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中国浙江省温州市多中心研究:2019 年新型冠状病毒病(COVID-19)的临床特征和影像学表现。

Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19):A multi-center study in Wenzhou city, Zhejiang, China.

机构信息

Department of Radiology, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, No.197 Ruijin Er Road, Shanghai 200025, China.

Department of Radiology, Ruian People's Hospital, Ruian 325200, Zhejiang province, China.

出版信息

J Infect. 2020 Apr;80(4):388-393. doi: 10.1016/j.jinf.2020.02.016. Epub 2020 Feb 26.

Abstract

BACKGROUND

Little is known about COVID-19 outside Hubei. The aim of this paper was to describe the clinical characteristics and imaging manifestations of hospitalized patients with confirmed COVID-19 infection in Wenzhou, Zhejiang, China.

METHODS

In this retrospective cohort study, 149 RT-PCR confirmed positive patients were consecutively enrolled from January 17th to February 10th, 2020 in three tertiary hospitals of Wenzhou. Outcomes were followed up until Feb 15th, 2020.

FINDINGS

A total of 85 patients had Hubei travel/residence history, while another 49 had contact with people from Hubei and 15 had no traceable exposure history to Hubei. Fever, cough and expectoration were the most common symptoms, 14 patients had decreased oxygen saturation, 33 had leukopenia, 53 had lymphopenia, and 82 had elevated C-reactive protein. On chest computed tomography (CT), lung segments 6 and 10 were mostly involved. A total of 287 segments presented ground glass opacity, 637 presented mixed opacity and 170 presented consolidation. Lesions were more localized in the peripheral lung with a patchy form. No significant difference was found between patients with or without Hubei exposure history. Seventeen patients had normal CT on admission of these, 12 had negative findings even10 days later.

INTERPRETATION

Most patients presented with a mild infection in our study. The imaging pattern of multifocal peripheral ground glass or mixed opacity with predominance in the lower lung is highly suspicious of COVID-19 in the first week of disease onset. Nevetheless, some patients can present with a normal chest finding despite testing positive for COVID-19.

FUNDING

We did not receive any fundings.

摘要

背景

对湖北以外地区的 COVID-19 了解甚少。本研究旨在描述浙江温州住院确诊 COVID-19 感染患者的临床特征和影像学表现。

方法

在这项回顾性队列研究中,连续纳入了 2020 年 1 月 17 日至 2 月 10 日期间温州 3 家三级医院的 149 例 RT-PCR 确诊阳性患者。研究结果随访至 2020 年 2 月 15 日。

发现

共有 85 例患者有湖北旅行/居住史,49 例患者与来自湖北的人有接触,15 例患者无湖北接触史可追溯。发热、咳嗽和咳痰是最常见的症状,14 例患者血氧饱和度降低,33 例患者白细胞减少,53 例患者淋巴细胞减少,82 例患者 C 反应蛋白升高。胸部 CT 上,6 个和 10 个肺段最常受累。共 287 个肺段呈磨玻璃样混浊,637 个肺段呈混合混浊,170 个肺段呈实变。病变主要位于外周肺,呈斑片状。有湖北暴露史与无湖北暴露史患者之间无显著差异。在这些患者中,有 17 例入院时 CT 正常,其中 12 例甚至在 10 天后仍为阴性。

解释

在我们的研究中,大多数患者表现为轻度感染。在疾病发病的第一周,多发病灶外周磨玻璃或混合混浊伴下肺为主的影像学模式高度提示 COVID-19。然而,尽管 COVID-19 检测呈阳性,一些患者的胸部 CT 可能正常。

无资金来源。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cab4/7102539/1576e9d71bc0/gr1_lrg.jpg

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