Chest Computed Tomography and Clinical Follow-Up of Discharged Patients with COVID-19 in Wenzhou City, Zhejiang, China.
Chest Computed Tomography and Clinical Follow-Up of Discharged Patients with COVID-19 in Wenzhou City, Zhejiang, China.
复制标题
DOI：
10.1513/annalsats.202004-324oc
复制
发表时间：
2020-10
影响因子：
8.3
通讯作者：
Jin M
中科院分区：
文献类型：
--
作者：
Liu C;Ye L;Xia R;Zheng X;Yuan C;Wang Z;Lin R;Shi D;Gao Y;Yao J;Sun Q;Wang X;Jin M
依据：许多临床研究都集中在冠状病毒病（COVID-19）住院患者的流行病学和临床特征上。然而，关于出院患者的临床随访报道很少。目的：描述中国浙江省温州市COVID-19患者的随访情况。研究方法：我们回顾性分析了COVID-19患者的4周随访，包括计算机断层扫描（CT）胸部扫描、血液检测和严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）核糖核酸的口咽拭子检测。分别于出院前最后一天、出院后2周、4周进行胸部CT扫描和血常规检查。在出院后1周和2周进行口咽拭子检查。51名普通COVID-19患者入组研究。所有CT和临床数据均于2020年1月23日至3月28日收集。结果如下：与出院前最后一次CT扫描发现的异常相比，出院后第一次和第二次随访时肺部的异常已逐渐被吸收。局灶性磨玻璃样阴影由17.7%降至9.8%。多发磨玻璃样阴影从80.4%下降到23.5%。实变病例由49.0%降至2.0%。小叶间隔增厚者由80.4%降至35.3%。胸膜下线条由29.4%降至7.8%。线纹不规则者由41.2%降至15.7%。25.5%的患者出院后首次CT扫描显示肺部病变完全吸收，第二次随访时肺部恢复率提高至64.7%。17.6%的出院患者核酸检测结果反复阳性，其中仅有33.3%的患者主诉有临床症状。复发阳性和阴性患者出院前最后一次CT扫描的特征无差异。在SARS-CoV-2核糖核酸检测结果再次阳性的出院患者中，55.6%的患者肺损伤完全吸收。结论：对于普通COVID-19患者，COVID-19引起的肺损伤是可逆的。少数病例出院后核酸检测结果反复阳性。
Rationale: Many clinical studies have focused on the epidemiological and clinical characteristics of inpatients with coronavirus disease (COVID-19). However, there are few reports about the clinical follow-up of discharged patients. Objectives: To describe the follow-up of patients with COVID-19 in Wenzhou City, Zhejiang, China. Methods: We retrospectively reviewed 4-week follow-ups in patients with COVID-19, including computed tomographic (CT) chest scanning, blood testing, and oropharyngeal-swab testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ribonucleic acid. The chest CT scans and blood tests were performed on the last day before discharge and 2 weeks and 4 weeks after discharge. The oropharyngeal-swab tests were performed at both 1 week and 2 weeks after discharge. Fifty-one patients with common COVID-19 were enrolled in the study. All the CT and clinical data were collected between January 23 and March 28, 2020. Results: Compared with the abnormalities found on the the last CT scans before discharge, the abnormalities in the lungs at the first and second follow-ups after discharge had been gradually absorbed. The cases with focal ground-glass opacity were reduced from 17.7% to 9.8% of cases. The cases with multiple ground-glass opacities decreased from 80.4% to 23.5%. The cases with consolidation were reduced from 49.0% to 2.0%. The cases with interlobular septal thickening were reduced from 80.4% to 35.3%. The cases with subpleural lines were reduced from 29.4% to 7.8%. The cases with irregular lines were reduced from 41.2% to 15.7%. The lung lesions of 25.5% patients were shown to be fully absorbed on the first CT scans after discharge, and the rate of lung recovery increased to 64.7% after the second follow-up. Nucleic-acid test results became recurrently positive in 17.6% of discharged patients, of whom only 33.3% complained of clinical symptoms. There were no differences in the characteristics of the last CT scans before discharge between the patients with recurrently positive test results and the patients with negative test results. The lung damage was fully absorbed in 55.6% of discharged patients with recurrence of positive test results for SARS-CoV-2 ribonucleic acid. Conclusions: The lung damage due to COVID-19 could be reversible for patients with common COVID-19. A few cases showed recurring positive results of nucleic-acid tests after discharge.