Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
Department of Radiology, Xianning central Hospital, Xianning, China.
PLoS One. 2020 Jul 2;15(7):e0235134. doi: 10.1371/journal.pone.0235134. eCollection 2020.
To investigate the computed tomography (CT) characteristics and diagnostic value of novel coronavirus pneumonia (NCP or COVID-19) in pregnancy.
This study included ten pregnant women infected with COVID-19, treated in the Zhongnan Hospital of Wuhan University from January 20, 2020 to February 6, 2020. Clinical and chest CT data were collected and clinical symptoms, laboratory indicators, and CT images were analyzed to explore CT characteristics and diagnostic value for COVID-19 during pregnancy.
Laboratory examination showed that white blood cell count was normal in nine patients, and slightly higher in one patient (10.23 × 109). The lymphocyte ratio decreased in two patients by 12% and 14%, respectively. The levels of C-reactive protein was elevated in seven patients (range, 21.16-60.3 mg/L) and the levels of D-dimer was increased in eight patients (range, 507-2141 ng/mL). Six patients had low levels of total protein (range, 35.3-56.5 mg/L). Two patients showed small patchy ground glass opacity (GGO) involving single lung, while eight patients showed multilobe GGO in both the lungs, with partial consolidation. Peripheral and non-peripheral lesion distributions were seen in ten (100%) and four (40%) patients, respectively. There were four patients who had signs of intra-bronchial air-bronchogram, six patients had small bilateral pleural effusions, while none had lymphadenopathy. Dynamic observations were performed in four patients after COVID-19 treatment. Among these four patients, one patient showed normal on the initial examination, and new lesions were observed after 3 days; 1 patient showed progression after 7 days of treatment, with expansion of the lesion area; and the other 2 patients showed improvement after 14 days of treatment, with reduction in the density and area of lesions and appearance of linear opacity.
The CT characteristics of COVID-19 in pregnancy were mainly observed in early and progressive stages, and multiple new lesions were common. And there were consolidations of varying sizes and degrees within the lesion. Moreover, the original ground glass lesions could be fused or partially absorbed. Six patients had small bilateral pleural effusion. In summary, CT scans can play an important role in early screening, dynamic observation, and efficacy evaluation of suspected or confirmed cases of pregnant women with COVID-19.
探讨新型冠状病毒肺炎（NCP 或 COVID-19）在妊娠中的计算机断层扫描（CT）特征和诊断价值。
本研究纳入 2020 年 1 月 20 日至 2 月 6 日期间在武汉大学中南医院就诊的 10 例 COVID-19 感染孕妇。收集临床和胸部 CT 数据，分析临床症状、实验室指标和 CT 图像，探讨 COVID-19 妊娠期间的 CT 特征和诊断价值。
实验室检查显示，9 例患者白细胞计数正常，1 例稍高（10.23×109）。2 例患者淋巴细胞比例分别下降 12%和 14%。7 例患者 C-反应蛋白升高（范围 21.16-60.3 mg/L），8 例患者 D-二聚体升高（范围 507-2141 ng/mL）。6 例患者总蛋白水平降低（范围 35.3-56.5 mg/L）。2 例患者表现为单肺局灶性小斑片状磨玻璃影（GGO），8 例患者表现为双肺多叶 GGO，部分实变。10 例（100%）患者病变分布于外周和非外周，4 例（40%）患者有支气管充气征。4 例患者在 COVID-19 治疗后进行了动态观察。这 4 例患者中，1 例初始检查正常，3 天后出现新病变；1 例治疗 7 天后进展，病变面积扩大；2 例患者治疗 14 天后好转，病变密度和面积减少，出现线性混浊。
COVID-19 妊娠患者的 CT 特征主要出现在早期和进展期，多为多发新病变。病变内有大小不一、程度不同的实变。此外，原始磨玻璃病变可融合或部分吸收。6 例患者有双侧少量胸腔积液。总之，CT 扫描在疑似或确诊 COVID-19 孕妇的早期筛查、动态观察和疗效评价中具有重要作用。
