Cancer Center, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
Eur Radiol. 2020 Aug;30(8):4417-4426. doi: 10.1007/s00330-020-06854-1. Epub 2020 Apr 11.
To characterize the chest computed tomography (CT) findings of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) according to clinical severity. We compared the CT features of common cases and severe cases, symptomatic patients and asymptomatic patients, and febrile and afebrile patients.
This was a retrospective analysis of the clinical and thoracic CT features of 120 consecutive patients with confirmed SARS-CoV-2 pneumonia admitted to a tertiary university hospital between January 10 and February 10, 2020, in Wuhan city, China.
On admission, the patients generally complained of fever, cough, shortness of breath, and myalgia or fatigue, with diarrhea often present in severe cases. Severe patients were 20 years older on average and had comorbidities and an elevated lactate dehydrogenase (LDH) level. There were no differences in the CT findings between asymptomatic and symptomatic common type patients or between afebrile and febrile patients, defined according to Chinese National Health Commission guidelines.
The clinical and CT features at admission may enable clinicians to promptly evaluate the prognosis of patients with SARS-CoV-2 pneumonia. Clinicians should be aware that clinically silent cases may present with CT features similar to those of symptomatic common patients.
• The clinical features and predominant patterns of abnormalities on CT for asymptomatic, typic common, and severe cases were summarized. These findings may help clinicians to identify severe patients quickly at admission. • Clinicians should be cautious that CT findings of afebrile/asymptomatic patients are not better than the findings of other types of patients. These patients should also be quarantined. • The use of chest CT as the main screening method in epidemic areas is recommended.
根据临床严重程度，描述严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的胸部计算机断层扫描（CT）特征。我们比较了普通病例和重症病例、有症状患者和无症状患者、发热患者和不发热患者的 CT 特征。
这是对 2020 年 1 月 10 日至 2 月 10 日期间在中国武汉市一家三级大学医院确诊为 SARS-CoV-2 肺炎的 120 例连续患者的临床和胸部 CT 特征进行的回顾性分析。
入院时，患者通常主诉发热、咳嗽、呼吸急促和肌痛或乏力，重症患者常有腹泻。重症患者平均年龄大 20 岁，有合并症和乳酸脱氢酶（LDH）升高。根据中国国家卫生健康委员会的指南，无症状和有症状的普通型患者之间或无热和发热患者之间的 CT 发现没有差异。
SARS-CoV-2 肺炎患者入院时的临床和 CT 特征可能使临床医生能够及时评估患者的预后。临床医生应该意识到，无症状病例可能出现类似于有症状普通型患者的 CT 特征。
• 总结了无症状、典型普通型和重症病例的临床特征和 CT 异常的主要模式。这些发现可能有助于临床医生在入院时快速识别重症患者。• 临床医生应谨慎，无热/无症状患者的 CT 表现并不优于其他类型患者的表现。这些患者也应被隔离。• 建议在流行地区使用胸部 CT 作为主要筛查方法。
