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Clinical and CT findings of COVID-19: differences among three age groups.

新型冠状病毒肺炎的临床和CT表现: 三个年龄组之间的差异。

  • 影响因子:2.79
  • DOI:10.1186/s12879-020-05154-9
  • 作者列表:"Wang J","Zhu X","Xu Z","Yang G","Mao G","Jia Y","Xie Z","Wang J","Ao W
  • 发表时间:2020-06-22
Abstract

BACKGROUND:The novel coronavirus pneumonia (coronavirus disease 2019, COVID-19) has spread around the world. We aimed to recapitulate the clinical and CT imaging features of COVID-19 and their differences in three age groups. METHODS:The clinical and CT data of patients with COVID-19 (n = 307) that had been divided into three groups (Group 1: < 40 years old; Group 2: 40 ≤ age < 60 years old; Group 3: ≥ 60 years old) according to age were analyzed retrospectively. RESULTS:Of all patients, 114 (37.1%) had histories of epidemiological exposure, 48 (15.6%) were severe/critical cases, 31 had hypertension (10.1%), 15 had diabetes mellitus (4.9%), 3 had chronic obstructive pulmonary disease (COPD, 1%). Among the three groups, severe/critical type, hypertension and diabetes occurred more commonly in the elderly group compared with Group 1&2 (P < 0.05, respectively). Cough and chest tightness/pain were more commonly appeared in Group 2&3 compared with Group 1 (P < 0.05, respectively). Compared with Group 1 and 2, there were more abnormal laboratory examination indexes (including CRP increase, abnormal percentage of lymphocytes, neutrophils and monocytes) in Group 3 (P < 0.05, respectively). CT images revealed that more lobes were affected and more subpleural lesions were involved in the elderly group, besides, crazy paving sign, bronchodilatation and pleural thickening were more commonly seen in the elderly group, with significant difference between Group 1&2, Group 2&3 (P < 0.05, respectively). CONCLUSIONS:COVID-19 presented representative clinical manifestations, laboratory examinations and CT findings, but three age groups possessed their own specific characteristics. Grasping the clinical and CT features stratified by age will be helpful for early definite diagnosis of COVID-19.

摘要

背景: 新冠肺炎 (冠状病毒病 2019,新型冠状病毒肺炎) 已在全球蔓延。我们的目的是总结新型冠状病毒肺炎的临床和CT影像特征及其在三个年龄组中的差异。 方法: 将 307 例新型冠状病毒肺炎患者分为 3 组 (组 1: <40 岁; 组 2: 40 岁 ≤ 年龄 <60 岁; 第 3 组: ≥ 60 岁) 按年龄进行回顾性分析。 结果: 所有患者中,114 (37.1%) 有流行病学暴露史,48 (15.6%) 为重症/危重病例,31 例有高血压 (10.1%),糖尿病 15 例 (4.9%),慢性阻塞性肺疾病 3 例 (1%)。三组中,老年组中重度/危重病型、高血压和糖尿病发生率高于第一组和第二组 (p <0.05)。与组 1 相比,组 2 和组 3 更常见咳嗽和胸闷/疼痛 (分别为p <0.05)。与 1 组和 2 组比较,3 组实验室检查指标异常 (包括CRP升高、淋巴细胞、中性粒细胞和单核细胞百分比异常) 更多 (p <0.05)。CT显示老年组累及肺叶较多,累及胸膜下病变较多,老年组以疯铺征、支气管扩张、胸膜增厚多见。组 1 和组 2 、组 2 和组 3 之间差异显著 (p <0.05)。 结论: 新型冠状病毒肺炎具有代表性的临床表现、实验室检查和CT表现,但 3 个年龄组有各自的特点。掌握按年龄分层的临床及CT特征,将有助于新型冠状病毒肺炎的早期明确诊断。

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呼吸道感染方向

呼吸道感染分为上呼吸道感染与下呼吸道感染。上呼吸道感染是指自鼻腔至喉部之间的急性炎症的总称,是最常见的感染性疾病。下呼吸道感染是最常见的感染性疾患,治疗时必须明确引起感染的病原体以选择有效的抗生素。

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