分析重症监护中 COVID-19 患者的临床表现和影像学特征。
Analysis of Clinical Manifestations and Imaging of COVID-19 Patients in Intensive Care.
机构信息
The Second Affiliated Hospital of Zhejiang Chinese Medical University, Xinhua Hospital of Zhejiang Province, Hangzhou 310005, China.
Oncology Department, Hangzhou Third Hospital, Hangzhou 310009, China.
出版信息
Contrast Media Mol Imaging. 2022 Jun 23;2022:9697285. doi: 10.1155/2022/9697285. eCollection 2022.
OBJECTIVE
The study aims to summarize and analyze the clinical and CT findings of severe COVID-19 patients.
METHODS
From February 11 to March 31, 2020, 61 COVID-19 patients in intensive care in the E1-3 ward of Tongji Hospital were analyzed retrospectively.
RESULTS
The main clinical manifestations were cough, expectoration in 56 cases (91.8%), shortness of breath, chest tightness in 48 cases (78.7%), fever in 61 cases (100%), muscle ache and weakness in 40 cases (65.6%), diarrhea or vomiting in 8 cases (13.1%), and headache in 4 cases (6.6%). After admission, the leukocyte count was normal in 40 cases (57.7%), higher in 9 cases (15.4%), and lower in 12 cases (26.9%). The lymphocyte count decreased in 53 cases (86.9%). CRP was increased in 29 cases (47.5%); PCT was increased in 15 cases (24.6%); ESR was increased in 38 cases (62.3%); D-dimer increased in 39 cases (63.9%); ALT/AST increased in 40 cases (65.6%); CK/CK-MB increased in 8 cases (13.1%); troponin I increased in 6 cases (9.8%); NT-proBNP increased in 35 cases (57.4%); IL-1 increased in 5 cases (8.2%); IL-2 receptor increased in 28 cases (45.9%); IL-6 increased in 23 cases (37.7%); IL-8 increased in 15 cases (24.6%); IL-10 increased in 12 cases (19.7%); and NTF increased in 22 cases (36.1%). The chest CT images showed that 38 cases (65.5%) of right lung lesions were more extensive than those of left lung lesions, 20 cases (34.5%) of left lung lesions were more extensive than those of right lung lesions, 42 cases (72.5%) of lower lobe lesions were more extensive than those of upper lobe lesions, 6 cases (10.3%) of upper lobe lesions were more extensive than those of lower lobe lesions, and 10 cases (17.2%) of upper and lower part lesions were roughly the same. Ground-glass opacity (GGO) was found in 12 cases (20.7%); GGO with focal consolidation in 38 cases (65.5%); small patchy edge fuzzy density increased in 24 cases (41.4%); large consolidation in 20 cases (34.5%); reticular or fibrous cord in 54 cases (93.1%); and air bronchogram in 8 cases (13.8%).
CONCLUSIONS
COVID-19 patients in intensive care have no specific clinical manifestation and CT findings. However, analysis and summary of relevant data can help us assess the severity of the disease, decide the timing of treatment, and predict prognosis.
目的
总结和分析重症 COVID-19 患者的临床和 CT 表现。
方法
回顾性分析 2020 年 2 月 11 日至 3 月 31 日期间在同济大学附属同济医院 E1-3 病房重症监护室的 61 例 COVID-19 患者。
结果
主要临床表现为咳嗽、咳痰 56 例（91.8%），呼吸急促、胸闷 48 例（78.7%），发热 61 例（100%），肌肉疼痛、乏力 40 例（65.6%），腹泻或呕吐 8 例（13.1%），头痛 4 例（6.6%）。入院后白细胞计数正常 40 例（57.7%），升高 9 例（15.4%），降低 12 例（26.9%）。淋巴细胞计数降低 53 例（86.9%）。CRP 升高 29 例（47.5%）；PCT 升高 15 例（24.6%）；ESR 升高 38 例（62.3%）；D-二聚体升高 39 例（63.9%）；ALT/AST 升高 40 例（65.6%）；CK/CK-MB 升高 8 例（13.1%）；肌钙蛋白 I 升高 6 例（9.8%）；NT-proBNP 升高 35 例（57.4%）；IL-1 升高 5 例（8.2%）；IL-2 受体升高 28 例（45.9%）；IL-6 升高 23 例（37.7%）；IL-8 升高 15 例（24.6%）；IL-10 升高 12 例（19.7%）；NTF 升高 22 例（36.1%）。胸部 CT 图像显示右肺病变 38 例（65.5%）较左肺病变广泛，左肺病变 20 例（34.5%）较右肺病变广泛，下叶病变 42 例（72.5%）较上叶病变广泛，上叶病变 6 例（10.3%）较下叶病变广泛，上、下叶病变 10 例（17.2%）大致相同。磨玻璃影（GGO） 12 例（20.7%）；GGO 伴局灶实变 38 例（65.5%）；小斑片状边缘模糊密度增高 24 例（41.4%）；大片实变 20 例（34.5%）；网状或纤维条索状 54 例（93.1%）；空气支气管征 8 例（13.8%）。
结论
重症监护室 COVID-19 患者无特异性临床表现和 CT 表现。然而，对相关数据的分析和总结有助于我们评估疾病的严重程度，决定治疗时机，并预测预后。
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