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Predictors of COVID-19 Infection: A Prevalence Study of Hospitalized Patients
Huilan Tu1, Hong Zhao1, Junwei Su1
1State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Insights
Predictors for coronavirus disease 2019 (COVID-19) in hospitalized patients include exposure history, elevated liver enzymes (ALT, LDH), absence of rhinorrhea, lymphopenia, and bilateral lung involvement on CT scans. These factors aid diagnosis, especially where nucleic acid testing is limited.
Area of Science:
- Medical Research
- Infectious Diseases
- Pulmonology
Background:
- The COVID-19 pandemic necessitated rapid identification of diagnostic predictors.
- Hospitalized patients present complex clinical scenarios for diagnosis.
Purpose of the Study:
- To identify independent predictors of COVID-19 in hospitalized patients.
- To evaluate the diagnostic utility of clinical, laboratory, and imaging findings.
Main Methods:
- A prevalence study compared 96 COVID-19 patients with 122 non-COVID-19 patients.
- Data collected included patient demographics, laboratory results, and pulmonary chest CT imaging.
- Logistic regression analysis identified independent risk factors.
Main Results:
- COVID-19 patients were older and had higher BMI.
- Independent predictors included exposure history, elevated ALT and LDH, absence of rhinorrhea, lymphopenia, and bilateral CT findings.
- Bilateral lung involvement on CT had the highest predictive value (AUC=0.904).
Conclusions:
- Exposure history, elevated ALT/LDH, lack of rhinorrhea, lymphopenia, and bilateral CT findings are robust predictors of COVID-19.
- These predictors are valuable for diagnosing COVID-19, particularly in resource-limited settings.
Aim:
To find the predictors of coronavirus disease 2019 (COVID-19) in hospitalized patients.
Methods:
A prevalence study compared the characteristics of COVID-19 patients with non-COVID-19 patients from January 19, 2020, to February 18, 2020, during the COVID-19 outbreak. Laboratory test results and pulmonary chest imaging of confirmed COVID-19 and non-COVID-19 patients were collected by retrieving medical records in our center.
Results:
96 COVID-19 patients and 122 non-COVID-19 patients were enrolled in this study. COVID-19 patients were older (53 vs. 39; P < 0.001) and had higher body mass index (BMI) than non-COVID-19 group (24.21 ± 3.51 vs. 23.00 ± 3.27, P = 0.011); however, differences in gender were not observed between the two groups. Logistic regression analysis showed that exposure history (OR: 23.34, P < 0.001), rhinorrhea (odds radio (OR): 0.12, P = 0.006), alanine aminotransferase (ALT) (OR: 1.03, P = 0.049), lactate dehydrogenase (LDH) (OR: 1.01, P = 0.020), lymphocyte (OR: 0.27, P = 0.007), and bilateral involvement on chest CT imaging (OR: 23.01, P < 0.001) were independent risk factors for COVID-19. Moreover, bilateral involvement on chest CT imaging (AUC = 0.904, P < 0.001) had significantly higher AUC than others in predicting COVID-19.
Conclusions:
Exposure history, elevated ALT and LDH, absence of rhinorrhea, lymphopenia, and bilateral involvement on chest CT imaging provide robust evidence for the diagnosis of COVID-19, especially in resource-limited conditions where nucleic acid detection is not readily available.
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