ABSTRACT
At present, the epidemic situation of coronavirus disease 2019 (COVID-19) in the world is still a very serious problem, rapid and accurate diagnosis of COVID-19 patients is of great significance for the epidemic prevention and disease control. The investigation and diagnosis process of a patient with COVID-19 were summarized in the present study, to provide valuable information for the clinical diagnosis or prevention of COVID-19 and disease control. The patient was a migrant worker who went to Chongqing and returned to his hometown in Jan. 23, 2020. During his stay in Chongqing, one of the patient's colleagues was diagnosis with COVID-19 after he went back to Ziyang from Chongqing, and eight other colleagues were also diagnosed. Hence, the patient was quarantined and received a nucleic acid test for SARS-COV-2 in Feb. 2. The COVID-19-related clinical symptoms such as paroxysmal cough, dry cough, and occasional cough with purulent sputum were developed after a few days. So, the expert doctors asked to transfer the patient to Ziyang Hospital, West China Hospital of Sichuan University. The patient received a nucleic acid test for SARS-COV-2 for 9 times although it was positive only in the last time, and the patient was finally diagnosed with COVID-19 in Feb. 21.
ABSTRACT
At present, Coronavirus Disease 2019(COVID-19)is spreading rapidly in China and other countries. The clinical symptoms of patients infected with SARS-CoV-2 are different, or even appear to be asymptomatic, which put forward higher requirements for the prevention and control of the entire epidemic. The SARS-CoV-2 nucleic acid test was used as the mean method for diagnosis of COVID-19. The present study reports a case of COVID-19 with no obvious gastrointestinal symptoms, but with consistently positive nucleic acid test into fecal and anal swab samples. The patient study in a university in Wuhan, he had respiratory symptoms during his school, and then returned home on winter vacation. The patient was admitted to the hospital because his condition was aggravated. According to the development of the disease and the needs of diagnosis and treatment, the patient underwent multiple nucleic acid tests for SARS-COV-2.As the symptoms improved significantly, the nucleic acid test of the sputum, anal swab and feces samples continued to be positive after the conversion of pharyngeal samples.So we uncover the clinical significance of nucleic acid test of SARS-CoV-2 from more than one specimen for diagnosing or treatment of COVID-19, and explore the epidemic prevention and control strategy of COVID-19.
ABSTRACT
BACKGROUND: In December 2019, coronavirus disease 2019 (COVID-19) was first found in Wuhan, China and soon was reported all around the world. METHODS: All confirmed cases with COVID-19 in Wenzhou from January 19 to February 20, 2020, were collected and analyzed. Of the 116 patients with COVID-19, 27 were diagnosed as severe cases. Among severe cases, 9 were treated in ICU. The data of blood routine examination were analyzed and compared among common patients (as common group), severe patients admitted to intensive care unit (as severe ICU group) and severe patients not admitted to ICU (as severe non-ICU group). The blood routine examination results were dynamically observed in the above groups after admission. RESULTS: Patients with COVID-19 have lower counts of leucocytes, lymphocytes, eosinophils, platelets, and hemoglobin, but have higher neutrophil-lymphocyte ratio (NLR) and monocyte-lymphocyte ratio (MLR), which were compared with controls (P < 0.001). In severe ICU group, patients have the lowest count of lymphocytes, but the highest neutrophil count and NLR among the above three groups (all P values < 0.05); NLR and MLR indicators were combined for diagnostic efficacy analysis of severe COVID-19, and its area under the curve reached 0.925. The odds ratio of the delay in days to the start of the increase of eosinophil count for predicting the outcome of patients with severe COVID-19 was 2.291 after age adjusted. CONCLUSIONS: Patients with COVID-19 have abnormal peripheral blood routine examination results. Dynamic surveillance of peripheral blood system especially eosinophils is helpful in the prediction of severe COVID-19 cases.