冠状病毒疾病 2019 (新型冠状病毒肺炎) CT表现: 系统综述和荟萃分析。
- 作者列表："Bao C","Liu X","Zhang H","Li Y","Liu J
PURPOSE:To date, considerable knowledge gaps remain regarding the chest CT imaging features of coronavirus disease 2019 (COVID-19). We performed a systematic review and meta-analysis of results from published studies to date to provide a summary of evidence on detection of COVID-19 by chest CT and the expected CT imaging manifestations. METHODS:Studies were identified by searching PubMed database for articles published between December 2019 and February 2020. Pooled CT positive rate of COVID-19 and pooled incidence of CT imaging findings were estimated using a random-effect model. RESULTS:A total of 13 studies met inclusion criteria. The pooled positive rate of the CT imaging was 89.76% and 90.35% when only including thin-section chest CT. Typical CT signs were ground glass opacities (83.31%), ground glass opacities with mixed consolidation (58.42%), adjacent pleura thickening (52.46%), interlobular septal thickening (48.46%), and air bronchograms (46.46%). Other CT signs included crazy paving pattern (14.81%), pleural effusion (5.88%), bronchiectasis (5.42%), pericardial effusion (4.55%), and lymphadenopathy (3.38%). The most anatomic distributions were bilateral lung infection (78.2%) and peripheral distribution (76.95%). The incidences were highest in the right lower lobe (87.21%), left lower lobe (81.41%), and bilateral lower lobes (65.22%). The right upper lobe (65.22%), right middle lobe (54.95%), and left upper lobe (69.43%) were also commonly involved. The incidence of bilateral upper lobes was 60.87%. A considerable proportion of patients had three or more lobes involved (70.81%). CONCLUSIONS:The detection of COVID-19 chest CT imaging is very high among symptomatic individuals at high risk, especially using thin-section chest CT. The most common CT features in patients affected by COVID-19 included ground glass opacities and consolidation involving the bilateral lungs in a peripheral distribution.
目的: 迄今为止，关于冠状病毒病 2019 (新型冠状病毒肺炎) 的胸部CT成像特征仍然存在相当大的知识差距。我们对迄今为止已发表的研究结果进行了系统综述和荟萃分析，以总结胸部CT检测新型冠状病毒肺炎的证据和预期的CT影像学表现。 方法: 通过检索PubMed数据库中 2019 年 12 月至 2020 年 2 月发表的文章确定研究。使用随机效应模型估计新型冠状病毒肺炎的汇总CT阳性率和CT影像结果的汇总发生率。 结果: 共有 13 项研究符合纳入标准。当仅包括胸部薄层CT时，CT显像的合并阳性率为 89.76% 和 90.35%。典型CT征象为磨玻璃影 (83.31%)，磨玻璃影伴混合实变 (58.42%)，邻近胸膜增厚 (52.46%)，小叶间隔增厚 (48.46%)，和空气支气管图 (46.46%)。其他CT征象包括疯狂铺路 (14.81%) 、胸腔积液 (5.88%) 、支气管扩张 (5.42%) 、心包积液 (4.55%) 和淋巴结肿大 (3.38%)。解剖分布以双侧肺部感染 (78.2%) 和外周分布 (76.95%) 最多。发生率最高的是右下叶 (87.21%) 、左下叶 (81.41%) 和双侧下叶 (65.22%)。右上叶 (65.22%) 、右中叶 (54.95%) 和左上叶 (69.43%) 也常受累。双侧上叶发生率为 60.87%。相当比例的患者有三个或更多的肺叶受累 (70.81%)。 结论: 对于有症状的高危人群，尤其是薄层胸部CT，胸部CT新型冠状病毒肺炎检出率较高。受新型冠状病毒肺炎影响的患者最常见的CT特征包括磨玻璃影和周围分布累及双侧肺的实变。
METHODS::Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.
METHODS::In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.
METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.