Clinical Features and Chest CT Manifestations of Coronavirus Disease 2019 (COVID-19) in a Single-Center Study in Shanghai, China.
中国上海一项单中心研究中冠状病毒病 2019 (新型冠状病毒肺炎) 的临床特征和胸部CT表现。
- 作者列表："Cheng Z","Lu Y","Cao Q","Qin L","Pan Z","Yan F","Yang W
:OBJECTIVE. Confronting the new coronavirus infection known as coronavirus disease 2019 (COVID-19) is challenging and requires excluding patients with suspected COVID-19 who actually have other diseases. The purpose of this study was to assess the clinical features and CT manifestations of COVID-19 by comparing patients with COVID-19 pneumonia with patients with non-COVID-19 pneumonia who presented at a fever observation department in Shanghai, China. MATERIALS AND METHODS. Patients were retrospectively enrolled in the study from January 19 through February 6, 2020. All patients underwent real-time reverse transcription-polymerase chain reaction (RT-PCR) testing. RESULTS. Eleven patients had RT-PCR test results that were positive for severe acute respiratory syndrome coronavirus 2, whereas 22 patients had negative results. No statistical difference in clinical features was observed (p > 0.05), with the exception of leukocyte and platelet counts (p < 0.05). The mean (± SD) interval between onset of symptoms and admission to the fever observation department was 4.40 ± 2.00 and 5.52 ± 4.00 days for patients with positive and negative RT-PCR test results, respectively. The frequency of opacifications in patients with positive results and patients with negative results, respectively, was as follows: ground-glass opacities (GGOs), 100.0% versus 90.9%; mixed GGO, 63.6% versus 72.7%; and consolidation, 54.5% versus 77.3%. In patients with positive RT-PCR results, GGOs were the most commonly observed opacification (seen in 100.0% of patients) and were predominantly located in the peripheral zone (100.0% of patients), compared with patients with negative results (31.8%) (p = 0.05). The median number of affected lung lobes and segments was higher in patients with positive RT-PCR results than in those with negative RT-PCR results (five vs 3.5 affected lobes and 15 vs nine affected segments; p < 0.05). Although the air bronchogram reticular pattern was more frequently seen in patients with positive results, centrilobular nodules were less frequently seen in patients with positive results. CONCLUSION. At the point during the COVID-19 outbreak when this study was performed, imaging patterns of multifocal, peripheral, pure GGO, mixed GGO, or consolidation with slight predominance in the lower lung and findings of more extensive GGO than consolidation on chest CT scans obtained during the first week of illness were considered findings highly suspicious of COVID-19.
: 目的。面对被称为冠状病毒疾病 2019 (新型冠状病毒肺炎) 的新型冠状病毒感染是具有挑战性的，需要排除实际上患有其他疾病的疑似新型冠状病毒肺炎患者。本研究的目的是通过比较在上海发热观察科就诊的新型冠状病毒肺炎肺炎和非新型冠状病毒肺炎肺炎患者的临床特征和CT表现，评估新型冠状病毒肺炎的临床特征和CT表现。中国。材料和方法。从 1 月 19 日到 20 20 年 2 月 6 日，患者被回顾性纳入研究。所有患者均行实时逆转录-聚合酶链反应 (RT-PCR) 检测。结果。11 例患者的RT-PCR检测结果为新型冠状病毒阳性，而 22 例患者的结果为阴性。除白细胞和血小板计数外 (p <0.05)，临床特征无统计学差异 (p> 0.05)。RT-PCR检测结果阳性和阴性的患者，症状发作至入院至发热观察科的平均 (± SD) 间隔时间分别为 4.40 ± 2.00 和 5.52 ± 4.00 天，分别。结果阳性患者和阴性患者的视光频率分别为: 磨玻璃影 (gos)，100.0% 对 90.9%; 混合GGO，63.6% 对 72.7%; 和整合，54.5% 对 77.3%。在RT-PCR结果阳性的患者中，gos是最常见的显影 (见于 100.0% 的患者)，主要位于外周区 (100.0% 的患者)，与阴性结果患者相比 (31.8%) (p = 0.05)。RT-PCR结果阳性的患者受累肺叶和节段的中位数数量高于RT-PCR结果阴性的患者 (5 个对 3.5 个受累肺叶和 15 个对 9 个受累肺叶)。; p <0.05)。虽然空气支气管网状模式在阳性结果患者中更常见，但小叶中心结节在阳性结果患者中较少见。结论。在本研究进行的新型冠状病毒肺炎爆发期间，多灶性、外周性、纯GGO、混合型GGO、或下肺轻度占优势的实变和在疾病第一周获得的胸部CT扫描中发现比实变更广泛的GGO被认为是高度怀疑新型冠状病毒肺炎的发现。
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.