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及时诊断和治疗可缩短新冠肺炎肺炎的痊愈时间,并降低连续胸部 CT 的最高和最后 CT 评分。

Timely Diagnosis and Treatment Shortens the Time to Resolution of Coronavirus Disease (COVID-19) Pneumonia and Lowers the Highest and Last CT Scores From Sequential Chest CT.

机构信息

Department of Radiology, Wuhu Second People's Hospital, Wuhu, China.

Shandong Medical Imaging Research Institute, Cheeloo College of Medicine, Shandong University, No. 324 Jinwu Rd, Jinan 250021, China.

出版信息

AJR Am J Roentgenol. 2020 Aug;215(2):367-373. doi: 10.2214/AJR.20.23078. Epub 2020 Mar 30.

Abstract

This study aims to assess correlations of the time from symptom onset to diagnosis and treatment with the time to disease resolution and CT scores as based on findings from sequential chest CT examinations. Thirty patients with coronavirus disease (COVID-19) confirmed by reverse transcription-polymerase chain reaction analysis underwent chest CT examinations. Five patients who did not have positive CT findings or who had not yet fulfilled criteria for discharge from the hospital were excluded. CT scores were determined according to CT findings and lung involvement. The time from symptom onset to diagnosis and treatment was recorded for each patient, and on the basis of this information, patients with COVID-19 were divided into group 1 (patients for whom this interval was ≤ 3 days) and group 2 (those for whom this interval was > 3 days). The CT scores for each group were fitted using a Lorentzian line-shape curve to show the variation tendency during treatment. The differences in age, sex, and last CT scores determined before discharge between the two groups were analyzed, and correlations of the time from symptom onset to diagnosis and treatment with the time to disease resolution as well as with the highest CT score also underwent statistical analysis. A total of 25 subjects were enrolled in the study. The fitted tendency curves for group 1 and group 2 were significantly different, with peak points showing that the estimated highest CT score was 10 and 16 for each group, respectively, and the time to disease resolution was 6 and 13 days, respectively. The Mann-Whitney test showed that the last CT scores were lower for group 1 than for group 2 ( = 0.025), although the chi-square test found no difference in age and sex between the groups. The time from symptom onset to diagnosis and treatment had a positive correlation with the time to disease resolution ( = 0.93; = 0.000) as well as with the highest CT score ( = 0.83; = 0.006). Timely diagnosis and treatment are key to providing a better prognosis for patients with COVID-19.

摘要

本研究旨在评估从症状出现到诊断和治疗的时间与疾病缓解时间和连续胸部 CT 检查的 CT 评分之间的相关性。30 例经逆转录-聚合酶链反应分析确诊的冠状病毒病(COVID-19)患者接受了胸部 CT 检查。排除了 5 例无阳性 CT 发现或尚未达到出院标准的患者。根据 CT 发现和肺部受累情况确定 CT 评分。记录每位患者从症状出现到诊断和治疗的时间,根据这些信息,将 COVID-19 患者分为第 1 组(间隔时间≤3 天的患者)和第 2 组(间隔时间>3 天的患者)。使用洛伦兹线型曲线拟合每组的 CT 评分,以显示治疗过程中的变化趋势。分析两组之间的年龄、性别和出院前最后一次 CT 评分的差异,并对从症状出现到诊断和治疗的时间与疾病缓解时间以及与最高 CT 评分的相关性进行统计分析。共纳入 25 例患者。第 1 组和第 2 组的拟合趋势曲线差异有统计学意义,峰值分别显示两组的估计最高 CT 评分为 10 和 16,疾病缓解时间分别为 6 和 13 天。Mann-Whitney 检验显示第 1 组的最后一次 CT 评分低于第 2 组( = 0.025),而卡方检验显示两组在年龄和性别方面无差异。从症状出现到诊断和治疗的时间与疾病缓解时间呈正相关( = 0.93; = 0.000),与最高 CT 评分呈正相关( = 0.83; = 0.006)。及时诊断和治疗是为 COVID-19 患者提供更好预后的关键。

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