Abstract
Background: The outbreak of COVID-19 has led to international concern. We aimed to establish an effective screening strategy in Shanghai, China, to aid early identification of patients with COVID-19.
Methods: We did a multicentre, observational cohort study in fever clinics of 25 hospitals in 16 districts of Shanghai. All patients visiting the clinics within the study period were included. A strategy for COVID-19 screening was presented and then suspected cases were monitored and analysed until they were confirmed as cases or excluded. Logistic regression was used to determine the risk factors of COVID-19.
Findings: We enrolled patients visiting fever clinics from Jan 17 to Feb 16, 2020. Among 53 617 patients visiting fever clinics, 1004 (1·9%) were considered as suspected cases, with 188 (0·4% of all patients, 18·7% of suspected cases) eventually diagnosed as confirmed cases. 154 patients with missing data were excluded from the analysis. Exposure history (odds ratio [OR] 4·16, 95% CI 2·74-6·33; p<0·0001), fatigue (OR 1·56, 1·01-2·41; p=0·043), white blood cell count less than 4 × 10 9 per L (OR 2·44, 1·28-4·64; p=0·0066), lymphocyte count less than 0·8 × 10 9 per L (OR 1·82, 1·00-3·31; p=0·049), ground glass opacity (OR 1·95, 1·32-2·89; p=0·0009), and having both lungs affected (OR 1·54, 1·04-2·28; p=0·032) were independent risk factors for confirmed COVID-19.
Interpretation: The screening strategy was effective for confirming or excluding COVID-19 during the spread of this contagious disease. Relevant independent risk factors identified in this study might be helpful for early recognition of the disease.
Funding: National Natural Science Foundation of China.
【초록키워드】 COVID-19, fatigue, hospital, lung, risk factor, clinics, Spread, China, Lymphocyte count, White blood cell, outbreak, International, Fever, Patient, multicentre, Shanghai, disease, patients, Analysis, exposure, Odds ratio, Science, Observational cohort study, Ground glass opacity, natural, 95% CI, confirmed cases, study period, foundation, independent risk factor, contagious, screening strategy, effective, enrolled, affected, was used, diagnosed, the disease, analysed, less, determine, excluded, patients with COVID-19, were excluded, 【제목키워드】 SARS-COV-2 infection, Symptom, risk factor, Patient, multicentre, Shanghai, Observational cohort study, presenting, Assessing,