Li Chenxi, Luo Fan, Xie Liqiu, Gao Yueqin, Zhang Na, Wu Bing
Department of Radiology, Public Health Clinical Center of Chengdu, Chengdu, 610000, China.
Department of Radiology, China West Hospital, Sichuan University, Chengdu 610041, China.
Quant Imaging Med Surg. 2020 Jun;10(6):1318-1324. doi: 10.21037/qims-20-530.
Our hospital is a designated institution for COVID-19 patients in Chengdu, China. This study aimed to analyze the clinical and chest CT features of 15 COVID-19 patients with positive reverse transcription-polymerase chain reaction (RT-PCR) retest results after discharge. Patients who met the current standards of discharge could still carry the SARS-CoV-2 virus.
Clinical manifestations, laboratory data, and chest CT images were retrospectively reviewed and analyzed.
The most common symptoms at Covid-19COVID-19 initial onset were fever (12/15, 80%) and cough (11/15, 73.3%). Most of the patients had a normal white blood cells (12/15, 80%), neutrophils (12/15, 80%), and lymphocytes count (13/15, 86.7%); some patients had increased C-reactive protein (CRP) (5/15, 33.3%), and increased lactate dehydrogenase (LDH) (4/15, 26.7%) during first admission. Five patients (33.3%) had a cough before their first discharge. The average interval from the first discharge to re-admission was 17 days (range, 9-30 days). At re-admission, two (13.3%) patients presented with cough, and one (6.6%) had chest pain with anxiety. At re-admission, all patients had normal clinical results except five (33.3%) patients had increased CRP compared with first discharging, two (13.3%) patients had increased neutrophils count, and one (6.6%) had increased CRP. The majority of patients had normal procalcitonin. Ground glass opacities (GGOs) and reticulation in the peripheral and subpleural areas were the most common CT manifestations, and six patients (40%) showed a transformation from reticulation to GGOs when re-admitted.
There may be no specific clinical characteristics to predict the re-detectability of the virus. A regular medical observation and a bi-monthly follow-up is recommended.
我院是中国成都的新冠肺炎定点收治机构。本研究旨在分析15例出院后逆转录聚合酶链反应（RT-PCR）复测结果呈阳性的新冠肺炎患者的临床及胸部CT特征。符合当前出院标准的患者仍可能携带严重急性呼吸综合征冠状病毒2（SARS-CoV-2）病毒。
对临床表现、实验室数据及胸部CT图像进行回顾性分析。
新冠肺炎初次发病时最常见的症状为发热（12/15，80%）和咳嗽（11/15，73.3%）。大多数患者白细胞（12/15，80%）、中性粒细胞（12/15，80%）及淋巴细胞计数正常（13/15，86.7%）；部分患者首次入院时C反应蛋白（CRP）升高（5/15，33.3%），乳酸脱氢酶（LDH）升高（4/15，26.7%）。5例患者（33.3%）首次出院前有咳嗽症状。首次出院至再次入院的平均间隔时间为17天（范围9 - 30天）。再次入院时，2例患者（13.3%）出现咳嗽，1例患者（6.6%）伴有胸痛及焦虑。再次入院时，除5例患者（33.3%）CRP较首次出院时升高、2例患者（13.3%）中性粒细胞计数升高及1例患者（6.6%）CRP升高外，所有患者临床检查结果均正常。大多数患者降钙素原正常。磨玻璃影（GGO）及外周和胸膜下区域的网状影是最常见的CT表现，6例患者（40%）再次入院时显示网状影转变为磨玻璃影。
可能没有可预测病毒再次检测阳性的特异性临床特征。建议进行定期医学观察及每两个月随访一次。
