Epidemiological and clinical characteristics in patients with SARS-CoV-2 antibody negative probable COVID-19 in Wuhan

  1. Limin Duan
  2. Shuai Zhang
  3. Mengfei Guo
  4. E Zhou
  5. Jinshuo Fan
  6. Xuan Wang
  7. Ling Wang
  8. Feng Wu
  9. Yang Jin

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Abstract

Background

Patients with suspected COVID-19 might be admitted to hospital. We aimed to describe the characteristic of SARS-CoV-2 antibody negative probable COVID-19 patients and give some suggestions to manage suspected COVID-19 patients.

Methods

We analyzed 616 confirmed COVID-19 patients and 35 SARS-CoV-2 antibody negative probable COVID-19 patients who were admitted in Wuhan Union Hospital from February 13, 2020 to February 16, 2020. Telephone interviews were conducted and medical records were reviewed for epidemiological, clinical, laboratory and radiographic data.

Results

Of the 35 SARS-CoV-2 antibody negative probable COVID-19 patients, all of them had tested at least 3 times of nucleic acid, 3 were believed to be non-SARS-CoV-2 infection. Compared with confirmed patients, antibody negative probable patients were younger (P=0.017), exhibited similar symptoms and chest CT images, had higher lymphocyte count (P=0.004) and albumin level (P<0.001), showed lower lactate dehydrogenase level (P=0.011) and erythrocyte sedimentation rate (P<0.001). During hospitalization, all the 35 patients had contacted with confirmed COVID-19 patients, but all used general face mask for protection and maintained a social distance of more than one meter from each other. All the isolation wards were kept ventilation and disinfected once a day. After discharged from hospital, all of them had negative nucleic acid tests and no one developed symptoms again.

Conclusions

The conditions of patients with AbN probable COVID-19 were less critical than those of patients with confirmed COVID-19. Room ventilation and daily disinfection, wearing face masks, and maintaining social distance might be helpful to prevent patients from hospital acquired COVID-19 infection.

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  1. ScreenIT

    SciScore for 10.1101/2020.06.18.20134619: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementIACUC: The study was approved by the Institutional Ethics Committee of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (20200036), the requirement for informed consent was exempted by the Ethics Committee.
    Consent: The study was approved by the Institutional Ethics Committee of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (20200036), the requirement for informed consent was exempted by the Ethics Committee.
    IRB: The study was approved by the Institutional Ethics Committee of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (20200036), the requirement for informed consent was exempted by the Ethics Committee.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    Suspected cases were considered to be confirmed if (1) real-time fluorescence RT-PCR for SARS-CoV-2 nucleic acid yielded positive results, or (2) Positive SARS-CoV-2 specific IgM and IgG antibody, or (3) Demonstration of a four-fold or greater increase in IgG antibody titer or conversion from a negative to a positive result between acute- and convalescent-phase serum specimens.
    SARS-CoV-2 nucleic acid yielded positive results, or (2
    suggested: None
    IgG
    suggested: None
    All discharged patients with suspected COVID-19 infection were interviewed by telephone to collect the updated SARS-CoV-2 nucleic acid and antibody results.
    SARS-CoV-2 nucleic acid
    suggested: None
    Software and Algorithms
    SentencesResources
    All statistical analyses were performed by using SAS software package (version 9.4).
    SAS
    suggested: (SASqPCR, RRID:SCR_003056)

    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. First, this is a retrospective study and there is no definite evidence that the AbN probable patients were infected with other pathogens. Second, not all suspected COVID-19 patients had tested SARS-CoV-2 antibody, those patients were excluded from our study and may cause selection bias. Third, no exposure control could be founded for the 35 AbN probable COVID-19 patients, we could not determine which measure are useful to protect patients from hospital acquired COVID-19 infection.

    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 10.1101/2020.06.18.20134619v1 on medRxiv