Analysis of factors associated early diagnosis in coronavirus disease 2019 (COVID-19)

Jinwei Ai; Junyan Gong; Limin Xing; Renjiao He; Fangtao Tian; Juan Wang; Jun Wang; Shengduo Polo Pei; Dongxuan Chen; Guoxin Huang; Meiling Zhang; Gaojing Qu; Wufeng Fan; Hongming Lin; Desheng Li; Bin Pei

The copyright holder for this preprint (which was not peer-reviewed) is . https://doi.org/10.1101/2020.04.09.20059352 doi: medRxiv preprint 15 There are 96 cases that have relatively obvious COVID-19 imaging features in their first chest CT examination result, which indicates chest CT diagnostic sensitivity is relatively high, which is 0.89 (96/108). With AUC = 0.724 also shows that independent chest CT diagnosis has medium diagnostic value. Multiple logistic regression analysis result shows that patient's age, contact history and decrease in lymphocyte count have independent diagnostic value of COVID-19. Although these indicator's diagnosis efficiency is relatively low (0.5 < AUC ≤ 0.7), combining chest CT result with age, contact history and decrease in lymphocyte can have a similar diagnosis accuracy with first nucleic acid test (AUC = 0.859). Therefore, these indicators are of great reference importance when nucleic acid RT-PCR test provides false negative result, or before the disease can be detected by nucleic acid RT-PCR test. By combing chest CT result with age, contact history and decrease in lymphocyte to diagnose COVID-19, miss diagnosis rate can be significantly reduced. In clinical work, when diagnosing patients with respiratory symptoms such as fever, cough, and sputum, the patient's chest CT imaging features should be paid attention to. Moreover, patient's age should be fully concerned; patient's anamnesis and epidemiological history (travel history in epidemic area, contact history with people from epidemic area or with confirmed cases) should be carefully inquired; and patient's lymphocyte count of blood routine test should be taken into consideration as well. This study further finds that age older than 41.5 years old and lymphocyte count lower than 1.53×10 9 /L are the threshold diagnostic numbers for age and lymphocyte count respectively. They have relatively high diagnostic values, with sensitivity of 0.70 and 0.82 respectively. All rights reserved. No reuse allowed without permission. the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.