Department of Radiology, the Third Affiliated Hospital of Nanchang University (also known as the First Hospital of Nanchang), Jiangxi, China.
Department of Radiology, JiangXi PingXiang people's hospital, Jiangxi, China.
J Xray Sci Technol. 2020;28(5):851-861. doi: 10.3233/XST-200711.
To assess prognosis or dynamic change from initial diagnosis until recovery of the patients with moderate coronavirus disease (COVID-19) pneumonia using chest CT images.
In this retrospective study, 33 patients (18 men, 15 women; median age, 49.0 years) with confirmed with moderate COVID-19 pneumonia in a multicenter hospital were included. The patients underwent at least four chest non-contrast-enhanced computed tomography (CT) scans at approximately 5-day intervals. We analyzed the clinical and CT characteristics of the patients. Moreover, the total CT score and the sum of lung involvement were determined for every CT scan.
The most widespread presenting symptoms were fever (32/33, 97.0%) and cough (17/33, 51.5%), which were often accompanied by decreased lymphocyte count (15/33, 45.5%) and increased C-reactive protein levels (18/33, 54.6%). Bilateral, multifocal ground glass opacities (32/33, 97.0%), consolidation (25/33, 75.8%), vascular thickening (23/33, 69.7%), and bronchial wall thickening (21/33, 63.6%) with peripheral distribution were the most frequent CT findings during moderate COVID-19 pneumonia. In patients recovering from moderate COVID-19 pneumonia, four stages (stages 1-4) of evolution were identified on chest CT with average CT scores of 3.4±2.3, 6.0±4.4, 5.6±3.8, and 4.9±3.2, respectively, from the onset of symptoms. For most patients, the peak of average total CT score increased for approximately 8 days after the onset of symptoms, after which it decreased gradually. The mean CT score of all patients was 4.7 at the time of discharge.
The moderate COVID-19 pneumonia CT score increased rapidly in a short period of time initially, followed by a slow decline over a relatively long time. The peak of the course occurred in stage 2. Complete recovery of patients with moderate COVID-19 pneumonia with high mean CT score at the time of discharge requires longer time.
使用胸部 CT 图像评估中度冠状病毒病（COVID-19）肺炎患者从初始诊断到恢复的预后或动态变化。
本回顾性研究纳入了一家多中心医院 33 例（男 18 例，女 15 例；中位年龄 49.0 岁）确诊为中度 COVID-19 肺炎的患者。这些患者至少接受了 4 次胸部非增强 CT 扫描，时间间隔约为 5 天。我们分析了患者的临床和 CT 特征。此外，还确定了每次 CT 扫描的总 CT 评分和肺受累总和。
最常见的首发症状为发热（33/33，97.0%）和咳嗽（17/33，51.5%），常伴有淋巴细胞计数减少（15/33，45.5%）和 C 反应蛋白水平升高（18/33，54.6%）。双侧、多灶性磨玻璃影（33/33，97.0%）、实变（25/33，75.8%）、血管增厚（23/33，69.7%）和支气管壁增厚（21/33，63.6%）伴外周分布是中度 COVID-19 肺炎最常见的 CT 表现。在从中度 COVID-19 肺炎恢复的患者中，胸部 CT 显示四个阶段（1-4 期）的演变，症状发作后的平均 CT 评分为 3.4±2.3、6.0±4.4、5.6±3.8 和 4.9±3.2。对于大多数患者，平均总 CT 评分的峰值在症状发作后约 8 天增加，随后逐渐下降。所有患者的平均 CT 评分为 4.7 分，为出院时。
中度 COVID-19 肺炎 CT 评分在短时间内迅速升高，随后在较长时间内缓慢下降。病程高峰出现在第 2 期。出院时 CT 评分较高的中度 COVID-19 肺炎患者完全恢复需要更长的时间。
