不同主要变异株引起的 2019 冠状病毒病（COVID-19）肺炎的 CT 表现比较。
Comparison of CT findings of coronavirus disease 2019 (COVID-19) pneumonia caused by different major variants.
机构信息
Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Department of Radiology, Japan Self-Defense Forces Central Hospital, 1-2-24, Ikejiri, Setagaya-ku, Tokyo, 154-0001, Japan.
出版信息
Jpn J Radiol. 2022 Dec;40(12):1246-1256. doi: 10.1007/s11604-022-01301-1. Epub 2022 Jun 28.
PURPOSE
To explore the CT findings and pneumonnia progression pattern of the Alpha and Delta variants of SARS-CoV-2 by comparing them with the pre-existing wild type.
METHOD
In this retrospective comparative study, a total of 392 patients with COVID-19 were included: 118 patients with wild type (70 men, 56.8 ± 20.7 years), 137 with Alpha variant (93 men, 49.4 ± 17.0 years), and 137 with Delta variant (94 men, 45.4 ± 12.4). Chest CT evaluation included opacities and repairing changes as well as lesion distribution and laterality. Chest CT severity score was also calculated. These parameters were statistically compared across the variants.
RESULTS
Ground glass opacity (GGO) with consolidation and repairing changes were more frequent in the order of Delta variant, Alpha variant, and wild type throughout the disease course. Delta variant showed GGO with consolidation more conspicuously than did the other two on days 1-4 (vs. wild type, Bonferroni corrected p = 0.01; vs. Alpha variant, Bonferroni corrected p = 0.003) and days 5-8 (vs. wild type, Bonferroni corrected p < 0.001; vs. Alpha variant, Bonferroni corrected-p = 0.003). Total lung CT severity scores of Delta variant were higher than those of wild type on days 1-4 and 5-8 (Bonferroni corrected p = 0.01 and Bonferroni corrected p = 0.005, respectively) and that of Alpha variant on days 1-4 (Bonferroni corrected p = 0.002). There was no difference in the CT findings between wild type and Alpha variant.
CONCLUSIONS
Pneumonia progression of Delta variant may be more rapid and severe in the early stage than in the other two.
目的
通过比较 Alpha 和 Delta 变异株与原有野生型 SARS-CoV-2 的 CT 表现和肺炎进展模式，探讨其 CT 表现。
方法
本回顾性对比研究共纳入 392 例 COVID-19 患者：野生型 118 例（男 70 例，56.8±20.7 岁），Alpha 变异株 137 例（男 93 例，49.4±17.0 岁），Delta 变异株 137 例（男 94 例，45.4±12.4 岁）。胸部 CT 评估包括磨玻璃影（GGO）和修复改变以及病变分布和侧别。还计算了胸部 CT 严重程度评分。比较了这些参数在不同变异株之间的差异。
结果
在整个病程中，Delta 变异株、Alpha 变异株和野生型的 GGO 伴实变和修复改变的发生率依次增高。与野生型相比，Delta 变异株在第 1-4 天（Bonferroni 校正后 p=0.01）和第 5-8 天（Bonferroni 校正后 p<0.001）更易出现 GGO 伴实变，与 Alpha 变异株相比，第 1-4 天（Bonferroni 校正后 p=0.003）和第 5-8 天（Bonferroni 校正后 p=0.003）更易出现 GGO 伴实变。第 1-4 天和第 5-8 天，Delta 变异株的总肺 CT 严重程度评分均高于野生型（Bonferroni 校正后 p=0.01 和 Bonferroni 校正后 p=0.005），第 1-4 天也高于 Alpha 变异株（Bonferroni 校正后 p=0.002）。野生型和 Alpha 变异株之间的 CT 表现无差异。
结论
Delta 变异株肺炎在早期可能比其他两株更迅速和严重。
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