Comparison between Suspected and Confirmed COVID-19 Respiratory Patients: What Is beyond the PCR Test

Journal of Clinical Medicine

Federica Albicini¹  Angelo Guido Corsico¹  Amelia Grosso¹  Erica Gini¹  Salvatore Battaglia²  Marta Amata²  Alida Benfante²  Ilaria Piccionello²  Stefania Principe²  Nicola Scichilone² 

[1] Department of Pulmonology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy;Department of Pulmonology–Palermo (PA) (Italy), AOUP Policlinico Paolo Giaccone, University of Palermo, 90127 Palermo, Italy;

关键词: COVID-19;    PCR test;    COVID-19 diagnosis;   

DOI  :  10.3390/jcm11112993

来源: DOAJ

【 摘 要 】

COVID-19 modified the healthcare system. Nasal-pharyngeal swab (NPS), with real-time reverse transcriptase-polymerase (PCR), is the gold standard for the diagnosis; however, there are difficulties related to the procedure that may postpone it. The study aims to evaluate whether other elements than the PCR-NPS are reliable and confirm the diagnosis of COVID-19. This is a cross-sectional study on data from the Lung Unit of Pavia (confirmed) and at the Emergency Unit of Palermo (suspected). COVID-19 was confirmed by positive NPS, suspected tested negative. We compared clinical, laboratory and radiological variables and performed Logistic regression to estimate which variables increased the risk of COVID-19. The derived ROC-AUCcurve, assessed the accuracy of the model to distinguish between COVID-19 suspected and confirmed. We selected 50 confirmed and 103 suspected cases. High Reactive C-Protein (OR: 1.02; CI95%: 0.11–1.02), suggestive CT-images (OR: 11.43; CI95%: 3.01–43.3), dyspnea (OR: 10.48; CI95%: 2.08–52.7) and respiratory failure (OR: 5.84; CI95%: 1.73–19.75) increased the risk of COVID-19, whereas pleural effusion decreased the risk (OR: 0.15; CI95%: 0.04–0.63). ROC confirmed the discriminative role of these variables between suspected and confirmed COVID-19 (AUC 0.91). Clinical, laboratory and imaging features predict the diagnosis of COVID-19, independently from the NPS result.

【 授权许可】

Unknown