This study aims to assess the peripheral blood cell count “signature” of Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2) to discriminate promptly between COronaVIrus Disease 19 (COVID-19) and community-acquired pneumonia (CAP). We designed a retrospective case-control study, enrolling 525 patients (283 COVID-19 and 242 with CAP). All patients had a fever and at least one of the following signs: cough, chest pain, or dyspnea. We excluded patients treated with immunosuppressants, steroids, or affected by diseases known to modify blood cell count. COVID-19 patients showed a significant reduction in white blood cells (neutrophils, lymphocytes, monocytes, eosinophils) and platelets. We studied these parameters univariately, combined the significant ones in a multivariate model (AUROC 0.86, Nagelkerke PSEUDO-R2 0.5, Hosmer–Lemeshow p -value 0.9) and examined its discriminative performance in an internally-randomized validation cohort (AUROC 0.84). The cut-off selected according to Youden’s Index (−0.13) showed a sensitivity of 84% and a specificity of 72% in the training cohort, and a sensitivity of 88% and a specificity of 73% in the validation cohort. In addition, we determined the probability of having COVID-19 pneumonia for each Model for possible Early COvid-19 Recognition (MECOR) Score value. In conclusion, our model could provide a simple, rapid, and cheap tool for prompt COVID-19 diagnostic triage in patients with CAP. The actual effectiveness should be evaluated in further, prospective studies also involving COVID-19 patients with negative nasopharyngeal swabs.
【저자키워드】 COVID-19, Neutrophils, SARS-CoV-2, coronavirus, Pneumonia, Triage, Diagnosis, Interstitial lung disease, Platelets, blood cell count, 【초록키워드】 Monocytes, Lymphocytes, Prospective Study, diagnostic, cough, Steroids, immunosuppressants, Probability, sensitivity, specificity, Cohort, White blood cell, nasopharyngeal swabs, eosinophils, Fever, Dyspnea, Patient, Model, Effectiveness, respiratory, disease, score, community-acquired pneumonia, case-control study, retrospective, COVID-19 patient, chest pain, index, Recognition, multivariate model, P -value, validation cohort, AUROC, cut-off, parameter, selected, affected, examined, addition, evaluated, excluded, reduction in, modify, patients treated, peripheral blood cell, 【제목키워드】 Model, Recognition, simple,