Parry Arshed Hussain, Wani Abdul Haseeb, Yaseen Mudasira, Shah Naveed Nazir, Dar Khurshid Ahmad
Department of Radiodiagnosis, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India.
Department of Radiodiagnosis, Government Medical College, Srinagar, Jammu & Kashmir, India.
BJR Open. 2020 Jul 31;2(1):20200033. doi: 10.1259/bjro.20200033. eCollection 2020.
The study aimed to describe the clinical and imaging course of reverse transcriptase polymerase chain reaction) confirmed coronavirus disease (COVID-19) patients who are asymptomatic at admission.
This was a retrospective observational study. Severe acute respiratory syndrome coronavisrus-2 (SARS-CoV-2) positive cases that were asymptomatic at admission were retrospectively enrolled. Specific clinical information, laboratory test results, chest CT imaging features and outcome data during hospital stay were collected and analyzed.
137 non-consecutive asymptomatic patients with reverse transcriptase polymerase chain reaction confirmed COVID-19 were enrolled in the present study. On admission, patients had no symptoms but chest CT findings were present in 61/137 (44.5%). Ground glass opacity (48, 78.7%) followed by ground glass opacity with crazy-paving pattern (9, 14.7%) were the commonest type of opacities with posterior, peripheral predominance and lower zone predilection. Among the initial CT positive group of 61 patients, follow-up imaging revealed progression of pulmonary opacities in 13/61 (21.4%), complete resorption in 21/61 (34.4%), partial resolution in 22/61 (36%) and no change in 5/61 (8.2%). The patients in progression group (54 ± 19.7 years) were older and had higher frequency of co-morbidities (46.2%) compared to the other three groups (10.4%). The patients in progression group had a significantly higher C-reactive protein, higher lactate dehydrogenase and lower lymphocyte count than the other groups (all -values < 0.05). The duration of hospital stay was longer in the progression group (27.1 ± 11.4 days) compared to the other three groups (16.12 ± 5.8) ( =< 0.05).
Nearly half of the asymptomatic cases with confirmed COVID-19 had abnormal chest CT imaging. Asymptomatic infections can have a variable clinicoradiological course. Clinically, some recover without developing symptoms, some present few mild symptoms whereas some deteriorate. Similarly, imaging follow-up may reveal resolution (partial or complete), progression or no change.
Clinicoradiological course of asymptomatic COVID-19 cases is diverse.
本研究旨在描述经逆转录聚合酶链反应确诊的新型冠状病毒肺炎（COVID-19）患者入院时无症状的临床及影像学病程。
这是一项回顾性观察研究。回顾性纳入入院时无症状的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）阳性病例。收集并分析住院期间的具体临床信息、实验室检查结果、胸部CT影像学特征及转归数据。
本研究纳入了137例经逆转录聚合酶链反应确诊为COVID-19的非连续性无症状患者。入院时，患者无症状，但137例中有61例（44.5%）存在胸部CT表现。磨玻璃影（48例，78.7%），其次是伴有铺路石样改变的磨玻璃影（9例，14.7%）是最常见的影像类型，以肺后部、外周及下肺野为主。在最初CT阳性的61例患者中，随访影像学显示13/61例（21.4%）肺部影像进展，21/61例（34.4%）完全吸收，22/61例（36%）部分吸收，5/61例（8.2%）无变化。进展组患者（54±19.7岁）年龄较大，合并症发生率较高（46.2%），高于其他三组（10.4%）。进展组患者的C反应蛋白、乳酸脱氢酶水平显著高于其他组，淋巴细胞计数低于其他组（所有P值<0.05）。进展组的住院时间（27.1±11.4天）长于其他三组（16.12±5.8天）（P<0.05）。
近一半经确诊的COVID-19无症状病例胸部CT影像异常。无症状感染的临床影像学病程可能各不相同。临床上，一些患者未出现症状即康复，一些患者出现轻微症状，而一些患者病情恶化。同样，影像学随访可能显示吸收（部分或完全）、进展或无变化。
无症状COVID-19病例的临床影像学病程多样。
