Clinical characteristics and prognosis of COVID-19 patients with initial presentation of lung lesions confined to a single pulmonary lobe.

BACKGROUND

COVID-19 patients showed certain characteristic features of multiple signs in bilateral lungs. Some patients only had a single pulmonary lobe lesion, which has not been reported previously. Single pulmonary lobe lesions are easily missed or misdiagnosed if they do not receive enough attention.

OBJECTIVE

To study the imaging manifestations, clinical features and outcomes of patients with COVID-19 with only one single pulmonary lobe lesion.

METHODS

Patient clinical data were collected only from patients with confirmed SARS-CoV-2 infection by RT-PCR, which was confined to only single lobe lesions on chest CT imaging findings at the onset. Which lobe was frequently involved, the imaging manifestations, clinical features and outcomes were also analyzed.

RESULT

From January 1, 2020, to March 14, 2020, a total of 367 inpatients were diagnosed with COVID-19, in which 50 (13.6%) patients were confirmed with only one single pulmonary lobe lesion. The most frequently involved lobe was the right lower lobe (18 patients, 36%, highest). Lesions in the lower lobe easily spread to all lobes of the bilateral lungs (<0.001, χ=10.264), especially the left lower lobe, and were less frequent in the right upper lobe. During hospitalization, 2 (4%) patients were admitted to the ICU, 2 (4%) patients died, and 28 (56%) patients developed lesions in other lobes within 6.32±3.71 days.

CONCLUSIONS

The general pattern of COVID-19 imaging with localized nodules may also cause severe respiratory symptoms of bilateral lung disease, serious complications, or even death in patients with multiple lobe lesions or bilateral lung lesions, which should not be underestimated.