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新型冠状病毒肺炎胸部CT异常表现:一项系统评价

Chest CT abnormalities in COVID-19: a systematic review.

作者信息

Ghayda Ramy Abou, Lee Keum Hwa, Kim Jae Seok, Lee Seul, Hong Sung Hwi, Kim Kyeong Seok, Kim Kyeong Eon, Seok Jinhyn, Kim Hajeong, Seo Jangsuk, Lee Seungmin, Koyanagi Ai, Jacob Louis, Smith Lee, Li Han, Kronbichler Andreas, Shin Jae Il

机构信息

Division of Urology, Brigham and Women's Hospital and Harvard Medical School Boston, MA 02115, USA.

Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.

出版信息

Int J Med Sci. 2021 Aug 1;18(15):3395-3402. doi: 10.7150/ijms.50568. eCollection 2021.

Abstract

Computed tomography (CT) of the chest is one of the main diagnositic tools for coronavirus disease 2019 (COVID-19) infection. To document the chest CT findings in patients with confirmed COVID-19 and their association with the clinical severity, we searched related literatures through PubMed, MEDLINE, Embase, Web of Science (inception to May 4, 2020) and reviewed reference lists of previous systematic reviews. A total of 31 case reports (3768 patients) on CT findings of COVID-19 were included. The most common comorbid conditions were hypertension (18.4%) and diabetes mellitus (8.3%). The most common symptom was fever (78.7%), followed by cough (60.2%). It took an average of 5.6 days from symptom onset to admission. The most common chest CT finding was vascular enlargement (84.8%), followed by ground-glass opacity (GGO) (60.1%), air-bronchogram (47.8%), and consolidation (41.4%). Most lung lesions were located in the lung periphery (72.2%) and involved bilateral lung (76%). Most patients showed normal range of laboratory findings such as white blood cell count (96.4%) and lymphocyte (87.2%). Compared to previous published meta-analyses, our study is the first to summarize the different radiologic characteristics of chest CT in a total of 3768 COVID-19 patients by compiling case series studies. A comprehensive diagnostic approach should be adopted for patients with known COVID-19, suspected cases, and for exposed individuals.

摘要

胸部计算机断层扫描(CT)是诊断2019冠状病毒病(COVID-19)感染的主要工具之一。为了记录确诊COVID-19患者的胸部CT表现及其与临床严重程度的关系,我们通过PubMed、MEDLINE、Embase、科学网(截至2020年5月4日)检索了相关文献,并查阅了以往系统评价的参考文献列表。共纳入31篇关于COVID-19 CT表现的病例报告(3768例患者)。最常见的合并症是高血压(18.4%)和糖尿病(8.3%)。最常见的症状是发热(78.7%),其次是咳嗽(60.2%)。从症状出现到入院平均需要5.6天。最常见的胸部CT表现是血管增粗(84.8%),其次是磨玻璃影(GGO)(60.1%)、空气支气管征(47.8%)和实变(41.4%)。大多数肺部病变位于肺周边(72.2%),累及双侧肺(76%)。大多数患者的实验室检查结果如白细胞计数(96.4%)和淋巴细胞(87.2%)在正常范围内。与以往发表的荟萃分析相比,我们的研究首次通过汇总病例系列研究总结了3768例COVID-19患者胸部CT的不同影像学特征。对于已知COVID-19患者、疑似病例和暴露个体,应采用综合诊断方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8701/8436104/67ea016d92cd/ijmsv18p3395g001.jpg

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