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新冠肺炎患者 1115 例的 CT 表现及临床特征:系统评价和荟萃分析。

CT Manifestations and Clinical Characteristics of 1115 Patients with Coronavirus Disease 2019 (COVID-19): A Systematic Review and Meta-analysis.

机构信息

Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, PR China.

Department of Cardiology, Guangdong Provincial People's Hospital, No. 106, Zhongshan 2nd Road, Guangzhou, 510000, China.

出版信息

Acad Radiol. 2020 Jul;27(7):910-921. doi: 10.1016/j.acra.2020.04.033. Epub 2020 May 5.

Abstract

RATIONALE AND OBJECTIVES

We aimed to assess the prevalence of significant computed tomographic(CT) manifestations and describe some notable features based on chest CT images, as well as the main clinical features of patients with coronavirus disease 2019(COVID-19).

MATERIALS AND METHODS

A systematic literature search of PubMed, EMBASE, the Cochrane Library, and Web of Science was performed to identify studies assessing CT features, clinical, and laboratory results of COVID-19 patients. A single-arm meta-analysis was conducted to obtain the pooled prevalence and 95% confidence interval (95% CI).

RESULTS

A total of 14 articles (including 1115 patients) based on chest CT images were retrieved. In the lesion patterns on chest CTs, we found that pure ground-glass opacities (GGO) (69%, 95% CI 58-80%), consolidation (47%, 35-60%) and "air bronchogram sign" (46%, 25-66%) were more common than the atypical lesion of "crazy-paving pattern" (15%, 8-22%). With regard to disease extent and involvement, 70% (95% CI 46-95%) of cases showed a location preference for the right lower lobe, 65% (58-73%) of patients presented with ≥3 lobes involvement, and meanwhile, 42% (32-53%) of patients had involvement of all five lobes, while 67% (55-78%) of patients showed a predominant peripheral distribution. An understanding of some important CT features might be helpful for medical surveillance and management. In terms of clinical features, muscle soreness (21%, 95% CI 15-26%) and diarrhea (7%, 4-10%) were minor symptoms compared to fever (80%, 74-87%) and cough (53%, 33-72%).

CONCLUSION

Chest CT manifestations in patients with COVID-19, as well as its main clinical characteristics, might be helpful in disease evolution and management.

摘要

目的

评估胸部 CT 表现的普遍性,根据胸部 CT 图像描述一些显著特征,并介绍 2019 年冠状病毒病(COVID-19)患者的主要临床特征。

材料和方法

对 PubMed、EMBASE、Cochrane 图书馆和 Web of Science 进行系统文献检索,以评估 COVID-19 患者的 CT 特征、临床和实验室结果。进行单臂荟萃分析以获得汇总患病率和 95%置信区间(95%CI)。

结果

共检索到 14 篇基于胸部 CT 图像的研究(包括 1115 例患者)。在胸部 CT 上的病变模式中,我们发现单纯磨玻璃影(GGO)(69%,95%CI 58-80%)、实变(47%,35-60%)和“空气支气管征”(46%,25-66%)比非典型的“铺路石征”(15%,8-22%)更常见。关于疾病程度和受累范围,70%(95%CI 46-95%)的病例显示右下叶位置偏好,65%(58-73%)的患者累及≥3 个肺叶,同时,42%(32-53%)的患者累及所有五个肺叶,而 67%(55-78%)的患者表现为主要的外周分布。了解一些重要的 CT 特征可能有助于医学监测和管理。在临床特征方面,与发热(80%,74-87%)和咳嗽(53%,33-72%)相比,肌肉疼痛(21%,95%CI 15-26%)和腹泻(7%,4-10%)是次要症状。

结论

COVID-19 患者的胸部 CT 表现及其主要临床特征可能有助于疾病的演变和管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3a7/7200137/973ce510add4/gr1_lrg.jpg

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