Infection Hospital, Anhui Provincial Hospital, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230022, Anhui Province, China.
Department of Respiratory, Hefei Second People's Hospital, Hefei Hospital Affiliated to Anhui Medical University, 1 Guangde Road, Hefei, 230011, Anhui Province, China.
Infect Dis Poverty. 2020 Aug 26;9(1):118. doi: 10.1186/s40249-020-00737-9.
Coronavirus disease 2019 (COVID-19) is currently the most serious infectious disease in the world. An accurate diagnosis of this disease in the clinic is very important. This study aims to improve the differential ability of computed tomography (CT) to diagnose COVID-19 and other community-acquired pneumonias (CAPs) and evaluate the short-term prognosis of these patients.
The clinical and imaging data of 165 COVID-19 and 118 CAP patients diagnosed in seven hospitals in Anhui Province, China from January 21 to February 28, 2020 were retrospectively analysed. The CT manifestations of the two groups were recorded and compared. A correlation analysis was used to examine the relationship between COVID-19 and age, size of lung lesions, number of involved lobes, and CT findings of patients. The factors that were helpful in diagnosing the two groups of patients were identified based on specificity and sensitivity.
The typical CT findings of COVID-19 are simple ground-glass opacities (GGO), GGO with consolidation or grid-like changes. The sensitivity and specificity of the combination of age, white blood cell count, and ground-glass opacity in the diagnosis of COVID-19 were 92.7 and 66.1%, respectively. Pulmonary consolidation, fibrous cords, and bronchial wall thickening were used as indicators to exclude COVID-19. The sensitivity and specificity of the combination of these findings were 78.0 and 63.6%, respectively. The follow-up results showed that 67.8% (112/165) of COVID-19 patients had abnormal changes in their lung parameters, and the severity of the pulmonary sequelae of patients over 60 years of age worsened with age.
Age, white blood cell count and ground-glass opacity have high accuracy in the early diagnosis of COVID-19 and the differential diagnosis from CAP. Patients aged over 60 years with COVID-19 have a poor prognosis. This result provides certain significant guidance for the diagnosis and treatment of new coronavirus pneumonia.
新型冠状病毒病（COVID-19）是目前世界上最严重的传染病。临床上准确诊断这种疾病非常重要。本研究旨在提高计算机断层扫描（CT）对 COVID-19 和其他社区获得性肺炎（CAP）的鉴别能力，并评估这些患者的短期预后。
回顾性分析 2020 年 1 月 21 日至 2 月 28 日在中国安徽省 7 家医院诊断的 165 例 COVID-19 和 118 例 CAP 患者的临床和影像学资料。记录并比较两组的 CT 表现。采用相关分析方法，研究 COVID-19 与年龄、肺部病变大小、累及肺叶数及 CT 表现的相关性。根据特异性和敏感性，确定有助于诊断两组患者的因素。
COVID-19 的典型 CT 表现为单纯磨玻璃密度影（GGO）、GGO 伴实变或网格样改变。年龄、白细胞计数和磨玻璃密度影联合诊断 COVID-19 的敏感性和特异性分别为 92.7%和 66.1%。肺实变、纤维条索和支气管壁增厚可作为排除 COVID-19 的指标，其联合诊断的敏感性和特异性分别为 78.0%和 63.6%。随访结果显示，67.8%（112/165）的 COVID-19 患者肺部参数有异常改变，60 岁以上患者的肺部后遗症严重程度随年龄增加而加重。
年龄、白细胞计数和磨玻璃密度影对 COVID-19 的早期诊断和 CAP 的鉴别诊断具有较高的准确性。年龄在 60 岁以上的 COVID-19 患者预后较差。该结果为新型冠状病毒肺炎的诊断和治疗提供了一定的重要指导。
