Clinical Characteristics of confirmed and clinically diagnosed patients with 2019 novel coronavirus pneumonia: a single-center, retrospective, case-control study

Background: Novel coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by SARS-CoV-2 At the peak of the outbreak in Wuhan (January and February), there are two types of COVID-19 patients: laboratory confirmation and clinical diagnosis This study aims to compare and analyze the clinical outcomes and characteristics of confirmed and clinically diagnosed COVID-19 patients to determine whether they are of the same type and require equal treatment More importantly, the prognostic factors of COVID-19 patients are explored Methods: A total of 194 hospitalized patients with COVID-19 pneumonia were retrospectively studied Demographic data, clinical characteristcs, laboratory results and prognostic information were collected by electronic medical record system and analyzed Results: Among 194 subjects included, 173 were confirmed and 21 were clinically diagnosed There were no significant differences in clinical outcomes (mortality rate 39[22 54%] vs 7[33 33%], P = 0 272) and hospital stay (19 00 vs 16 90 days, P = 0 411) between the confirmed and clinically diagnosed group, and prognostic factors were similar between them Older age, lower albumin levels, higher serum Lactate dehydrogenase (LDH) levels, higher D-D levels, longer prothrombin time (PT), higher IL-6 levels, lower T cells indicated poor prognosis in patients with COVID-19 pneumonia NK cell has the highest AUC among all measured indicators (NK AUC = 0 926, P <0 001) Conclusion: Laboratory-confirmed and clinically diagnosed COVID-19 patients are similar in clinical outcomes and most clinical characteristics They are of the same type and require equal treatment Age, AST, LDH, BUN, PT, D-D, IL6, white blood cell and neutrophil counts, T cell and T cell subset counts can efficiently predict clinical outcomes Resumen Antecedentes: el nuevo coronavirus 2019 (COVID-19) es una nueva enfermedad infecciosa causada por el virus SARS-CoV-2 Durante el pico del brote en Wuhan (enero y febrero), se detectaron dos tipos de pacientes portadores del COVID-19: pacientes confirmados a traves de pruebas de laboratorio y pacientes confirmados por diagnostico clinico El objetivo de este estudio es comparar y analizar los resultados clinicos y las caracteristicas de los pacientes con COVID-19 confirmados y clinicamente diagnosticados para determinar si son del mismo tipo y si necesitan el mismo tratamiento El estudio es importante tambien para explorar los factores pronosticos de los pacientes con COVID-19 Metodos: Un total de 194 pacientes hospitalizados con neumonia COVID-19 fueron estudiados retrospectivamente Se utilizo un sistema de registro medico electronico para recopilar los datos demograficos, las caracteristicas clinicas, los resultados de laboratorio y la informacion pronostica, para luego ser analizada Resultados: De los 194 pacientes incluidos, 173 dieron positivo y 21 fueron diagnosticados clinicamente No se presentaron diferencias significativas en los resultados clinicos (tasa de mortalidad 39[22,54%] vs 7[33,33%], P = 0,272) y la estancia hospitalaria (19,00 vs 16,90 dias, P = 0,411) entre el grupo de confirmados y el grupo diagnosticado clinicamente, y los factores pronostico fueron similares entre ellos Edad avanzada, niveles mas bajos de albumina, niveles mas altos de lactato deshidrogenasa (LDH) en suero, niveles mas altos de D-D, mayor tiempo de protrombina (PT), altos niveles de IL-6, celulas T mas bajas indicaban mal pronostico en pacientes con neumonia por COVID-19 La celula NK tiene el AUC mas alto entre todos los indicadores medidos (NK AUC = 0,926, P <0,001) Conclusion: Los grupos de pacientes COVID-19 confirmados en laboratorio y diagnosticados clinicamente arrojan resultados clinicos similares y tienen la mayoria de las caracteristicas clinicas Son del mismo tipo y requieren el mismo tratamiento La edad, AST, LDH, BUN, PT, D-D, IL6, los recuentos de globulos blancos y neutrofilos, recuentos de subgrupos de celulas T y celulas T pueden predecir los resultados clinicos de forma eficaz