Analysis of 2019 novel coronavirus infection and clinical characteristics of outpatients: An epidemiological study from a fever clinic in Wuhan, China

Abstract

Background: Since the outbreak of 2019 novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) pneumonia, thousands of patients with fever or cough were flocked into fever clinic of designated hospitals in Wuhan, China. To date, no data have ever been reported to reflect the prevalence of coronavirus disease 2019 (COVID-19) among these outpatients. Moreover, it is almost unknown to discriminate COVID-19 and nucleic acid negative patients based on clinical features in the fever clinics.

Methods: The infectious status of SARS-CoV-2 was estimated among the outpatients. The epidemiological and clinical characteristics were compared between COVID-19 and nucleic acid negative patients.

Results: The nucleic acid positive rate for SARS-CoV-2 in the outpatients from our fever clinic was 67·1%, while the majority of patients with COVID-19 were mild cases. The predominant initial symptom in those patients with COVID-19 was fever (78.2%), followed by cough (15.6%). Very significantly lower number of eosinophils was characterized in patients with COVID-19 as compared with that of nucleic acid negative patients. More importantly, the proportion of subjects with eosinophil counts lower than normal levels in patients with COVID-19 was much higher than that of nucleic acid negative patients. Fever combined with bilateral ground-glass opacities in computed tomography imaging and eosinophil count below the normal level are probably a valuable indicator of COVID-19 infection in those outpatients.

Conclusions: Those findings may provide critical information for the regions, such as Europe and United States that are facing the same situation as Wuhan experienced, and could be valuable to prevent those nucleic acid negative patients from misdiagnosis before antibody testing.

Keywords: COVID-19; diagnostic indicator; eosinophil; fever clinic.

Figure 1

Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection of eosinophil. A, The number of esonophil drops dramatically in patients with coronavirus disease 2019 (COVID‐19). Figures show peripheral blood mononuclear cells esonophil ratios in patients recovered from viral infection or still under critical conditions. B, Virus infection of eosinophil was analyzed with flow‐cytometry. Presence of viral antigen in eosinophil was shown. C, Percentage of infected eosinophil in patients with COVID‐19 who recovered or still under critical conditions

Figure 2

Representative images of the thoracic computed tomography (CT) scans showing multiple ground‐glass opacity and consolidation shadows in the lower lobe of both lungs. Some thickened blood vessels can be seen