The pulmonary sequalae in discharged patients with COVID-19: a short-term observational study
The pulmonary sequalae in discharged patients with COVID-19: a short-term observational study
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DOI：
10.1186/s12931-020-01385-1
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发表时间：
2020-05-24
影响因子：
5.8
通讯作者：
Liang, Bo
中科院分区：
文献类型：
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作者：
Liu, Dehan;Zhang, Wanshu;Liang, Bo
背景 一批 2019 年冠状病毒病 (COVID-19) 肺炎患者已从中国武汉的医院出院。我们的目的是确定每个时间点的累积放射学完全缓解百分比，探讨相关影响因素，并描述出院后不同时间点的胸部CT表现。方法 纳入2020年2月5日至2020年3月10日期间连续出院、按时接受系列胸部CT扫描的经RT-PCR确诊的COVID-19肺炎患者。收集并分析所有患者的放射学特征。总 CT 评分是出院时确定的非 GGO 受累的总和。随后，所有患者在出院后第1周、第2周和第3周均接受了胸部CT扫描。分析不同时间点的成像特征和分布。结果 共有149名完成全部CT扫描的患者接受了评估；其中男性 67 名（45.0%），女性 82 名（55.0%），中位年龄 43 岁（IQR 36-56）。出院时以及出院后第 1、2 和 3 周期间，放射学完全缓解的累积百分比分别为 8.1%（12 名患者）、41.6%（62 名）、50.3%（75 名）和 53.0%（79 名）。 3周随访时患者年龄为44岁。出院时观察到的异常主要模式是磨玻璃样混浊（GGO）（125 [83.9%]）、纤维条纹（81 [54.4%]）和邻近胸膜增厚（33 [22.1%]）。 GGO、纤维条纹和邻近胸膜增厚的阳性计数逐渐减少，而GGO和纤维条纹分别在出院后第1周和第3周出现明显消退。在进化过程中发现了“有色”征和支气管血管束扭曲两个特殊特征。结论 COVID-19肺炎患者肺部病灶在短期随访中可完全吸收，无后遗症。出院后两周可能是早期放射学评估的最佳时间点。
Background A cluster of patients with coronavirus disease 2019 (COVID-19) pneumonia were discharged from hospitals in Wuhan, China. We aimed to determine the cumulative percentage of complete radiological resolution at each time point, to explore the relevant affecting factors, and to describe the chest CT findings at different time points after hospital discharge. Methods Patients with COVID-19 pneumonia confirmed by RT-PCR who were discharged consecutively from the hospital between 5 February 2020 and 10 March 2020 and who underwent serial chest CT scans on schedule were enrolled. The radiological characteristics of all patients were collected and analysed. The total CT score was the sum of non-GGO involvement determined at discharge. Afterwards, all patients underwent chest CT scans during the 1st, 2nd, and 3rd weeks after discharge. Imaging features and distributions were analysed across different time points. Results A total of 149 patients who completed all CT scans were evaluated; there were 67 (45.0%) men and 82 (55.0%) women, with a median age of 43 years old (IQR 36-56). The cumulative percentage of complete radiological resolution was 8.1% (12 patients), 41.6% (62), 50.3% (75), and 53.0% (79) at discharge and during the 1st, 2nd, and 3rd weeks after discharge, respectively. Patients 44 years old at the 3-week follow-up. The predominant patterns of abnormalities observed at discharge were ground-glass opacity (GGO) (125 [83.9%]), fibrous stripe (81 [54.4%]), and thickening of the adjacent pleura (33 [22.1%]). The positive count of GGO, fibrous stripe and thickening of the adjacent pleura gradually decreased, while GGO and fibrous stripe showed obvious resolution during the first week and the third week after discharge, respectively. "Tinted" sign and bronchovascular bundle distortion as two special features were discovered during the evolution. Conclusion Lung lesions in COVID-19 pneumonia patients can be absorbed completely during short-term follow-up with no sequelae. Two weeks after discharge might be the optimal time point for early radiological estimation.