The coronavirus disease 2019 (COVID-19) outbreak in Wuhan, China, spread rapidly throughout China and gradually to some countries abroad. How is the development of an epidemic controlled? Early diagnosis is one of the important contents in prevention and control. COVID-19 patients with early mild pneumonia often lack typical evidence to make a definitive diagnosis. Based on the analysis of the cases of 4 patients, this article finds that early diagnosis requires a combination of epidemiology, clinical manifestations, imaging, and etiology, with particular emphasis on epidemiology history and chest computed tomography (CT) manifestations.

An outbreak of novel coronavirus(2019-nCoV) that began in Wuhan, China, is rapidly spreading to all over China, and gradually to multiple countries. Regarding to put the epidemic prevention and spread under the control, early identification and diagnosis play a critical role. Patients with initially no or mild symptoms of Novel Coronavirus Pneumonia (2019-nCoV), namely “stealth” infection, often lack of typical clinical evidence to establish the diagnosis. Based on the clinical analysis of 4 cases in stealth infection, the results of this study highlight that early diagnosis requires a combination of epidemiological history, clinical manifestations, early chest CT examination, and 2019-nCoV RNA test (nucleic acid test), with particular emphasis on definite epidemiological history and early chest CT findings when positive nucleic acid tests lag behind.

Objectives: To discuss the prevention and containment of COVID-19 at a general hospital in Shenzhen China; to analyze the epidemiological and clinical characteristics of its confirmed patients, which is intended to provide a model for other hospitals in COVID-19 management.Methods: The General Hospital of Shenzhen University sets up 4 medical zones relative to the COVID-19 prevention and containment. In so doing, the suspected patients classified into different kind of ward receive different treatment (Classified and Separated Treatment). The epidemiological distribution and clinical characteristics of 28 confirmed cases in the hospital were analyzed.Results: There are no medical personnel infected cases, no cross-infection among the patients in the hospital, and no misdiagnosis or missed diagnosis of COVID-19. The majority of cases in the group is from 15 to 60 years old, 25 cases had a definite travel history or close contact history in the epidemic area, and parents and spouses of the confirmed patients are the main contact groups. Fever and respiratory symptoms have a high proportion, 4 diarrhea and 4 asymptomatic cases. Additionally, the decrease of lymphocyte is observed in 8 cases. Chest CT scan shows viral pneumonia in 14 cases，All patients were confirmed by nucleic acid tests.Conclusions: Classified and Separated Treatment facilitates management of COVID-19 in the general hospital. Relative to suspected patients in the general hospital, diagnosis matters more than treatment. Epidemiological history, lymphocyte count, and chest CT scan play an important role as the indicator in early diagnosis of COVID-19.