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Research article
Maurizio Sanguinetti
Policlinico Universitario Agostino Gemelli
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9780-7059
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Since December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged as a novel etiologic agent of viral pneumonia. We aimed to compare clinical features of 165 Italian patients with laboratory confirmed or unconfirmed 2019-nCoV pneumonia.
Methods: On March 31 2020, hospitalized patients who presented with fever and/or respiratory symptoms, exposures, and presence of lung imaging features consistent with 2019-nCoV pneumonia, were included. Before admission to a hospital ward, patients underwent RT-PCR based SARS-CoV-2 RNA detection in their nasopharyngeal swab samples.
Results: Of 165 patients studied, 119 had positive RT-PCR results and 46 were RT-PCR negative for two days or longer (i.e., when the last swab sample was obtained). The median age was 70 years (IQR, 58–78), and 123 (74.6%) of 165 patients had at least one comorbidity. The majority of patients (101/165, 61.2%) had a mild pneumonia, and the remaining patients (64/165, 38.8%) a severe/critical pneumonia. We did not find any substantial difference in symptoms, incubation periods, and radiographic/CT abnormalities as well as in many of the biological abnormalities recorded. However, at multivariable analysis, higher concentrations of hemoglobin (OR, 1.34; 95% CI, 1.11‒1.65; P = 0.003) and lower counts of leukocytes (OR, 0.81; 95% CI, 0.72‒0.90; P <0.001) were statistically associated with confirmed COVID-19 diagnosis. While mortality rates were similar, patients with confirmed diagnosis were more likely to receive antivirals (95% vs 19.6%, P <0.001) and to develop ARDS (63% vs 37%, P = 0.003) than those with unconfirmed COVID-19 diagnosis.
Conclusions: Our findings suggest that unconfirmed 2019-nCoV pneumonia cases may be actually COVID-19 cases and that clinicians should be cautious when managing patients with presentations compatible with COVID-19.
Keywords
Pneumonia, COVID-19, Clinical and laboratory findings, Outcomes
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CURRENT STATUS: Published
View the published article at BMC Infectious Diseases.
No community comments so far
Submission checks complete
On 14 Oct, 2020
Editorial decision: Accept
On 12 Oct, 2020
Version 2
Posted 05 Oct, 2020
No comments provided
Reviewers invited
Invitations sent on 02 Oct, 2020
Editor assigned
On 28 Sep, 2020
Submission checks complete
On 27 Sep, 2020
Editor invited
On 27 Sep, 2020
No comments provided
Editorial decision: Major revision
On 16 Sep, 2020
Review #2 received
Received 15 Sep, 2020
Review #1 received
Received 30 Aug, 2020
Reviewer #2 agreed
On 27 Aug, 2020
Reviewer #1 agreed
On 25 Aug, 2020
Reviewers invited
Invitations sent on 13 Jul, 2020
Editor assigned
On 15 Jun, 2020
First submitted
On 14 Jun, 2020
Submission checks complete
On 14 Jun, 2020
Editor invited
On 14 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Infectious Diseases.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Maurizio Sanguinetti
Policlinico Universitario Agostino Gemelli
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9780-7059
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Infectious Diseases.
No community comments so far
Submission checks complete
On 14 Oct, 2020
Editorial decision: Accept
On 12 Oct, 2020
Version 2
Posted 05 Oct, 2020
No comments provided
Reviewers invited
Invitations sent on 02 Oct, 2020
Editor assigned
On 28 Sep, 2020
Submission checks complete
On 27 Sep, 2020
Editor invited
On 27 Sep, 2020
No comments provided
Editorial decision: Major revision
On 16 Sep, 2020
Review #2 received
Received 15 Sep, 2020
Review #1 received
Received 30 Aug, 2020
Reviewer #2 agreed
On 27 Aug, 2020
Reviewer #1 agreed
On 25 Aug, 2020
Reviewers invited
Invitations sent on 13 Jul, 2020
Editor assigned
On 15 Jun, 2020
First submitted
On 14 Jun, 2020
Submission checks complete
On 14 Jun, 2020
Editor invited
On 14 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Infectious Diseases.
Background: Since December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged as a novel etiologic agent of viral pneumonia. We aimed to compare clinical features of 165 Italian patients with laboratory confirmed or unconfirmed 2019-nCoV pneumonia.
Methods: On March 31 2020, hospitalized patients who presented with fever and/or respiratory symptoms, exposures, and presence of lung imaging features consistent with 2019-nCoV pneumonia, were included. Before admission to a hospital ward, patients underwent RT-PCR based SARS-CoV-2 RNA detection in their nasopharyngeal swab samples.
Results: Of 165 patients studied, 119 had positive RT-PCR results and 46 were RT-PCR negative for two days or longer (i.e., when the last swab sample was obtained). The median age was 70 years (IQR, 58–78), and 123 (74.6%) of 165 patients had at least one comorbidity. The majority of patients (101/165, 61.2%) had a mild pneumonia, and the remaining patients (64/165, 38.8%) a severe/critical pneumonia. We did not find any substantial difference in symptoms, incubation periods, and radiographic/CT abnormalities as well as in many of the biological abnormalities recorded. However, at multivariable analysis, higher concentrations of hemoglobin (OR, 1.34; 95% CI, 1.11‒1.65; P = 0.003) and lower counts of leukocytes (OR, 0.81; 95% CI, 0.72‒0.90; P <0.001) were statistically associated with confirmed COVID-19 diagnosis. While mortality rates were similar, patients with confirmed diagnosis were more likely to receive antivirals (95% vs 19.6%, P <0.001) and to develop ARDS (63% vs 37%, P = 0.003) than those with unconfirmed COVID-19 diagnosis.
Conclusions: Our findings suggest that unconfirmed 2019-nCoV pneumonia cases may be actually COVID-19 cases and that clinicians should be cautious when managing patients with presentations compatible with COVID-19.
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