Predictive Factors for the Diagnosis of Coronavirus Disease 2019

Objective: We evaluated patients suspected or confirmed to have coronavirus disease 2019 (COVID- 19) to determine predictive factors for the diagnosis of COVID- 19. Method(s): We conducted a retrospective cohort study at The Jikei University Hospital, Tokyo, Japan. This study included adult patients who underwent medical examination for suspected or confirmed COVID- 19 in April and May 2020. We analyzed the clinical characteristics, blood test results, and findings of computed tomography of the chest from the medical record system of the hospital. Result(s): Of the 267 patients included in this study, 27 were found to be positive for COVID- 19 on reverse transcription polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2 (SARS- CoV- 2). Of the patients, 128 (47.9%) were men, and the median age was 47 years (interquartile range, 34.5- 65). Twenty- two (8.2%) patients had a history of close contact with a COVID- 19 patient. The most common symptoms were fever, general malaise, and cough. Multivariate analysis with the logistic regression model revealed that close contact, fever for 4 or more days, dysgeusia, and dysosmia were independent predictive factors for reverse transcription polymerase chain reaction test results being positive for SARS- CoV- 2. Conclusion(s): Patients who have had close contact with a COVID- 19 patient, fever for 4 days or more, dysgeusia, or dysosmia should undergo diagnostic testing for SARS- CoV- 2.Copyright © 2021 Jikei University School of Medicine. All rights reserved.

A CASE OF COVID-19 AFTER TRACHEOSTOMY DIAGNOSED BY A THIRD-TIME RT-PCR.

Reverse -transcription polymerase chain reaction (RT-PCR)testing is necessary for the definitive diagnosis of coronavirus disease 2019(COVID-19), and is most often performed on pharyngeal swabs. However, it has become clear that even if the RT-PCR is negative, COVID-19 cannot be ruled out altogether. We encountered a patient who developed COVID-19 after a tracheostomy. He developed fever and respiratory failure and was suspected as having developed COVID-19, but RT-PCR conducted on upper airway specimens was negative twice in succession;a third RT-PCR test conducted on a sputum specimen later confirmed a positive result for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2). In cases with clinically suspected infection with SARS-CoV-2, RT-PCR should be repeated, and lower respiratory tract specimens should be used from the beginning if the infection occurs before or after tracheostomy. Copyright © 2021 Society of Oto-Rhino-Laryngology Tokyo. All rights reserved.