Mogami Roberto, Lopes Agnaldo Jose, Araújo Filho Ronaldo Carvalho, de Almeida Fernando Carlos Santos, Messeder Alexandre Malta da Costa, Koifman Ana Celia Baptista, Guimarães Amanda Barbosa, Monteiro Alexandra
Hospital Universitário Pedro Ernesto da Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil.
Radiol Bras. 2021 Jan-Feb;54(1):1-8. doi: 10.1590/0100-3984.2020.0133.
To define diagnostic criteria for coronavirus disease 2019 (COVID-19) on computed tomography (CT); to study the correlation between CT and polymerase chain reaction (PCR) testing for infection with severe acute respiratory syndrome coronavirus 2; and to determine whether the extent of parenchymal involvement and the need for mechanical ventilation are associated with the CT findings and clinical characteristics of patients with COVID-19.
This was a retrospective study of 155 patients with COVID-19 treated between March and May 2020. We attempted to determine whether the CT findings correlated with age and clinical variables, as well as whether the need for mechanical ventilation correlated with the extent of the pulmonary involvement.
On average, the patients with COVID-19 were older than were those without (mean age, 54.8 years vs. 45.5 years; = 0.031). The most common CT finding (seen in 88.6%) was ground-glass opacity, which correlated significantly with a diagnosis of COVID-19 ( = 0.0001). The CT findings that correlated most strongly with the need for mechanical ventilation were parenchymal bands ( = 0.013), bronchial ectasia ( = 0.046), and peribronchovascular consolidations ( = 0.012). The presence of one or more comorbidities correlated significantly with more extensive parenchymal involvement ( = 0.023). For the diagnosis of COVID-19, CT had a sensitivity of 84.3%, a specificity of 36.7%, and an accuracy of 73.5% ( = 0.012 vs. PCR).
The patterns of CT findings are useful for the diagnosis of COVID-19 and the evaluation of disease severity criteria. The presence of any comorbidity is associated with greater severity of COVID-19.
确定2019冠状病毒病（COVID-19）的计算机断层扫描（CT）诊断标准；研究CT与严重急性呼吸综合征冠状病毒2感染的聚合酶链反应（PCR）检测之间的相关性；并确定实质受累程度和机械通气需求是否与COVID-19患者的CT表现及临床特征相关。
这是一项对2020年3月至5月间接受治疗的155例COVID-19患者的回顾性研究。我们试图确定CT表现是否与年龄及临床变量相关，以及机械通气需求是否与肺部受累程度相关。
COVID-19患者的平均年龄高于非COVID-19患者（平均年龄，54.8岁对45.5岁；P = 0.031）。最常见的CT表现（88.6%可见）是磨玻璃影，其与COVID-19诊断显著相关（P = 0.0001）。与机械通气需求相关性最强的CT表现为实质条索影（P = 0.013）、支气管扩张（P = 0.046）和支气管血管周围实变（P = 0.012）。一种或多种合并症的存在与更广泛的实质受累显著相关（P = 0.023）。对于COVID-19的诊断，CT的敏感性为84.3%，特异性为36.7%，准确性为73.5%（与PCR相比，P = 0.012）。
CT表现模式有助于COVID-19的诊断及疾病严重程度标准的评估。任何合并症的存在都与COVID-19的更严重程度相关。
