• Chunjin Ke, Chong Yu, Daoyuan Yue, Xing Zeng, Zhiquan Hu, and Chunguang Yang.
• Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
• Med Clin (Barc). 2020 Oct 23; 155 (8): 327334327-334.

BackgroundNovel coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by SARS-CoV-2. At the peak of the outbreak in Wuhan (January and February), there are two types of COVID-19 patients: laboratory confirmation and clinical diagnosis. This study aims to compare and analyze the clinical outcomes and characteristics of confirmed and clinically diagnosed COVID-19 patients to determine whether they are of the same type and require equal treatment. More importantly, the prognostic factors of COVID-19 patients are explored.MethodsA total of 194 hospitalized patients with COVID-19 pneumonia were retrospectively studied. Demographic data, clinical characteristcs, laboratory results and prognostic information were collected by electronic medical record system and analyzed.ResultsAmong 194 subjects included, 173 were confirmed and 21 were clinically diagnosed. There were no significant differences in clinical outcomes (mortality rate 39[22.54%] vs 7[33.33%], P=0.272) and hospital stay (19.00 vs 16.90 days, P=0.411) between the confirmed and clinically diagnosed group, and prognostic factors were similar between them. Older age, lower albumin levels, higher serum Lactate dehydrogenase (LDH) levels, higher D-D levels, longer prothrombin time (PT), higher IL-6 levels, lower T cells indicated poor prognosis in patients with COVID-19 pneumonia. NK cell has the highest AUC among all measured indicators (NK AUC=0.926, P<0.001).ConclusionLaboratory-confirmed and clinically diagnosed COVID-19 patients are similar in clinical outcomes and most clinical characteristics. They are of the same type and require equal treatment. Age, AST, LDH, BUN, PT, D-D, IL6, white blood cell and neutrophil counts, T cell and T cell subset counts can efficiently predict clinical outcomes.Copyright © 2020 Elsevier España, S.L.U. All rights reserved.

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