Rapid Diagnosis, Isolation, and Treatment of Patients with 2019-Novel Coronavirus Pneumonia: A Retrospective Study of 10-Minute Rapid Test for Coronavirus Antigens

Background: In December, 2019, a novel coronavirus pneumonia (NCP) was first reported in Wuhan, China. NCP outbreak spread rapidly nationwide and grobally, Subsequently, The central government of China has implemented the most stringent epidemic prevention and control measures. The epidemic situation in China has been controlled very effectively at present. However, the epidemic situation in other countries and regions around the world is very serious. We aim to find a way to more quickly diagnose and isolate the patients with NCP. Method: In accordance with the China’s national guidelines for the prevention, control, diagnosis and treatment of NCP, our hospital quickly established a separate fever clinic and isolation ward, set up the medical groups for fever clinics and isolation wards. We prepared protective equipment including goggles, medical face shields, surgical masks, surgical gloves, N95 masks, disposable hats, protective clothing, isolation clothing, waterproof shoes and disinfection equipment. All staff were strictly protected against airborne transmission including triage, nursing, treatment, sampling, testing, radiation and other staff associated with suspected and confirmed cases. Patients with epidemiological history and clinical manifestations must be triage to see a doctor in the fever clinic. Suspected cases were admitted to isolation ward, and critically ill patients were admitted to the emergency intensive care unit. For suspected patients, a rapid canine coronavirus antigen(CCV-Ag) test was performed on some patients before the nucleic acid was detected. Findings: From January 23 to March 28, 2020, all suspected cases were quickly isolated. Five cases were included for the study, 4(80.0%) cases were admitted to the emergency isolation ward, and 1(20.0%) case was admitted to the emergency intensive care unit.3(60%) cases were confirmed by RT-PCR of COVID-19 nucleic acid. The epidemiology of 2(66.7%) confirmed patients were related to Wuhan, and 1(33.3%) was not related to Wuhan. The first swabs of the confirmed cases 1 and 3 tested positive. In case 2, the first swab test was negative and the second positive. In case 4, two swabs were negative. In case 5, the first swab was negative and the second bronchoalveolar lavage fluid was negative. The most common symptoms in confirmed cases are fever and dry cough. Other symptoms are not very specific, including sore throat, fatigue, headache, muscle aches, abdominal discomfort, etc. Our confirmed cases are mild cases, their blood pressure, respiratory rate and oxygen saturation are basically normal。The blood routine of the confirmed cases showed that the WBC count, lymphocytes count, and neutrophils count were basically normal, thrombocytopenia occurred in one case. C-reactive protein was normal or elevated, and all chest CT scans were characterized by ground-glass opacities and infiltration in one or both lungs, more apparent in the peripheral zone of lungs. The rapid CCV-Ag test was also positive in 3 confirmed patients, and the testing took about 10 minutes, compared to 6 hours for RT-PCR, the test time was significantly reduced. All confirmed cases received respiratory quinolone antibiotics and antiviral treatment. We have no medical staff infected with COVID-19.Within 64 days after Wuhan lockdown (23 January to 28 March), mortality of NCP in other parts of China was significantly lower than in Wuhan (2.34% vs 5.12%). Interpretation: Epidemiological history, chest CT images combined with rapid detection of CCV-Ag can more quickly diagnose and isolate patients suffered from NCP. There may be a certain degree of similarity between CCV-Ag and COVID-19 antigen, and further investigation and research are urgently needed. Lockdown outbreak center or severe areas timely can significantly reduce mortality by more than half in other areas. Funding Statement: This study has no any fund. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: This study was approved by the Medical Ethics Committee of Shenzhen Hospital of Southern Medical University.