A comparative multi-centre study on the clinical and imaging features of comfirmed and uncomfirmed patients with COVID-19

Congliang Miao; Jinqiang Zhuang; Mengdi Jin; Huanwen Xiong; Peng Huang; Qi Zhao; Li Miao; Jiang Du; Xinying Yang; Peijie Huang; Jiang Hong

Our study showed that the white blood cell count and the absolute value of lymphocytes in confirmed group was significantly lower than that in unconfirmed group. Qin et al demonstrated that lymphocytes counts in most severe COVID-19 patients was reduced, which suggests that SARS-CoV2 might impaired immune system and mainly damaged lymphocytes, especially T lymphocytes (20) . This was similar to SARS-CoV, which spread through the respiratory mucosa and infect other cells, triggering a series of inflammatory responses and cytokine storm, resulting in changes in lymphocytes (21) . Therefore, the reduced white blood cell count and lymphocytes could be used as a reference index for clinical diagnosis of COVID-19. In addition, the ESR of the confirmed group was significantly higher than that of unconfirmed group, while there was no statistical difference in CRP and procalcitonin between the two groups. Therefore, ESR could help clinicians distinguish between COVID-19 and winter respiratory diseases. Although previous studies had shown that some patients with confirmed COVID-19 had abnormal alanine aminotransferase (ALT), aspartate aminotransferase (AST), LDH, D-dimer, myoglobin and troponin I, but there was no statistical significance between the two groups in this study. The underlying reason might be that the majority of patients with COVID-19 outside Hubei province were mild infections, with a small proportion of critically ill cases, while hepatic injury, All rights reserved. No reuse allowed without permission. the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.