Abstract: Objective To investigate the clinical symptoms, nucleic acid detection and chest CT findings of 4 special cases with coronavirus disease 2019(COVID-19). Methods In this study, 4 patients whose nucleic acid detection was inconsistent with CT signs and clinical symptoms were selected from 17 patients diagnosed as COVID-19 from January 21 to February 12 in 2020 in Xianyang Central Hospital in Shaanxi Province, and their materials such as general data, clinical symptoms, epidemiological history, laboratory examination and chest CT manifestations were analyzed. Results Among the 4 patients, the result of nucleic acid detection of one patient turned negative after treatment, but CT manifestations and clinical symptoms were alleviated or aggravated alternatively. One patient's nucleic acid detection and clinical symptoms were significantly lagged behind CT manifestations. Two patients had fever and positive result of nucleic acid detection, but the results of many times of CT examinations were negative. Conclusion There are differences in time and manifestations of clinical symptoms, nucleic acid detection and CT results in patients with COVID-19, comprehensive judgment in combination with epidemic history, clinical symptoms, nucleic acid detection and CT manifestations is beneficial to improve the diagnostic accuracy and prognosis of patients.