Zhang Linlin, Wang Diane C, Huang Qihong, Wang Xiangdong
Zhongshan Hospital Institute of Clinical Science, Fudan University Shanghai Medical School, Shanghai, China.
Department of Emergency, Sunshine Coast University Hospital, Birtinya, Queensland, Australia.
Clin Transl Med. 2020 Jan;10(1):28-35. doi: 10.1002/ctm2.17. Epub 2020 Apr 4.
A new coronavirus SARS-CoV-2 has caused outbreaks in multiple countries and the number of cases is rapidly increasing through human-to-human transmission. Clinical phenomes of patients with SARS-CoV-2 infection are critical in distinguishing it from other respiratory infections. The extent and characteristics of those phenomes varied depending on the severities of the infection, for example, beginning with fever or a mild cough, progressed with signs of pneumonia, and worsened with severe or even fatal respiratory difficulty in acute respiratory distress syndrome. We summarized clinical phenomes of 3795 patients with COVID-19 based on 80 published reports from the onset of outbreak to March 2020 to emphasize the importance and specificity of those phenomes in diagnosis and treatment of infection, and evaluate the impact on medical services. The data show that the incidence of male patients was higher than that of females and the level of C-reaction protein was increased as well as most patients' imaging included ground-glass opacity. Clinical phenomes of SARS-CoV-2 infection were compared with those of SARS-CoV and MERS-CoV infections. There is an urgent need to develop an artificial intelligence-based machine learning capacity to analyze and integrate radiomics- or imaging-based, patient-based, clinician-based, and molecular measurements-based data to fight the outbreak of COVID-19 and enable more efficient responses to unknown infections in future.
一种新型冠状病毒SARS-CoV-2已在多个国家引发疫情，且病例数正通过人际传播迅速增加。SARS-CoV-2感染患者的临床表型对于将其与其他呼吸道感染区分开来至关重要。这些表型的范围和特征因感染严重程度而异，例如，起初表现为发热或轻度咳嗽，随后出现肺炎体征，在急性呼吸窘迫综合征中则会恶化为严重甚至致命的呼吸困难。我们基于从疫情爆发至2020年3月发表的80份报告，总结了3795例新冠肺炎患者的临床表型，以强调这些表型在感染诊断和治疗中的重要性及特异性，并评估其对医疗服务的影响。数据显示，男性患者的发病率高于女性，C反应蛋白水平升高，且大多数患者的影像学表现包括磨玻璃影。将SARS-CoV-2感染的临床表型与SARS-CoV和MERS-CoV感染的临床表型进行了比较。迫切需要开发基于人工智能的机器学习能力，以分析和整合基于放射组学或影像学、基于患者、基于临床医生以及基于分子测量的数据，以应对新冠肺炎疫情，并在未来更有效地应对未知感染。
