Factors Associated with a Positive Severe Acute Respiratory Syndrome Coronavirus 2 Testing in Suspected Cases Presenting with Pneumonia: A Retrospective Cohort Study in a Single Medical Center

Respiration. 2020;99(9):739-747. doi: 10.1159/000508398. Epub 2020 Nov 18.

Abstract

Background: Coronavirus disease 2019 (COVID-19) has become a global emerging infectious disease.

Objectives: To analyze the initial clinical characteristics of COVID-19 suspected and confirmed patients on admission in order to find out which kinds may be more likely to get positive nucleic acid testing results, and to explore the risk factors associated with all-cause death.

Methods: Medical records from 309 highly suspected cases with pneumonia were collected from February 13, 2020, to March 14, 2020, in a COVID-19-designated hospital of Wuhan. The majority of the clinical data were collected on the first day of hospital admission.

Results: Of 309 patients with median age 64 years (interquartile ranges [IQR], 53-72 years), 111 patients (35.9%) were confirmed by nucleic acid testing (median age 64 years, IQR: 56-71 years; 48 males). Of those 111 patients, 13 (11.7%) patients died. In multivariate analysis, factors associated with positive testing included fatigue (odds ratios [OR] = 3.14; 95% confidence interval [CI]: 1.88-5.24, p < 0.001), cough (OR = 0.55; 95% CI: 0.32-0.95, p = 0.032), no less than 1 comorbidity (OR = 1.77; 95% CI: 1.06-2.98, p = 0.030), and severe pneumonia (OR = 2.67; 95% CI: 1.20-5.97, p = 0.016). Furthermore, age, dyspnea, noneffective antibiotic treatment, white blood cell, lymphocyte, platelets, and organ dysfunction (e.g., higher lactate dehydrogenase) were significantly associated with all-cause in-hospital death in patients with COVID-19.

Conclusion: Patients with severe forms of this disease were more likely to get positive results. Age and organ dysfunction were associated with a greater risk of death.

Keywords: Coronavirus disease 2019; Negative SARS-CoV-2 testing; Pneumonia; Positive SARS-CoV-2 testing; Risk factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Alanine Transaminase / metabolism
  • Anti-Bacterial Agents / therapeutic use
  • Aspartate Aminotransferases / metabolism
  • C-Reactive Protein / metabolism
  • COVID-19 / diagnosis
  • COVID-19 / epidemiology*
  • COVID-19 / metabolism
  • COVID-19 / physiopathology
  • COVID-19 Nucleic Acid Testing
  • COVID-19 Serological Testing
  • Cause of Death
  • Child
  • Child, Preschool
  • China / epidemiology
  • Cohort Studies
  • Comorbidity
  • Cough / physiopathology*
  • Creatine Kinase / metabolism
  • Fatigue / physiopathology*
  • Female
  • Fever / physiopathology
  • Fibrin Fibrinogen Degradation Products / metabolism
  • Hospital Mortality*
  • Hospitalization
  • Humans
  • Immunoglobulin G
  • Immunoglobulin M
  • Infant
  • Infant, Newborn
  • L-Lactate Dehydrogenase / metabolism
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Pneumonia / drug therapy
  • Pneumonia / epidemiology*
  • Pneumonia / microbiology
  • Pneumonia / physiopathology
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2
  • Serum Albumin / metabolism
  • Severity of Illness Index
  • Treatment Failure
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Fibrin Fibrinogen Degradation Products
  • Immunoglobulin G
  • Immunoglobulin M
  • Serum Albumin
  • fibrin fragment D
  • C-Reactive Protein
  • L-Lactate Dehydrogenase
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • Creatine Kinase