CT and clinical assessment in asymptomatic and pre-symptomatic patients with early SARS-CoV-2 in outbreak settings.
CT and clinical assessment in asymptomatic and pre-symptomatic patients with early SARS-CoV-2 in outbreak settings.
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在爆发环境中，无症状和症状前SARS-COV-2患者的CT和临床评估。
DOI：
10.1007/s00330-020-07401-8
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发表时间：
2021-05
影响因子：
5.9
通讯作者：
Wood BJ
中科院分区：
文献类型：
--
作者：
Varble N;Blain M;Kassin M;Xu S;Turkbey EB;Amalou A;Long D;Harmon S;Sanford T;Yang D;Xu Z;Xu D;Flores M;An P;Carrafiello G;Obinata H;Mori H;Tamura K;Malayeri AA;Holland SM;Palmore T;Sun K;Turkbey B;Wood BJ
SARS-CoV-2患者的早期感染动力学尚不清楚。我们的目的是调查和表征无症状和症状前SARS-CoV-2患者的临床、实验室和影像学特征之间的相关性。74例RT-PCR证实的SARS-CoV-2感染患者在就诊时无症状。所有这些都是从日本和中国爆发环境中暴露或旅行风险后胸部CT扫描和阳性RT-PCR的825名患者中回顾性确定的。在入院后一天内获得每位患者的CT，并在深度学习工具的帮助下审查浸润亚型和百分比。分析临床、实验室和影像学特征的相关性，并采用单变量和多变量logistic回归进行比较。74例最初无症状的患者中有48例（65%）在症状发作前3.8天出现CT浸润。最常见的CT浸润是磨玻璃影（45/48; 94%）和实变影（22/48; 46%）。患者体温（p < 0.01）、CRP（p < 0.01）和KL-6（p = 0.02）与CT浸润的存在相关。浸润量（p = 0.01）、肺部受累百分比（p = 0.01）和实变（p = 0.043）与随后症状的发展相关。在三分之二的患者中，COVID-19 CT浸润先于症状。体温升高和实验室评估可能会发现无症状的SARS-CoV-2 CT浸润患者在介绍，CT浸润的特点可以帮助确定无症状的SARS-CoV-2患者随后出现症状。通过更好地了解早期疾病或SARS-CoV-2暴露患者的CT浸润，可以阐明胸部CT在COVID-19中的作用。·74名（65%）预先选择的SARS-CoV-2无症状患者中有48名（65%）胸部CT结果异常。· CT浸润比症状发作早3.8天（范围1-5）。· KL-6、CRP和升高的体温鉴定出具有CT浸润的患者。较高的浸润体积、肺部受累百分比和肺实变确定了出现症状的患者。
The early infection dynamics of patients with SARS-CoV-2 are not well understood. We aimed to investigate and characterize associations between clinical, laboratory, and imaging features of asymptomatic and pre-symptomatic patients with SARS-CoV-2. Seventy-four patients with RT-PCR-proven SARS-CoV-2 infection were asymptomatic at presentation. All were retrospectively identified from 825 patients with chest CT scans and positive RT-PCR following exposure or travel risks in outbreak settings in Japan and China. CTs were obtained for every patient within a day of admission and were reviewed for infiltrate subtypes and percent with assistance from a deep learning tool. Correlations of clinical, laboratory, and imaging features were analyzed and comparisons were performed using univariate and multivariate logistic regression. Forty-eight of 74 (65%) initially asymptomatic patients had CT infiltrates that pre-dated symptom onset by 3.8 days. The most common CT infiltrates were ground glass opacities (45/48; 94%) and consolidation (22/48; 46%). Patient body temperature (p < 0.01), CRP (p < 0.01), and KL-6 (p = 0.02) were associated with the presence of CT infiltrates. Infiltrate volume (p = 0.01), percent lung involvement (p = 0.01), and consolidation (p = 0.043) were associated with subsequent development of symptoms. COVID-19 CT infiltrates pre-dated symptoms in two-thirds of patients. Body temperature elevation and laboratory evaluations may identify asymptomatic patients with SARS-CoV-2 CT infiltrates at presentation, and the characteristics of CT infiltrates could help identify asymptomatic SARS-CoV-2 patients who subsequently develop symptoms. The role of chest CT in COVID-19 may be illuminated by a better understanding of CT infiltrates in patients with early disease or SARS-CoV-2 exposure. • Forty-eight of 74 (65%) pre-selected asymptomatic patients with SARS-CoV-2 had abnormal chest CT findings. • CT infiltrates pre-dated symptom onset by 3.8 days (range 1–5). • KL-6, CRP, and elevated body temperature identified patients with CT infiltrates. Higher infiltrate volume, percent lung involvement, and pulmonary consolidation identified patients who developed symptoms.
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影响因子：
56.3
作者：
Tabata, Sakiko;Imai, Kazuo;Tamura, Kaku
通讯作者：
Tamura, Kaku
DOI：
10.1148/ryct.2020200092
发表时间：
2020-04-01
期刊：
RADIOLOGY-CARDIOTHORACIC IMAGING
影响因子：
--
作者：
Wen, Zeying;Chi, Yonge;Wang, Daoqing
通讯作者：
Wang, Daoqing
影响因子：
8.4
作者：
Wan, Ren;Mao, Zhi-Qun;Wei-Chen
通讯作者：
Wei-Chen
影响因子：
82.9
作者：
He, Xi;Lau, Eric H. Y.;Leung, Gabriel M.
通讯作者：
Leung, Gabriel M.
影响因子：
19
作者：
Mizumoto, Kenji;Kagaya, Katsushi;Chowell, Gerardo
通讯作者：
Chowell, Gerardo