Department of General Internal Medicine, Ningbo First Hospital, Ningbo University, Ningbo, Zhejiang, China.
Division of Respiratory Medicine, National Institute for Health Research, Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, United Kingdom.
Singapore Med J. 2022 Apr;63(4):219-224. doi: 10.11622/smedj.2021004. Epub 2021 Jan 21.
We aimed to compare the early clinical manifestations, laboratory results and chest computed tomography (CT) images of COVID-19 patients with those of other community-acquired pneumonia (CAP) patients to differentiate CAP from COVID-19 before reverse transcription-polymerase chain reaction results are obtained.
The clinical and laboratory data and chest CT images of 51 patients were assessed in a fever observation ward for evidence of COVID-19 between January and February 2020.
24 patients had laboratory-confirmed COVID-19, whereas 27 individuals had negative results. No statistical difference in clinical features was found between COVID-19 and CAP patients, except for diarrhoea. There was a significant difference in lymphocyte and eosinophil counts between COVID-19 and CAP patients. In total, 22 (91.67%) COVID-19 patients had bilateral involvement and multiple lesions according to their lung CT images; the left lower lobe (87.50%) and right lower lobe (95.83%) were affected most often, and all lesions were located in the peripheral zones of the lung. The most common CT feature of COVID-19 was ground-glass opacity, found in 95.83% of patients, compared to 66.67% of CAP patients.
Diarrhoea, lymphocyte counts, eosinophil counts and CT findings (e.g. ground-glass opacity) could help to distinguish COVID-19 from CAP at an early stage of infection, based on findings from our fever observation ward.
本研究旨在比较 COVID-19 患者与其他社区获得性肺炎(CAP)患者的早期临床表现、实验室结果和胸部计算机断层扫描(CT)图像,以便在获得逆转录-聚合酶链反应结果之前,将 CAP 与 COVID-19 区分开来。
2020 年 1 月至 2 月,我们在发热观察病房评估了 51 例疑似 COVID-19 患者的临床和实验室数据及胸部 CT 图像。
24 例患者经实验室确诊为 COVID-19,27 例患者结果为阴性。COVID-19 患者与 CAP 患者的临床特征无统计学差异,除腹泻外。COVID-19 患者与 CAP 患者的淋巴细胞和嗜酸性粒细胞计数存在显著差异。根据肺部 CT 图像,22 例(91.67%)COVID-19 患者均存在双侧受累和多发病灶;左下叶(87.50%)和右下叶(95.83%)受累最常见,所有病变均位于肺外周区。COVID-19 的最常见 CT 特征是磨玻璃影,见于 95.83%的患者,而 CAP 患者为 66.67%。
根据发热观察病房的研究结果,腹泻、淋巴细胞计数、嗜酸性粒细胞计数和 CT 表现(如磨玻璃影)有助于在感染早期将 COVID-19 与 CAP 区分开来。