Department of Radiology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
Department of Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
Sci Rep. 2020 Jul 14;10(1):11548. doi: 10.1038/s41598-020-68509-x.
The objective of this study is to expound the CT features of COVID-19 patients whose throat swab samples were negative for two consecutive nucleic acid tests after treatment. We retrospectively reviewed 46 COVID-19 patients with two consecutive negative RT-PCR tests after treatment. The cases were divided into moderate group and severe/critical group according to disease severity. Clinical and CT scanning data were collected. CT signs of pulmonary lesions and the score of lung involvement were expounded. Thirty-nine moderate cases and seven severe/critical cases were included. Residual pulmonary lesions were visible in CT images. Moderate patients showed peripheral lesions while severe/critical cases exhibited both central and peripheral lesions with all lobes involvement. Mixed ground glass opacity (GGO) and pulmonary consolidation were noted. A larger proportion of severe patients showed reticular pulmonary interstitium thickening. Air bronchogram, pleural effusion, vascular enlargement, bronchial wall thickening, bronchiectasis, pleural thickening and pleural adhesion were more frequently observed in severe/critical group. The severe/critical group showed higher CT score. Pulmonary lesions persisted even after twice consecutive negative nucleic acid tests. We strongly recommended regular follow-up of CT scans after nucleic acid tests conversion. Evaluation of complete remission should base on chest CT.
本研究旨在阐述治疗后连续两次咽拭子核酸检测均为阴性的 COVID-19 患者的 CT 特征。我们回顾性分析了 46 例治疗后连续两次 RT-PCR 检测均为阴性的 COVID-19 患者。根据疾病严重程度将病例分为中度组和重症/危重组。收集临床和 CT 扫描数据。阐述肺部病变的 CT 征象和肺部受累评分。纳入 39 例中度病例和 7 例重症/危重组。CT 图像可见残留肺部病变。中度患者表现为外周病变，而重症/危重组则表现为中央和外周病变，累及所有肺叶。混合磨玻璃密度（GGO）和肺实变。更严重的患者表现出更多的网状肺间质增厚。重症/危重组中更常观察到空气支气管征、胸腔积液、血管增大、支气管壁增厚、支气管扩张、胸膜增厚和胸膜粘连。重症/危重组的 CT 评分更高。即使两次连续核酸检测均为阴性，肺部病变仍持续存在。我们强烈建议在核酸检测转为阴性后定期进行 CT 扫描随访。完全缓解的评估应基于胸部 CT。
