Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China.
Wuhan Wuchang Hospital, Wuchang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China.
Front Public Health. 2021 May 13;9:596938. doi: 10.3389/fpubh.2021.596938. eCollection 2021.
The coronavirus disease 2019 (COVID-19) outbreak is spreading rapidly around the world. We aimed to explore early warning information for patients with severe/critical COVID-19 based on quantitative analysis of chest CT images at the lung segment level. A dataset of 81 patients with coronavirus disease 2019 (COVID-19) treated at Wuhan Wuchang hospital in Wuhan city from 21 January 2020 to 14 February 2020 was retrospectively analyzed, including ordinary and severe/critical cases. The time course of all subjects was divided into four stages. The differences in each lobe and lung segment between the two groups at each stage were quantitatively analyzed using the percentage of lung involvement (PLI) in order to investigate the most important segment of lung involvement in the severe/critical group and its corresponding time point. Lung involvement in the ordinary and severe/critical groups reached a peak on the 18th and 14th day, respectively. In the first stage, PLIs in the right middle lobe and the left superior lobe between the two groups were significantly different. In the second stage and the fourth stage, there were statistically significant differences between the two groups in the whole lung, right superior lobe, right inferior lobe and left superior lobe. The rapid progress of the lateral segment of the right middle lobe on the second day and the anterior segment of the right upper lobe on the 13th day may be a warning sign for severe/critical patients. Age was the most important demographic characteristic of the severe/critical group. Quantitative assessment based on the lung segments of chest CT images provides early warning information for potentially severe/critical patients.
新型冠状病毒肺炎（COVID-19）疫情在全球范围内迅速蔓延。本研究旨在通过对肺部 CT 图像的定量分析，探讨严重/危重症 COVID-19 患者的早期预警信息。本研究回顾性分析了 2020 年 1 月 21 日至 2 月 14 日期间在武汉市武昌医院治疗的 81 例 COVID-19 患者的数据，包括普通型和严重/危重型患者。将所有患者的病程分为 4 个阶段，定量分析两组患者在每个阶段各肺叶及肺段的差异，采用肺累及百分比（PLI）评估肺受累最严重的肺段及其相应的时间点。普通型和严重/危重型患者的肺部受累分别于第 18 天和第 14 天达到高峰。第 1 阶段，两组间右中叶和左上叶的 PLI 差异有统计学意义。第 2 阶段和第 4 阶段，两组间全肺、右上叶、右下叶和左上叶的 PLI 差异有统计学意义。第 2 天右中叶外侧段和第 13 天右肺上叶前段快速进展可能是严重/危重症患者的预警信号。年龄是严重/危重症组最重要的人口统计学特征。基于 CT 图像肺段的定量评估为潜在严重/危重症患者提供了早期预警信息。
