Early Clinical and CT Manifestations of Coronavirus Disease 2019 (COVID-19) Pneumonia
Early Clinical and CT Manifestations of Coronavirus Disease 2019 (COVID-19) Pneumonia
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DOI：
10.2214/ajr.20.22961
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发表时间：
2020-08-01
影响因子：
5
通讯作者：
Zhang, Dongyou
中科院分区：
文献类型：
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作者：
Han, Rui;Huang, Lu;Zhang, Dongyou
OBJECTIVE.本研究的目的是探讨冠状病毒病（COVID-19）肺炎的早期临床和CT表现。本回顾性研究入组了经严重急性呼吸综合征冠状病毒2型（SA RS-CoV-2）核酸检测（逆转录-聚合酶链反应）确诊的COVID-19肺炎患者。分析其临床表现、实验室检查及CT表现。108例患者（38例男性，70例女性;年龄范围21-90岁）入组研究。临床表现为发热94例（87%），干咳65例（60%），乏力42例（39%）。97例（90%）患者的实验室检查结果为WBC计数正常，65例（60%）患者的淋巴细胞计数正常或降低。107例（99%）患者超敏C反应蛋白水平升高。病灶分布为单叶38例（35%），二叶或三叶24例（22%），四叶或五叶46例（43%）。主要累及外周（97例患者[90%]），常见病变形状为斑片状（93例患者[86%]）。65例（60%）患者出现磨玻璃样阴影（000），44例（41%）患者出现（1例（10例）合并实变。病变大小从小于1 cm（10例患者[9%]）到大于3 cm（56例患者[52%]）不等。血管增粗86例（80%），疯狂铺路征43例（40%），支气管充气征52例（48%），晕征69例（64%）。COVID-19肺炎的早期临床和实验室表现为低热至中度发热、干咳和疲劳，白细胞计数正常，淋巴细胞计数减少，超敏C反应蛋白水平升高。早期CT表现为斑片状GGO伴或不伴实变，累及多个肺叶，以外周带为主，伴晕征、血管增厚、疯狂铺路征或支气管充气征。
OBJECTIVE. The purpose of this study was to investigate early clinical and CT manifestations of coronavirus disease (COVID-19) pneumonia.MATERIALS AND METHODS. Patients with COVID-19 pneumonia confirmed by severe acute respiratory syndrome coronavirus 2 (SA RS-CoV-2) nucleic acid test (reverse transcription-polymerase chain reaction) were enrolled in this retrospective study. The clinical manifestations, laboratory results, and CT findings were evaluated.RESULTS. One hundred eight patients (38 men, 70 women; age range, 21-90 years) were included in the study. The clinical manifestations were fever in 94 of 108 (87%) patients, dry cough in 65 (60%), and fatigue in 42 (39%). The laboratory results were normal WBC count in 97 (90%) patients and normal or reduced lymphocyte count in 65 (60%). High-sensitivity C-reactive protein level was elevated in 107 (99%) patients. The distribution of involved lobes was one lobe in 38 (35%) patients, two or three lobes in 24 (22%), and four or five lobes in 46 (43%). The major involvement was peripheral (97 patients [90%]), and the common lesion shape was patchy (93 patients [86%]). Sixty-five (60%) patients had ground-glass opacity (000), and 44 (41%) had (1(10 with consolidation. The size of lesions varied from smaller than 1 cm (10 patients [9%]) to larger than 3 cm (56 patients [52%]). Vascular thickening (86 patients [80%]), crazy paving pattern (43 patients [40%]), air bronchogram sign (52 patients [48%]), and halo sign (69 [64%]) were also observed in this study.CONCLUSION. The early clinical and laboratory findings of COVID-19 pneumonia are low to midgrade fever, dry cough, and fatigue with normal WBC count, reduced lymphocyte count, and elevated high-sensitivity C-reactive protein level. The early CT findings are patchy GGO with or without consolidation involving multiple lobes, mainly in the peripheral zone, accompanied by halo sign, vascular thickening, crazy paving pattern, or air bronchogram sign.