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Chest CT Findings in Patients With Coronavirus Disease 2019 and Its Relationship With Clinical Features.

冠状病毒病 2019 患者的胸部CT表现及其与临床特征的关系。

  • 影响因子:6.73
  • DOI:10.1097/RLI.0000000000000670
  • 作者列表:"Wu J","Wu X","Zeng W","Guo D","Fang Z","Chen L","Huang H","Li C
  • 发表时间:2020-05-01
Abstract

OBJECTIVES:The aim of this study was to investigate the chest computed tomography (CT) findings in patients with confirmed coronavirus disease 2019 (COVID-19) and to evaluate its relationship with clinical features. MATERIALS AND METHODS:Study sample consisted of 80 patients diagnosed as COVID-19 from January to February 2020. The chest CT images and clinical data were reviewed, and the relationship between them was analyzed. RESULTS:Totally, 80 patients diagnosed with COVID-19 were included. With regards to the clinical manifestations, 58 (73%) of the 80 patients had cough, and 61 (76%) of the 80 patients had high temperature levels. The most frequent CT abnormalities observed were ground glass opacity (73/80 cases, 91%), consolidation (50/80 cases, 63%), and interlobular septal thickening (47/80, 59%). Most of the lesions were multiple, with an average of 12 ± 6 lung segments involved. The most common involved lung segments were the dorsal segment of the right lower lobe (69/80, 86%), the posterior basal segment of the right lower lobe (68/80, 85%), the lateral basal segment of the right lower lobe (64/80, 80%), the dorsal segment of the left lower lobe (61/80, 76%), and the posterior basal segment of the left lower lobe (65/80, 81%). The average pulmonary inflammation index value was (34% ± 20%) for all the patients. Correlation analysis showed that the pulmonary inflammation index value was significantly correlated with the values of lymphocyte count, monocyte count, C-reactive protein, procalcitonin, days from illness onset, and body temperature (P < 0.05). CONCLUSIONS:The common chest CT findings of COVID-19 are multiple ground glass opacity, consolidation, and interlobular septal thickening in both lungs, which are mostly distributed under the pleura. There are significant correlations between the degree of pulmonary inflammation and the main clinical symptoms and laboratory results. Computed tomography plays an important role in the diagnosis and evaluation of this emerging global health emergency.

摘要

目的: 本研究的目的是调查确诊的冠状病毒病 2019 (新型冠状病毒肺炎) 患者的胸部CT表现,并评估其与临床特征的关系。 材料和方法: 研究样本为 2020 年 1 月至 2 月诊断为新型冠状病毒肺炎的 80 例患者。回顾胸部CT图像和临床资料,分析两者之间的关系。 结果: 共纳入 80 例确诊为新型冠状病毒肺炎患者。关于临床表现,80 例患者中有 58 例 (73%) 有咳嗽,80 例患者中有 61 例 (76%) 有高温水平。最常见的CT异常为磨玻璃影 (73/80 例,91%) 、实变 (50/80 例,63%) 和小叶间隔增厚 (47/80,59%)。病灶多为多发,平均累及 12 ± 6 肺段。最常见的受累肺段为右下叶背侧段 (69/80,86%),右下叶后基底段 (68/80,85%),右下叶外侧基底段 (64/80,80%),左下叶背侧段 (61/80,76%),和左下叶后基底段 (65/80,81%)。所有患者的平均肺部炎症指数值为 (34% ± 20%)。C orrelation分析显示肺部炎症指标值差异c antly c orrelated值淋巴c yte c量,单声道c yte c量,C-rea c蛋白,c al c itonin、发病天数和体温 (P <0.05)。 结论: 新型冠状病毒肺炎常见的胸部CT表现为双肺多发磨玻璃影、实变、小叶间隔增厚,多分布于胸膜下。肺部炎症程度与主要临床症状及实验室检查结果有显著相关性。计算机断层扫描在这一新兴的全球卫生突发事件的诊断和评估中起着重要作用。

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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.

影响因子:4.36
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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.

翻译标题与摘要 下载文献
影响因子:2.48
发表时间:2020-04-01
来源期刊:Infection
DOI:10.1007/s15010-020-01401-y
作者列表:["Cheng ZJ","Shan J"]

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.

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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