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中国武汉 COVID-19 肺炎入院时无症状病例的 CT 影像学表现与临床病程。

CT imaging and clinical course of asymptomatic cases with COVID-19 pneumonia at admission in Wuhan, China.

机构信息

Department of Thoracic Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China.

Department of Radiology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China.

出版信息

J Infect. 2020 Jul;81(1):e33-e39. doi: 10.1016/j.jinf.2020.04.004. Epub 2020 Apr 12.

Abstract

PURPOSE

Aimed to characterize the CT imaging and clinical course of asymptomatic cases with COVID-19 pneumonia.

METHODS

Asymptomatic cases with COVID-19 pneumonia confirmed by SARS-COV-2 nucleic acid testing in Renmin Hospital of Wuhan University were retrospectively enrolled. The characteristics of CT imaging and clinical feature were collected and analyzed.

RESULTS

58 asymptomatic cases with COVID-19 pneumonia admitted to our hospital between Jan 1, 2020 and Feb 23, 2020 were enrolled. All patients had history of exposure to SARS-CoV-2. On admission, patients had no symptoms and laboratory findings were normal. The predominant feature of CT findings in this cohort was ground glass opacity (GGO) (55, 94.8%) with peripheral (44, 75.9%) distribution, unilateral location (34, 58.6%) and mostly involving one or two lobes (38, 65.5%), often accompanied by characteristic signs. After short-term follow-up, 16 patients (27.6%) presented symptoms with lower lymphocyte count and higher CRP, mainly including fever, cough and fatigue. The evolution of lesions on CT imaging were observed in 10 patients (17.2%). The average days of hospitalization was19.80±10.82 days, and was significantly longer in progression patients (28.60±7.55 day).

CONCLUSION

CT imaging of asymptomatic cases with COVID-19 pneumonia has definite characteristics. Since asymptomatic infections as "covert transmitter", and some patients can progress rapidly in the short term. It is essential to pay attention to the surveillance of asymptomatic patients with COVID-19. CT scan has great value in screening and detecting patients with COVID-19 pneumonia, especially in the highly suspicious, asymptomatic cases with negative nucleic acid testing.

摘要

目的

旨在描述 COVID-19 肺炎无症状感染者的 CT 影像学表现和临床病程。

方法

回顾性分析 2020 年 1 月 1 日至 2 月 23 日期间在武汉大学人民医院经 SARS-CoV-2 核酸检测确诊的 COVID-19 肺炎无症状感染者。收集并分析其 CT 影像学和临床特征。

结果

共纳入 58 例 COVID-19 肺炎无症状感染者,所有患者均有接触 SARS-CoV-2 史。入组时,患者无任何症状,实验室检查均正常。该队列 CT 表现的主要特征是磨玻璃密度影(GGO)(55 例,94.8%),呈外周分布(44 例,75.9%)、单侧分布(34 例,58.6%),多累及一个或两个肺叶(38 例,65.5%),常伴有特征性征象。短期随访后,16 例(27.6%)患者出现症状,表现为淋巴细胞计数降低和 CRP 升高,主要包括发热、咳嗽和乏力。10 例(17.2%)患者 CT 影像学上的病变有演变。患者的平均住院时间为 19.80±10.82 天,进展患者的住院时间明显更长(28.60±7.55 天)。

结论

COVID-19 肺炎无症状感染者的 CT 影像学表现具有一定特征。由于无症状感染者作为“隐性传播者”,部分患者在短期内可迅速进展。因此,有必要对 COVID-19 无症状感染者进行监测。CT 扫描在 COVID-19 肺炎患者的筛查和检测中具有重要价值,特别是在高度疑似、核酸检测阴性的无症状患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c4a8/7152865/d38d8f030c6c/gr1_lrg.jpg

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