Confirmed or unconfirmed cases of 2019 novel coronavirus pneumonia in Italian patients: a retrospective analysis of clinical features

Giulia De Angelis, Brunella Posteraro, Paola Cattani, Francesco Franceschi, Maurizio Sanguinetti, Antonio Gasbarrini, Federico Biscetti, Gianluca Ianiro, Lorenzo Zileri Dal Verme

Risultato della ricerca: Contributo in rivistaArticolo in rivista

3 Citazioni (Scopus)

Abstract

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 2 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.
Lingua originaleEnglish
pagine (da-a)775-780
Numero di pagine6
RivistaBMC Infectious Diseases
Volume20
DOI
Stato di pubblicazionePubblicato - 2020

Keywords

  • Aged
  • Betacoronavirus
  • COVID-19
  • Clinical and laboratory findings
  • Coronavirus Infections
  • Diagnosis, Differential
  • Female
  • Fever
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Outcomes
  • Pandemics
  • Pneumonia
  • Pneumonia, Viral
  • Real-Time Polymerase Chain Reaction
  • Retrospective Studies
  • SARS-CoV-2
  • Specimen Handling

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