Marco Catherine A, Repas Steven J, Studebaker Haely, Buderer Nancy, Burkhammer Joseph, Shecter Jonathan, Hinton Amanda, Ballester J Michael, Angeles John Paul, Kleeman Benjamin
Department of Emergency Medicine Wright State University Boonshoft School of Medicine Dayton Ohio USA.
Wright State University Boonshoft School of Medicine Dayton Ohio USA.
J Am Coll Emerg Physicians Open. 2021 Mar 3;2(2):e12399. doi: 10.1002/emp2.12399. eCollection 2021 Apr.
The 2019-20 coronavirus pandemic is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19). This study was undertaken to identify and compare findings of chest radiography and computed tomography among patients with SARS-CoV-2 infection.
This retrospective study was undertaken at a tertiary care center. Eligible subjects included consecutive patients age 18 and over with documented SARS-CoV-2 infection between March and July 2020. The primary outcome measures were results of chest radiography and computed tomography among patients with documented SARS-CoV-2 infection.
Among 724 subjects, most were admitted to a medical floor (46.4%; N = 324) or admitted to an ICU (10.9%; N = 76). A substantial number of subjects were intubated during the emergency department visit or inpatient hospitalization (15.3%; N = 109). The majority of patients received a chest radiograph (80%; N = 579). The most common findings were normal, bilateral infiltrates, ground-glass opacities, or unilateral infiltrate. Among 128 patients who had both chest radiography and computed tomography, there was considerable disagreement between the 2 studies (52.3%; N = 67; 95% confidence interval: 43.7% to 61.0%).). The presence of bilateral infiltrates (infiltrates or ground-glass opacities) was associated with clinical factors including older age, ambulance arrivals, more urgent triage levels, higher heart rate, and lower oxygen saturation. Bilateral infiltrates were associated with poorer outcomes, including higher rate of intubation, greater number of inpatient days, and higher rate of death.
Common radiographic findings of SARS-CoV-2 infection include infiltrates or ground-glass opacities. There was considerable disagreement between chest radiography and computed tomography. Computed tomography was more accurate in defining the extent of involved lung parenchyma. The presence of bilateral infiltrates was associated with morbidity and mortality.
2019 - 2020年冠状病毒大流行由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起，该病毒导致2019冠状病毒病（COVID-19）。本研究旨在识别并比较SARS-CoV-2感染患者的胸部X线摄影和计算机断层扫描结果。
本回顾性研究在一家三级医疗中心进行。符合条件的受试者包括2020年3月至7月期间年龄在18岁及以上且有记录的SARS-CoV-2感染的连续患者。主要观察指标是有记录的SARS-CoV-2感染患者的胸部X线摄影和计算机断层扫描结果。
在724名受试者中，大多数被收治到普通内科病房（46.4%；n = 324）或重症监护病房（10.9%；n = 76）。相当数量的受试者在急诊科就诊或住院期间接受了插管（15.3%；n = 109）。大多数患者接受了胸部X线摄影（80%；n = 579）。最常见的表现为正常、双侧浸润、磨玻璃影或单侧浸润。在128名同时进行了胸部X线摄影和计算机断层扫描的患者中，两项检查结果之间存在相当大的差异（52.3%；n = 67；95%置信区间：43.7%至61.0%）。双侧浸润（浸润或磨玻璃影）的出现与包括年龄较大、救护车送达、更紧急的分诊级别、心率较高和血氧饱和度较低等临床因素相关。双侧浸润与较差的预后相关，包括更高的插管率、更多的住院天数和更高的死亡率。
SARS-CoV-2感染常见的影像学表现包括浸润或磨玻璃影。胸部X线摄影和计算机断层扫描结果之间存在相当大的差异。计算机断层扫描在确定受累肺实质范围方面更准确。双侧浸润的出现与发病率和死亡率相关。
