Differential diagnoses in COVID-19 pandemic: a retrospective descriptive study

Abstract

Since February 2020, severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) infection rapidly spread across Southern Switzerland. The available literature on differential diagnoses of coronavirus 2019 (COVID-19) is scarce. Our study aims to review differential diagnoses of SARS-CoV-2 infections in public hospitals in Southern Switzerland and describe patients’ related outcomes. Between 01.03.2020 and 15.04.2020, 344 patients had a chest computed tomography-scan at admission, 210 of them were pathological. 172 patients had a positive nasopharyngeal swab for SARS-CoV-2, and 38 patients needed an additional diagnostic work-up and were included in this study. Among the selected patients, 8 underwent 2 polymerase chain reaction (PCR) for SARS-CoV-2, while 18 patients were subjected to 3 PCR. We observed 29 infective cases, 3 due to cardiovascular etiologies, 2 due to chronic obstructive pulmonary disease exacerbation, 1 due to cryptogenic organizing pneumonia, 3 not related to respiratory diseases. Our results highlight the importance of differential diagnosis in times of widespread occurrence of COVID-19, considering the similarity of symptoms and imaging appearance with other respiratory conditions.