Background Since December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged as a novel etiologic agent of viral pneumonia. We aimed to compare clinical features of 165 Italian patients with laboratory confirmed or unconfirmed 2019-nCoV pneumonia. Methods On March 31, 2020, hospitalized patients who presented with fever and/or respiratory symptoms, exposures, and presence of lung imaging features consistent with 2019-nCoV pneumonia were included. Before admission to a hospital ward, patients underwent RT-PCR based SARS-CoV-2 RNA detection in their nasopharyngeal swab samples. Results Of 165 patients studied, 119 had positive RT-PCR results and 46 were RT-PCR negative for 2 days or longer (i.e., when the last swab sample was obtained). The median age was 70 years (IQR, 58–78), and 123 (74.6%) of 165 patients had at least one comorbidity. The majority of patients (101/165, 61.2%) had a mild pneumonia, and the remaining patients (64/165, 38.8%) a severe/critical pneumonia. We did not find any substantial difference in symptoms, incubation periods, and radiographic/CT abnormalities as well as in many of the biological abnormalities recorded. However, at multivariable analysis, higher concentrations of hemoglobin (OR, 1.34; 95% CI, 1.11–1.65; P = 0.003) and lower counts of leukocytes (OR, 0.81; 95% CI, 0.72–0.90; P < 0.001) were statistically associated with confirmed COVID-19 diagnosis. While mortality rates were similar, patients with confirmed diagnosis were more likely to receive antivirals (95% vs 19.6%, P < 0.001) and to develop ARDS (63% vs 37%, P = 0.003) than those with unconfirmed COVID-19 diagnosis. Conclusions Our findings suggest that unconfirmed 2019-nCoV pneumonia cases may be actually COVID-19 cases and that clinicians should be cautious when managing patients with presentations compatible with COVID-19.
【저자키워드】 COVID-19, Pneumonia, outcomes, Clinical and laboratory findings, 【초록키워드】 SARS-CoV-2, ARDS, coronavirus, Antiviral, 2019-nCoV, Diagnosis, Comorbidity, RT-PCR, Symptoms, Laboratory, Viral pneumonia, Nasopharyngeal swab, Fever, Patient, COVID-19 diagnosis, hemoglobin, mortality rate, Admission, clinical feature, positive RT-PCR, SARS-CoV-2 RNA detection, Concentration, respiratory symptoms, Lung imaging, leukocyte, acute respiratory syndrome, 95% CI, clinician, COVID-19 case, median age, multivariable analysis, abnormality, mild pneumonia, while, hospital ward, feature, swab sample, Result, develop, majority, hospitalized patient, recorded, was obtained, statistically, receive, biological abnormality, IQR, Italian patient, pneumonia case, with COVID-19, 【제목키워드】 2019 novel coronavirus, Retrospective analysis, clinical feature, Italian, Confirmed,