Department of Respiratory and Critical Care Medicine, Shenzhen Hospital, Southern Medical University, NO 1333, Xinhu Road, Baoan District, Shenzhen, 518100, China.
Department of Orthopaedics, The University of Hong Kong - Shenzhen Hospital, Shenzhen, 518053, China.
BMC Infect Dis. 2021 Apr 8;21(1):333. doi: 10.1186/s12879-021-06013-x.
The clinical and imaging features of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections that progressed to coronavirus disease 2019 (COVID-19) have been explored in numerous studies. However, little is known about these features in patients who received negative respiratory nucleic acid test results after the infections resolved. In this study, we aim to describe these features in a group of Chinese patients.
This retrospective study includes 51 patients with mild-to-moderate COVID-19 (median age: 34.0 years and 47.1% male) between January 31 and February 28, 2020. Demographic, clinical, laboratory, and computed tomography (CT) imaging data were collected before and after two consecutive negative respiratory SARS-CoV-2 tests.
Following a negative test result, the patients' clinical symptoms continued to recover, but abnormal imaging findings were observed in all moderate cases. Specifically, 77.4% of patients with moderate COVID-19 exhibited multi-lobar lung involvement and lesions were more frequently observed in the lower lobes. The most common CT imaging manifestations were ground-glass opacities (51.6%) and fibrous stripes (54.8%%). Twelve of the 31 patients with moderate COVID-19 underwent repeated chest CT scans after a negative SARS-CoV-2 test. Among them, the ground-glass opacities decreased by > 60% within 1 week in seven patients (58.3%), but by < 5% in four patients (13.8%).
Following a positive and subsequent negative SARS-CoV-2 tests, patients with COVID-19 continued to recover despite exhibiting persistent clinical symptoms and abnormal imaging findings.
大量研究已经探讨了严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染患者进展为 2019 年冠状病毒病（COVID-19）的临床和影像学特征。然而，对于感染消退后呼吸道核酸检测结果为阴性的患者，这些特征知之甚少。在本研究中，我们旨在描述一组中国患者的这些特征。
这项回顾性研究纳入了 2020 年 1 月 31 日至 2 月 28 日期间 51 例轻度至中度 COVID-19 患者（中位年龄：34.0 岁，47.1%为男性）。收集了两次连续呼吸道 SARS-CoV-2 检测均为阴性前后的人口统计学、临床、实验室和计算机断层扫描（CT）影像学数据。
在检测结果为阴性后，患者的临床症状继续恢复，但所有中度病例均观察到异常影像学表现。具体而言，77.4%的中度 COVID-19 患者存在多肺叶受累，病变更常发生在下肺叶。最常见的 CT 影像学表现为磨玻璃影（51.6%）和纤维条纹（54.8%）。31 例中度 COVID-19 患者中有 12 例在 SARS-CoV-2 检测结果为阴性后接受了重复胸部 CT 扫描。其中，7 例（58.3%）患者的磨玻璃影在 1 周内减少了 >60%，但 4 例（13.8%）患者减少了 <5%。
在 SARS-CoV-2 检测结果由阳性转为阴性后，COVID-19 患者尽管持续存在临床症状和异常影像学表现，但仍继续恢复。
