A differential diagnosis model for patients with COVID-19 and non-COVID-19 pneumonia based on laboratory indicators

ABSTRACT

OBJECTIVE: To retrospectively analyze the clinical characteristics, imaging features and laboratory indexes of the patients with COVID-19 and non-COVID-19 so as to seek for differential diagnosis indexes. METHODS: A total of 66 patients with COVID-19 and 40 non-COVID-19 patients were recruited as study subjects who were treated in the hospital from Jan 2020 to Apr 2020. The demographic data, clinical symptoms, underlying diseases, imaging features, length of hospital stay and laboratory test indexes at the admission were statistically analyzed. RESULTS: The white blood cell(WBC),albumin(ALB) and prealbumin(PALB) of the COVID-19 patients were remarkably lower than those of the non-COVID-19 patients;while the length of hospital stay, aspartate aminotransferase(AST), international normalized ratio(INR), fibrinogen(Fbg), lactate dehydrogenase(LDH), tumor specific growth factor(TSGF) and ferritin(Ferritin) of the COVID-19 group were remarkably higher than those of the non-COVID-19 group. The COVID-19 patients had a higher frequency of air bronchogram, reticular pattern, number of affected lobes and number of affected segments, but a lower frequency of centrilobular nodules than did the non-COVID-19 patients. The length of hospital stay of the COVID-19 patients was positively correlated with the age but was negatively correlated with LYM and ALB, and the length of hospital stay of the patients complicated with diabetes mellitus and hypertension was longer than the patients with other complications. Receiver operating characteristic(ROC) curve analysis showed that the areas under curves of WBC, TSGF, LDH and Ferritin were more than 75% in distinguishing between COVID-19 and non-COVID-19. Multivariate logistic regression analysis showed that TSGF, LDH and Ferritin were the independent factors for distinguishing between COVID-19 and non-COVID-19, and the area under curve of the joint detection of the three indexes was 0.9181. CONCLUSION: The ordinary COVID-19 patients and non-COVID-19 patients vary in some clinical characteristic, imaging features and clinical laboratory indexes. The joint diagnosis model of TSGF, LDH and Ferritin may be used as an effective indicator for distinguishing between ordinary COVID-19 and non-COVID-19.