About: Eosinopenia and elevated C-reactive protein facilitate triage of COVID-19 patients in fever clinic: a retrospective case-control study

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About: Eosinopenia and elevated C-reactive protein facilitate triage of COVID-19 patients in fever clinic: a retrospective case-control study Goto Sponge NotDistinct Permalink

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Eosinopenia and elevated C-reactive protein facilitate triage of COVID-19 patients in fever clinic: a retrospective case-control study
Creator	Chen, F Wang, Lin Wang, Zheng Wang, L Li, ( Xu, L Chen, Fenghua Ding, Xiuli Geng, Zhi Li, Qilin Xia, Geqing Lei, S Lei, Shijun Pan, An Xu, Luming Chen#, Heng-Gui Chen, Heng-Gui Ding#, Xiuli Li#, Qilin Ms, Geng Xia#, Geqing
Source	Elsevier; Medline; PMC
abstract	Abstract Background Coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is currently a pandemic affecting over 200 countries. Many cities have established designated fever clinics to triage suspected COVID-19 patients from other patients with similar symptoms. However, given the limited availability of the nucleic acid test as well as long waiting time for both the test and radiographic examination, the quarantine or therapeutic decisions for a large number of mixed patients were often not made in time. We aimed to identify simple and quickly available laboratory biomarkers to facilitate effective triage at the fever clinics for sorting suspected COVID-19 patients from those with COVID-19-like symptoms. Methods We collected clinical, etiological, and laboratory data of 989 patients who visited the Fever Clinic at Wuhan Union Hospital, Wuhan, China, from Jan 31 to Feb 21. Based on polymerase chain reaction (PCR) nucleic acid testing for SARS-CoV-2 infection, they were divided into two groups: SARS-CoV-2-positive patients as cases and SARS-CoV-2-negative patients as controls. We compared the clinical features and laboratory findings of the two groups, and analyzed the diagnostic performance of several laboratory parameters in predicting SARS-CoV-2 infection and made relevant comparisons to the China diagnosis guideline of having a normal or decreased number of leukocytes (≤9•5 109/L) or lymphopenia (<1•1 109/L). Findings Normal or decreased number of leukocytes (≤9•5 109/L), lymphopenia (<1•1 109/L), eosinopenia (<0•02 109/L), and elevated hs-CRP (≥4 mg/L) were presented in 95•0%, 52•2%, 74•7% and 86•7% of COVID-19 patients, much higher than 87•2%, 28•8%, 31•3% and 45•2% of the controls, respectively. The eosinopenia produced a sensitivity of 74•7% and specificity of 68•7% for separating the two groups with the area under the curve (AUC) of 0•717. The combination of eosinopenia and elevated hs-CRP yielded a sensitivity of 67•9% and specificity of 78•2% (AUC=0•730). The addition of eosinopenia alone or the combination of eosinopenia and elevated hs-CRP into the guideline-recommended diagnostic parameters for COVID-19 improved the predictive capacity with higher than zero of both net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Interpretation The combination of eosinopenia and elevated hs-CRP can effectively triage suspected COVID-19 patients from other patients attending the fever clinic with COVID-19-like initial symptoms. This finding would be particularly useful for designing triage strategies in an epidemic region having a large number of patients with COVID-19 and other respiratory diseases while limited medical resources for nucleic acid tests and radiographic examination. Funding This work was supported by the National Natural Science Foundation of China (NSFC) and the Major Scientific and Technological Innovation Projects of Hubei Province (MSTIP).
has issue date	2020-05-03(xsd:dateTime)
bibo:doi	10.1016/j.eclinm.2020.100375
bibo:pmid	32368728
has license	els-covid
sha1sum (hex)	f2128fc043b17bdbc1759ecefd06725ea37f7af6
schema:url	https://doi.org/10.1016/j.eclinm.2020.100375
resource representing a document's title	Eosinopenia and elevated C-reactive protein facilitate triage of COVID-19 patients in fever clinic: a retrospective case-control study
has PubMed Central identifier	PMC7196382
has PubMed identifier	32368728
schema:publication	EClinicalMedicine
resource representing a document's body	covid:f2128fc043b17bdbc1759ecefd06725ea37f7af6#body_text
is schema:about of	named entity 'doi' named entity 'elevated' named entity 'symptoms' named entity 'case-control study' named entity 'C-reactive protein' named entity 'elevated' named entity 'triage' named entity 'FEVER CLINIC' named entity 'TRIAGE' named entity 'CURRENTLY' named entity 'PROTEIN ' named entity 'COVID-19' named entity 'suspected' named entity 'fever' named entity 'C-reactive protein' named entity 'patients' named entity 'COVID-19' named entity 'Journal' named entity 'fever' named entity 'Coronavirus disease' named entity 'doi' named entity 'SARS-CoV-2' named entity 'C-reactive protein' named entity 'triage' named entity 'retrospective case-control study' named entity 'triage' named entity 'C-reactive protein' named entity 'triage' named entity 'PCR tests' named entity 'Africa' named entity 'COVID' named entity 'quarantine' named entity 'PPV' named entity 'COVID-19 outbreak' named entity 'eosinopenia' named entity 'COVID' named entity 'sensitivity analysis' named entity 'lymphopenia' named entity 'China' named entity 'Biomarkers' named entity 'eosinopenia' named entity 'leukocytes' named entity 'nucleic acid test' named entity 'pneumonia' named entity 'area under the curve' named entity 'eosinopenia' named entity 'detection limit' named entity 'College Station, Texas' named entity 'SARS-CoV-2' named entity 'nucleic acid testing' named entity 'cross-validation' named entity 'sensitivity, specificity' named entity 'eosinopenia' named entity 'Eosinopenia' named entity 'COVID-19 outbreak' named entity 'eosinopenia' named entity 'triage' named entity 'hs-CRP' named entity 'hs-CRP' named entity 'radiographic' named entity 'fever'

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