Department of Radiology, Wuhan No. 1 Hospital, Zhongshan Ave 215, Wuhan, 430022, China.
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
AJR Am J Roentgenol. 2020 Aug;215(2):338-343. doi: 10.2214/AJR.20.22961. Epub 2020 Mar 17.
The purpose of this study was to investigate early clinical and CT manifestations of coronavirus disease (COVID-19) pneumonia. Patients with COVID-19 pneumonia confirmed by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid test (reverse transcription-polymerase chain reaction) were enrolled in this retrospective study. The clinical manifestations, laboratory results, and CT findings were evaluated. One hundred eight patients (38 men, 70 women; age range, 21-90 years) were included in the study. The clinical manifestations were fever in 94 of 108 (87%) patients, dry cough in 65 (60%), and fatigue in 42 (39%). The laboratory results were normal WBC count in 97 (90%) patients and normal or reduced lymphocyte count in 65 (60%). High-sensitivity C-reactive protein level was elevated in 107 (99%) patients. The distribution of involved lobes was one lobe in 38 (35%) patients, two or three lobes in 24 (22%), and four or five lobes in 46 (43%). The major involvement was peripheral (97 patients [90%]), and the common lesion shape was patchy (93 patients [86%]). Sixty-five (60%) patients had ground-glass opacity (GGO), and 44 (41%) had GGO with consolidation. The size of lesions varied from smaller than 1 cm (10 patients [9%]) to larger than 3 cm (56 patients [52%]). Vascular thickening (86 patients [80%]), crazy paving pattern (43 patients [40%]), air bronchogram sign (52 patients [48%]), and halo sign (69 [64%]) were also observed in this study. The early clinical and laboratory findings of COVID-19 pneumonia are low to midgrade fever, dry cough, and fatigue with normal WBC count, reduced lymphocyte count, and elevated high-sensitivity C-reactive protein level. The early CT findings are patchy GGO with or without consolidation involving multiple lobes, mainly in the peripheral zone, accompanied by halo sign, vascular thickening, crazy paving pattern, or air bronchogram sign.
本研究旨在探讨 2019 冠状病毒病（COVID-19）肺炎的早期临床和 CT 表现。我们对经严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）核酸检测（逆转录-聚合酶链反应）确诊的 COVID-19 肺炎患者进行了回顾性研究。评估了患者的临床表现、实验室结果和 CT 表现。共纳入 108 例患者（38 例男性，70 例女性；年龄 21~90 岁）。94 例（87%）患者有发热，65 例（60%）有干咳，42 例（39%）有乏力。97 例（90%）患者白细胞计数正常，65 例（60%）患者淋巴细胞计数正常或减少。107 例（99%）患者高敏 C 反应蛋白水平升高。受累肺叶分布为一叶 38 例（35%），两叶或三叶 24 例（22%），四叶或五叶 46 例（43%）。主要累及部位为外周（97 例[90%]），常见病变形态为斑片状（93 例[86%]）。65 例（60%）患者有磨玻璃密度影（GGO），44 例（41%）有 GGO 合并实变。病变大小从小于 1cm（10 例[9%]）到大于 3cm（56 例[52%]）不等。血管增厚（86 例[80%]）、铺路石征（43 例[40%]）、空气支气管征（52 例[48%]）和晕征（69 例[64%]）也在本研究中观察到。COVID-19 肺炎的早期临床和实验室表现为中低度发热、干咳、乏力，白细胞计数正常，淋巴细胞计数减少，高敏 C 反应蛋白水平升高。早期 CT 表现为斑片状磨玻璃密度影伴或不伴实变，累及多个肺叶，主要位于外周区，伴有晕征、血管增厚、铺路石征或空气支气管征。
