Epidemiological, Clinical, Laboratorial and CT Imaging Features of Hospitalized Patients with Initially Negative Detection of SARS-CoV-2 in China

Yingjian Liang, Xiaobin Zheng, Meizhu Chen, Changli Tu, Cuiyan Tan, Yiying Huang, Zhenguo Wang, Jian Wu, Jing Liu Department of Pulmonary and Critical Care Medicine (PCCM), The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, People’s Republic of ChinaCorrespondence: Jing Liu; Xiaobin ZhengDepartment of Pulmonary and Critical Care Medicine (PCCM), The Fifth Affiliated Hospital of Sun Yat-sen University, 52 East Meihua Road, Zhuhai City, 519000, People’s Republic of ChinaTel/Fax +867562528733Email liujing25@mail.sysu.edu.cn; zhxbin@mail.sysu.edu.cnPurpose: The main objective of this study was to decipher the general epidemiology, clinical characteristic, laboratory finding and chest computed tomography (CT) imaging features of the novel coronavirus disease (COVID-19) patients whose initial detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)is negative.Methods: Nearly 100 confirmed cases admitted to The Fifth Affiliated Hospital of Sun Yat-sen University from 18th January to 26th February, 2020, were screened. Clinical records, laboratory results and CT images were reviewed for nine COVID-19 patients with initially negative RT-PCR detection.Results: Fever and cough were common, and one patient merely present gastrointestinal symptoms. Increasing CRP and decreasing ALB were showed in nearly half of the patients among negative detection and return to normal level after real time polymerase chain reaction (RT-PCR) results converted from positive to negative. Left lower lobe was affected nearly in all the patients. A patient received oxygen support timely according his high Mulbsta score.Conclusion: Our study elucidated on the clinical features of hospitalized patients with initially negative detection of SARS-CoV nucleic acid. Patient merely with symptoms associated with digestive system should be screened for COVID-19. CT scan and repeated RT-PCR are two powerful diagnostic tools. Mulbsta score assessing in the early stage enhances the confidence of severity evaluation in physician.Keywords: COVID-19, negative detection, clinical characteristic, laboratory finding, CT images features