hospital of Chongqing Medical University, China Declaration of Interests: All authors declare no competing interests. Ethics Approval Statement: Data collection and analysis and follow-up were part of a continuing public health outbreak investigation as determined by the National Health Commission of the People’s Republic of China, and were therefore considered exempt from institutional review board approval. Patient confidentiality was maintained.