Prevalence and clinical features of 2019 novel coronavirus disease (COVID-19) in the Fever Clinic of a teaching hospital in Beijing: a single-center, retrospective study

  1. Ying Liang
  2. Jingjin Liang
  3. Qingtao Zhou
  4. Xiaoguang Li
  5. Fei Lin
  6. Zhonghua Deng
  7. Biying Zhang
  8. Lu Li
  9. Xiaohua Wang
  10. Hong Zhu
  11. Qingbian Ma
  12. Xiaomei Tong
  13. Jie Xu
  14. Yongchang Sun

Reviewed by

Read the full article See related articles

Listed in

Log in to save this article

Abstract

Background

With the spread of COVID-19 from Wuhan, Hubei Province to other areas of the country, medical staff in Fever Clinics faced the challenge of identifying suspected cases among febrile patients with acute respiratory infections. We aimed to describe the prevalence and clinical features of COVID-19 as compared to pneumonias of other etiologies in a Fever Clinic in Beijing.

Methods

In this single-center, retrospective study, 342 cases of pneumonia were diagnosed in Fever Clinic in Peking University Third Hospital between January 21 to February 15, 2020. From these patients, 88 were reviewed by panel discussion as possible or probable cases of COVID-19, and received 2019-nCoV detection by RT-PCR. COVID-19 was confirmed by positive 2019-nCoV in 19 cases, and by epidemiological, clinical and CT features in 2 cases (the COVID-19 Group, n=21), while the remaining 67 cases served as the non-COVID-19 group. Demographic and epidemiological data, symptoms, laboratory and lung CT findings were collected, and compared between the two groups.

Findings

The prevalence of COVID-19 in all pneumonia patients during the study period was 6.14% (21/342). Compared with the non-COVID-19 group, more patients with COVID-19 had an identified epidemiological history (90.5% versus 32.8%, P <0.001). The COVID-19 group had lower WBC [5.19×10 9 /L (±1.47) versus 7.21×10 9 /L (±2.94), P <0.001] and neutrophil counts [3.39×10 9 /L (±1.48) versus 5.38×10 9 /L (±2.85), P <0.001] in peripheral blood. However, the count of lymphocytes was not different. On lung CT scans, involvement of 4 or more lobes was more common in the COVID-19 group (45% versus 16.4%, P =0.008).

Interpretation

In the period of COVID-19 epidemic outside Hubei Province, the prevalence of COVID-19 in patients with pneumonia visiting our Fever Clinic in Beijing was 6.14%. Epidemiological evidence was important for prompt case finding, and lower blood WBC and neutrophil counts may be useful for differentiation from pneumonia of other etiologies.

Funding

None.

Article activity feed

  1. ScreenIT

    SciScore for 10.1101/2020.02.25.20027763: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: The study protocol was approved by the ethics committee of Peking University Third Hospital and the data were analyzed anonymously.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analyses were performed using SPSS software, version 22.0 (IBM, Armonk, NY, USA).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our study had several limitations. As a single-center, retrospective study of patients mainly from Haidian District in Beijing, the prevalence of COVID-19 in this Fever Clinic was not representative. The sample was small-sized and mostly mild and moderate in severity, which may not reflect the whole picture of the disease. Furthermore, the pathogens causing pneumonia in patients without COVID-19 were not identified, therefore we were unable to evaluate the prevalence of other common viral pneumonias of this season, such as influenza pneumonia and adenoviral pneumonia, making specific comparisons between different viral pneumonias unavailable.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.02.25.20027763v2 on medRxiv
  3. Version published to 10.1101/2020.02.25.20027763v1 on medRxiv