Zou You, Zou Jia-Ni, Zhuang Ya-Se, Wang Bin-Ru, Sun Liu, Xu Shan, Li Sheng-Lan, Shen Li-Jun, Liang Geng-Tian, Hua Qing-Quan, Huang Wen-Cai, Chen Shi-Ming
Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University Wuhan 430060, Hubei, P. R. China.
Department of Radiology, General Hospital of The Central Theater Command of The People's Liberation Army Wuhan 430070, Hubei, P. R. China.
Am J Transl Res. 2021 Jun 15;13(6):6191-6199. eCollection 2021.
The aim of this study was to evaluate factors affecting the recurrence of positive RT-PCR results. By performing a retrospective analysis, we evaluated the clinical data of recurrent positive coronavirus disease 2019 (COVID-19) patients in multiple medical institutions in Wuhan. We recruited COVID-19 patients who were hospitalized from January 1 to March 10, 2020, in three tertiary hospitals in Wuhan, met the discharge criteria and received at least one additional nucleic acid test before leaving the hospital. According to the RT-PCR results, patients were split into a recurrent positive group (RPos group) and a nonrecurrent positive group (non-RPos group). Clinical characteristics, therapeutic schedules and antibody titers were compared between the two groups. AI-assisted chest high-resolution computed tomography (HRCT) technology was applied to investigate pulmonary inflammatory exudation and compare the extent of lung areas with different densities. This study involved 122 COVID-19 patients. There were no significant differences in age, sex, preexisting diseases, clinical symptoms, clinical classification, course of disease, therapeutic schedules or serum-specific antibodies between the two groups. A higher proportion of patients who showed pulmonary inflammatory exudation on HRCT scans were recurrent positive at the time of discharge than other patients (81.6% vs 13.7%, < 0.01). In addition, the degree of pulmonary fibrosis was higher in the RPos group than in the non-RPos group ( < 0.05). Subpleural exudation at the peripheral edge of the lung and extensive pulmonary fibrosis at the time of discharge represent risk factors for the recurrence of COVID-19.
本研究的目的是评估影响逆转录聚合酶链反应(RT-PCR)结果呈阳性复发的因素。通过进行回顾性分析,我们评估了武汉多家医疗机构中新型冠状病毒肺炎(COVID-19)复发阳性患者的临床数据。我们招募了2020年1月1日至3月10日在武汉三家三级医院住院、符合出院标准且在出院前至少接受过一次额外核酸检测的COVID-19患者。根据RT-PCR结果,将患者分为复发阳性组(RPos组)和非复发阳性组(非RPos组)。比较了两组之间的临床特征、治疗方案和抗体滴度。应用人工智能辅助胸部高分辨率计算机断层扫描(HRCT)技术研究肺部炎症渗出情况,并比较不同密度肺区的范围。本研究纳入了122例COVID-19患者。两组在年龄、性别、基础疾病、临床症状、临床分型、病程、治疗方案或血清特异性抗体方面均无显著差异。HRCT扫描显示有肺部炎症渗出的患者出院时复发阳性的比例高于其他患者(81.6%对13.7%,<0.01)。此外,RPos组的肺纤维化程度高于非RPos组(<0.05)。出院时肺周边胸膜下渗出和广泛肺纤维化是COVID-19复发的危险因素。