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[2019冠状病毒病(COVID-19)患者的肺部CT实质改变]

[Parenchymal lung changes on CT in patients with coronavirus disease 2019 (COVID-19)].

作者信息

Halldorsson Arnljotur Bjorn, Axelsson Gisli Thor, Jonsson Helgi Mar, Isaksson Johann David, Hardardottir Hronn, Gudmundsson Gunnar, Hansdottir Sif

机构信息

Landpitali, National University Hospital of Iceland, Department of radiology.

University of Iceland, Faculty of medicine.

出版信息

Laeknabladid. 2021 Oct;107(10):460-468. doi: 10.17992/lbl.2021.10.655.

Abstract

Introduction Infections due to COVID-19 can lead to life threatening pneumonia. Accompanying severe disease are more prominent pulmonary changes on Computed Tomography (CT) scan of the chest. The goal of this study was to describe pulmonary CT changes during acute COVID-19 and at follow up and whether the extent of changes correlate with severity of illness, demographics or other risk factors. Materials and methods Included in this study are all individuals that had confirmed COVID-19 and came for a follow up CT of the chest at Landspitali from May to September 2020. Information regarding medical history was obtained retrospectively from medical charts. All CT scans were reviewed using an international staging system to evaluate the extent of lung changes. Results Eighty-five patients with a mean age of 59 years were included in the study. Sixty patients (71%) were hospitalized during the acute phase and 18 (21%) were admitted to the ICU. During the acute phase more pronounced lung involvement was seen in males and patients admitted to the ICU. At follow-up females had less lung involvement but there was a significant relationship between a higher CT score and age, ICU admissions and days in the ICU. Full recovery was seen at follow-up CT in 31% of patients (median 68,5 days between acute and follow-up imaging). Conclusion Patients with severe COVID-19 have more pronounced lung involvement on CT than patients with milder disease during the acute phase and follow-up. Older patients and males are at greater risk of acute and persistent COVID-19 related lung changes.

摘要

引言

新型冠状病毒肺炎(COVID-19)感染可导致危及生命的肺炎。伴随严重疾病的是胸部计算机断层扫描(CT)上更明显的肺部变化。本研究的目的是描述急性COVID-19期间及随访时的肺部CT变化,以及变化程度是否与疾病严重程度、人口统计学特征或其他风险因素相关。

材料与方法

本研究纳入了2020年5月至9月在兰斯皮塔利医院确诊为COVID-19并前来进行胸部随访CT检查的所有个体。有关病史的信息是从病历中回顾性获取的。所有CT扫描均使用国际分期系统进行评估,以评估肺部变化的程度。

结果

85例平均年龄59岁的患者纳入本研究。60例(71%)在急性期住院,18例(21%)入住重症监护病房(ICU)。在急性期,男性和入住ICU的患者肺部受累更明显。随访时,女性肺部受累较少,但CT评分较高与年龄、ICU入院情况及在ICU的天数之间存在显著关系。31%的患者在随访CT时完全恢复(急性期与随访影像之间的中位时间为68.5天)。

结论

在急性期和随访期间,重症COVID-19患者的CT肺部受累比轻症患者更明显。老年患者和男性发生急性和持续性COVID-19相关肺部变化的风险更高。

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