How to differentiate COVID-19 pneumonia from heart failure with computed tomography at initial medical contact during epidemic period

Zhaowei Zhu; Jianjun Tang; Xiangping Chai; Zhenfei Fang; Qiming Liu; Xinqun Hu; Danyan Xu; Jia He; Liang Tang; Shi Tai; Yuzhi Wu; Shenghua Zhou

It is essential to identify the suspected patients as early as possible to control the spread of the disease. Up to present, China has updated to the 7 th edition of the diagnosis for suspected patients. Contact history, clinical manifestation (fever or respiratory symptoms), lab test (white blood cell count normal or decreased, lymphocyte count decreased) and imagine of pulmonary CT are included in the evaluation. A patient can be suspected if fulfill contact history and any 2 of the latter 3. Even for patients without clear contact history, the latter 3 can be as evidence for suspected patients. For patients with heart failure in the absence of fever, chest uncomfortable or chest pain or apnea sometimes combined with respiratory symptom. In this study, 4 patients in 12 have respiratory symptoms. Besides, nearly half of COVID-19 patients may not have fever at admission(6) and the lymphocyte count in patients with heart failure can also be decreased. So pulmonary CT as an objective method will be a key point for patients without clear contact history and typical symptoms.