Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19):A multi-center study in Wenzhou city, Zhejiang, China.
浙江省温州市 2019 例新型冠状病毒病 (新型冠状病毒肺炎) 的临床特点和影像学表现。
- 作者列表："Yang W","Cao Q","Qin L","Wang X","Cheng Z","Pan A","Dai J","Sun Q","Zhao F","Qu J","Yan F
BACKGROUND:Little is known about COVID-19 outside Hubei. The aim of this paper was to describe the clinical characteristics and imaging manifestations of hospitalized patients with confirmed COVID-19 infection in Wenzhou, Zhejiang, China. METHODS:In this retrospective cohort study, 149 RT-PCR confirmed positive patients were consecutively enrolled from January 17th to February 10th, 2020 in three tertiary hospitals of Wenzhou. Outcomes were followed up until Feb 15th, 2020. FINDINGS:A total of 85 patients had Hubei travel/residence history, while another 49 had contact with people from Hubei and 15 had no traceable exposure history to Hubei. Fever, cough and expectoration were the most common symptoms, 14 patients had decreased oxygen saturation, 33 had leukopenia, 53 had lymphopenia, and 82 had elevated C-reactive protein. On chest computed tomography (CT), lung segments 6 and 10 were mostly involved. A total of 287 segments presented ground glass opacity, 637 presented mixed opacity and 170 presented consolidation. Lesions were more localized in the peripheral lung with a patchy form. No significant difference was found between patients with or without Hubei exposure history. Seventeen patients had normal CT on admission of these, 12 had negative findings even10 days later. INTERPRETATION:Most patients presented with a mild infection in our study. The imaging pattern of multifocal peripheral ground glass or mixed opacity with predominance in the lower lung is highly suspicious of COVID-19 in the first week of disease onset. Nevetheless, some patients can present with a normal chest finding despite testing positive for COVID-19. FUNDING:We did not receive any fundings.
背景: 湖北以外的新型冠状病毒肺炎知之甚少。本文旨在探讨浙江省温州市新型冠状病毒肺炎感染住院患者的临床特点及影像学表现。 方法: 本回顾性队列研究连续入选温州市 3 所三级医院于 2020 年 1 月 17 日至 2 月 10 日间经RT-PCR确诊为阳性的患者 149 例。结果随访至 2020 年 2 月 15 日。 结果: 共有 85 例患者有湖北旅游/居留史，另有 49 例与湖北人有过接触，15 例无湖北可追溯接触史。最c的症状是发热、咳痰和c，c氧饱和度下降 14 例，白细胞减少 33 c，淋巴细胞减少 53 例，82 例有升高的C-rea c蛋白。在胸部计算机断层扫描 (CT) 上，肺段 6 和 10 大部分受累。共有 287 个节段呈现磨玻璃不透明度，637 呈现混合不透明度，170 呈现巩固。病灶更局限于周围肺，呈片状。在有无湖北接触史的患者之间未发现显著差异。17 例患者入院时CT正常，12 例 10 天后复查阴性。 解读: 在我们的研究中，大多数患者表现为轻度感染。多灶性周边磨玻璃或混合混浊的影像模式，以下肺为主，高度怀疑发病第一周新型冠状病毒肺炎。然而，一些患者可以表现为正常的胸部发现，尽管新型冠状病毒肺炎检测呈阳性。 资金: 我们没有收到任何资金。
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.