Clinical Features of Early Stage COVID-19 in a Primary Care Setting

Background: The coronavirus disease 2019 (COVID-19) pandemic remains a global healthcare crisis. Nevertheless, the majority of COVID-19 cases involve mild to moderate symptoms in the early stages. The lack of information relating to these cases necessitates further investigation.Methods: Patients vi...

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Autores principales:	Yohei Kawatani, Kei Nakayama, Atsushi Sawamura, Koichi Fujikawa, Motoki Nagai, Takaki Hori
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	COVID-19 primary care predictive value predictive score SARS-CoV-2 monocyte-to-neutrophile ratio Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/a16de982cf884c6a9ea092bb9bd59861
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spelling	oai:doaj.org-article:a16de982cf884c6a9ea092bb9bd598612021-11-30T12:09:16ZClinical Features of Early Stage COVID-19 in a Primary Care Setting2296-858X10.3389/fmed.2021.764884https://doaj.org/article/a16de982cf884c6a9ea092bb9bd598612021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.764884/fullhttps://doaj.org/toc/2296-858XBackground: The coronavirus disease 2019 (COVID-19) pandemic remains a global healthcare crisis. Nevertheless, the majority of COVID-19 cases involve mild to moderate symptoms in the early stages. The lack of information relating to these cases necessitates further investigation.Methods: Patients visiting the outpatient clinic at the Kamagaya General Hospital were screened by interview and body temperature check. After initial screening, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was suspected in 481 patients who then underwent blood tests and the loop-mediated isothermal amplification (LAMP) test for SARS-CoV-2. Clinical characteristics between positive and negative SARS-CoV-2 groups were compared. Further, the novel predictive value of routine blood test results for SARS-CoV-2 infection was evaluated using ROC analysis.Results: A total of 15,560 patients visited our hospital during the study period. After exclusion and initial screening by interview, 481 patients underwent the LAMP test and routine blood tests. Of these patients, 69 (14.3%) were positive for SARS-CoV-2 and diagnosed with COVID-19 (positive group), and 412 (85.7%) were negative (negative group). The median period between the first onset of symptoms and visit to our hospital was 3.4 and 2.9 days in the negative and positive groups, respectively. Cough (p = 0.014), rhinorrhea (p = 0.039), and taste disorders (p < 0.001) were significantly more common in the positive group, while gastrointestinal symptoms in the negative group (p = 0.043). The white blood cell count (p < 0.001), neutrophil count (p < 0.001), and percentage of neutrophils (p < 0.001) were higher in the negative group. The percentage of monocytes (p < 0.001) and the levels of ferritin (p < 0.001) were higher in the positive group. As per the predictive values for COVID-19 using blood tests, the values for the area under the curve for the neutrophil-to-monocyte ratio (NMR), white blood cell-to-hemoglobin ratio (WHR), and the product of the two (NMWH) were 0.857, 0.837, and 0.887, respectively.Conclusion: Symptoms in early stage COVID-19 patients were similar to those in previous reports. Some blood test results were not consistent with previous reports. NMR, WHR, and NMWH are novel diagnostic scores in early-stage mild-symptom COVID-19 patients in primary care settings.Yohei KawataniKei NakayamaAtsushi SawamuraKoichi FujikawaMotoki NagaiTakaki HoriFrontiers Media S.A.articleCOVID-19primary carepredictive valuepredictive scoreSARS-CoV-2monocyte-to-neutrophile ratioMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 primary care predictive value predictive score SARS-CoV-2 monocyte-to-neutrophile ratio Medicine (General) R5-920
spellingShingle	COVID-19 primary care predictive value predictive score SARS-CoV-2 monocyte-to-neutrophile ratio Medicine (General) R5-920 Yohei Kawatani Kei Nakayama Atsushi Sawamura Koichi Fujikawa Motoki Nagai Takaki Hori Clinical Features of Early Stage COVID-19 in a Primary Care Setting
description	Background: The coronavirus disease 2019 (COVID-19) pandemic remains a global healthcare crisis. Nevertheless, the majority of COVID-19 cases involve mild to moderate symptoms in the early stages. The lack of information relating to these cases necessitates further investigation.Methods: Patients visiting the outpatient clinic at the Kamagaya General Hospital were screened by interview and body temperature check. After initial screening, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was suspected in 481 patients who then underwent blood tests and the loop-mediated isothermal amplification (LAMP) test for SARS-CoV-2. Clinical characteristics between positive and negative SARS-CoV-2 groups were compared. Further, the novel predictive value of routine blood test results for SARS-CoV-2 infection was evaluated using ROC analysis.Results: A total of 15,560 patients visited our hospital during the study period. After exclusion and initial screening by interview, 481 patients underwent the LAMP test and routine blood tests. Of these patients, 69 (14.3%) were positive for SARS-CoV-2 and diagnosed with COVID-19 (positive group), and 412 (85.7%) were negative (negative group). The median period between the first onset of symptoms and visit to our hospital was 3.4 and 2.9 days in the negative and positive groups, respectively. Cough (p = 0.014), rhinorrhea (p = 0.039), and taste disorders (p < 0.001) were significantly more common in the positive group, while gastrointestinal symptoms in the negative group (p = 0.043). The white blood cell count (p < 0.001), neutrophil count (p < 0.001), and percentage of neutrophils (p < 0.001) were higher in the negative group. The percentage of monocytes (p < 0.001) and the levels of ferritin (p < 0.001) were higher in the positive group. As per the predictive values for COVID-19 using blood tests, the values for the area under the curve for the neutrophil-to-monocyte ratio (NMR), white blood cell-to-hemoglobin ratio (WHR), and the product of the two (NMWH) were 0.857, 0.837, and 0.887, respectively.Conclusion: Symptoms in early stage COVID-19 patients were similar to those in previous reports. Some blood test results were not consistent with previous reports. NMR, WHR, and NMWH are novel diagnostic scores in early-stage mild-symptom COVID-19 patients in primary care settings.
format	article
author	Yohei Kawatani Kei Nakayama Atsushi Sawamura Koichi Fujikawa Motoki Nagai Takaki Hori
author_facet	Yohei Kawatani Kei Nakayama Atsushi Sawamura Koichi Fujikawa Motoki Nagai Takaki Hori
author_sort	Yohei Kawatani
title	Clinical Features of Early Stage COVID-19 in a Primary Care Setting
title_short	Clinical Features of Early Stage COVID-19 in a Primary Care Setting
title_full	Clinical Features of Early Stage COVID-19 in a Primary Care Setting
title_fullStr	Clinical Features of Early Stage COVID-19 in a Primary Care Setting
title_full_unstemmed	Clinical Features of Early Stage COVID-19 in a Primary Care Setting
title_sort	clinical features of early stage covid-19 in a primary care setting
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/a16de982cf884c6a9ea092bb9bd59861
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Clinical Features of Early Stage COVID-19 in a Primary Care Setting

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