Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China.
Int J Med Sci. 2020 Jul 30;17(14):2125-2132. doi: 10.7150/ijms.48074. eCollection 2020.
To present the temporal changes of CT manifestations in COVID-19 patients from a single fangcang shelter hospital and to facilitate the understanding of the disease course. This retrospective study included 98 patients (males: females, 43:55, mean year, 49±12 years) with confirmed COVID-19 at Jianghan fangcang shelter hospital admitted between Feb 05, 2020, and Feb 09, 2020, who had initial chest CTs at our hospital. Radiographic features and CT scores were analyzed. A total of 267 CT scans of 98 patients were evaluated. Our study showed a high median total CT score of 7 within the first week from symptom onset, peaked in the 2 week at 10, followed by persistently high levels of CT score with 9.5, 7 and 7 for the week 3, 4, and >4, respectively, and a prolonged median disease course (30 days, the median interval between the onset of initial symptoms and discharge). Ground-glass opacity (GGO) (58%, 41/71) was the earliest and most frequent finding in week 1. Consolidation (26%, 14/53) and mixed pattern (40%, 21/53) were predominant patterns in 2 week. GGO and reticular were the main patterns of later phase CT scans in patients with relatively advanced diseases who had longer illness duration (≥4 weeks). Among the 94 CT abnormalities obtained within 3 days from the twice RT-PCR test turned negative, the mixed pattern was mainly presented in patients with disease duration of 2-3 weeks, for GGO and reticular were common during the whole course. Discharged patients from fangcang shelter hospital demonstrated a high extent of lung abnormalities on CT within the first week from symptom onset, peaked at 2 week, followed by persistence of high levels and a prolonged median disease course. GGO was the predominant pattern in week 1, consolidation and mixed pattern in 2 week, whereas GGO and reticular patterns in later stages (≥4 weeks).
为了呈现方舱医院内 COVID-19 患者的 CT 表现的时间变化，便于了解疾病过程。本回顾性研究纳入了 2020 年 2 月 5 日至 2 月 9 日在江汉方舱医院确诊的 98 例 COVID-19 患者（男：女，43：55，平均年龄 49±12 岁），他们在我院进行了首次胸部 CT 检查。分析了影像学特征和 CT 评分。共评估了 98 例患者的 267 次 CT 扫描。我们的研究显示，从症状出现后的第一周内，中位总 CT 评分中位数为 7，在第 2 周达到峰值 10，随后 CT 评分持续高水平，第 3、4 和>4 周分别为 9.5、7 和 7，中位疾病持续时间（30 天，从初始症状出现到出院的中位数间隔）延长。磨玻璃影（GGO）（58%，41/71）是最早且最常见的表现，出现在第 1 周。实变（26%，14/53）和混合模式（40%，21/53）是第 2 周的主要模式。在疾病持续时间较长（≥4 周）的病情相对较重的患者的后期 CT 扫描中，GGO 和网状影是主要的 CT 表现模式。在两次 RT-PCR 检测结果转为阴性后 3 天内获得的 94 例 CT 异常中，混合模式主要见于疾病持续时间为 2-3 周的患者，GGO 和网状影在整个病程中较为常见。从方舱医院出院的患者在症状出现后的第一周内 CT 显示肺部异常程度较高，在第 2 周达到峰值，随后持续高水平并延长中位疾病持续时间。GGO 是第 1 周的主要模式，实变和混合模式在第 2 周，而在后期（≥4 周）则是 GGO 和网状模式。
