CT imaging and clinical course of asymptomatic cases with COVID-19 pneumonia at admission in Wuhan, China
CT imaging and clinical course of asymptomatic cases with COVID-19 pneumonia at admission in Wuhan, China
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中国武汉市无症状 COVID-19 肺炎病例入院时的 CT 成像和临床病程
DOI：
10.1016/j.jinf.2020.04.004
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发表时间：
2020-07-01
影响因子：
28.2
通讯作者：
Geng, Qing
中科院分区：
文献类型：
--
作者：
Meng, Heng;Xiong, Rui;Geng, Qing
目的：探讨无症状新冠肺炎肺炎的CT表现和临床病程特点。方法：对武汉大学人民医院收治的经SARS-COV-2核酸检测确诊的无症状新冠肺炎肺炎病例进行回顾性分析。结果：纳入本院2020年1月1日至2020年2月23日收治的58例无症状新冠肺炎肺炎患者。所有患者均有SARS-CoV-2接触史。入院时，患者没有任何症状，实验室检查正常。本组病例CT表现以磨玻璃样密度影(GGO)为主(55例，94.8%)，周边分布(44例，75.9%)，单侧(34例，58.6%)，多累及单叶或双叶(38例，65.5%)，常伴有特征性征象。经短期随访，16例(27.6%)患者出现淋巴细胞计数降低、C反应蛋白升高的症状，主要表现为发热、咳嗽、乏力。CT上观察到10例(17.2%)病变的演变。平均住院天数为19.80±10.82天，进展期明显延长(28.60±7.55天)。结论：无症状新冠肺炎肺炎的CT表现具有一定的特点。由于无症状感染为“隐蔽传播者”，部分患者可在短期内快速进展。重视对新冠肺炎无症状患者的监测至关重要。CT扫描对新冠肺炎肺炎患者的筛查和发现有重要价值，特别是对高度怀疑、无症状、核酸检测阴性的肺炎患者。(C)2020年英国感染协会。爱思唯尔有限公司出版。保留所有权利。
Purpose: Aimed to characterize the CT imaging and clinical course of asymptomatic cases with COVID-19 pneumonia.Methods: Asymptomatic cases with COVID-19 pneumonia confirmed by SARS-COV-2 nucleic acid testing in Renmin Hospital of Wuhan University were retrospectively enrolled. The characteristics of CT imaging and clinical feature were collected and analyzed.Results: 58 asymptomatic cases with COVID-19 pneumonia admitted to our hospital between Jan 1, 2020 and Feb 23, 2020 were enrolled. All patients had history of exposure to SARS-CoV-2. On admission, patients had no symptoms and laboratory findings were normal. The predominant feature of CT findings in this cohort was ground glass opacity (GGO) (55, 94.8%) with peripheral (44, 75.9%) distribution, unilateral location (34, 58.6%) and mostly involving one or two lobes (38, 65.5%), often accompanied by characteristic signs. After short-term follow-up, 16 patients (27.6%) presented symptoms with lower lymphocyte count and higher CRP, mainly including fever, cough and fatigue. The evolution of lesions on CT imaging were observed in 10 patients (17.2%). The average days of hospitalization was19.80 +/- 10.82 days, and was significantly longer in progression patients (28.60 +/- 7.55 day).Conclusion: CT imaging of asymptomatic cases with COVID-19 pneumonia has definite characteristics. Since asymptomatic infections as "covert transmitter", and some patients can progress rapidly in the short term. It is essential to pay attention to the surveillance of asymptomatic patients with COVID-19. CT scan has great value in screening and detecting patients with COVID-19 pneumonia, especially in the highly suspicious, asymptomatic cases with negative nucleic acid testing. (C) 2020 The British Infection Association. Published by Elsevier Ltd. All rights reserved.