Association of radiologic findings with mortality of patients infected with 2019 novel coronavirus in Wuhan, China
Association of radiologic findings with mortality of patients infected with 2019 novel coronavirus in Wuhan, China
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DOI：
10.1371/journal.pone.0230548
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发表时间：
2020-03-19
期刊：
影响因子：
3.7
通讯作者：
Hu, Yi
中科院分区：
文献类型：
--
作者：
Yuan, Mingli;Yin, Wen;Hu, Yi
2019年新型冠状病毒（2019-nCoV）感染的肺炎（NCIP）的放射学特征尚未完全了解，对于诊断和预测预后尤为重要。回顾性分析27例确诊为NCIP的患者的临床资料和CT表现，分析其影像学表现与死亡率的关系。27例患者包括12例男性和15例女性，中位年龄为60岁（IQR 47-69）。17例患者痊愈出院，10例患者在医院死亡。死亡组的中位年龄高于存活组（68（IQR 63-73）vs 55（IQR 35-60），P = 0.003）。死亡组的合并症发生率明显高于存活组（80%vs29%，P = 0.018）。主要CT表现为磨玻璃样改变（67%），双侧受累（86%），周边及中央分布（74%），下带受累（96%）。死亡组的中位CT评分高于存活组（30（IQR 7-13）vs 12（IQR 11-43），P = 0.021），实变（40%vs 6%，P = 0.047）和支气管充气征（60%vs 12%，P = 0.025）的发生率较高。CT评分24.5的最佳截止值预测死亡率的敏感性为85.6%，特异性为84.5%。2019-nCoV更容易感染患有慢性合并症的老年人。NCIP的CT表现以磨玻璃影为主，伴有实变影，主要分布于周围或周围与中央相结合，多累及双肺及下肺。简单的CT评分方法能够预测死亡率。
Radiologic characteristics of 2019 novel coronavirus (2019-nCoV) infected pneumonia (NCIP) which had not been fully understood are especially important for diagnosing and predicting prognosis. We retrospective studied 27 consecutive patients who were confirmed NCIP, the clinical characteristics and CT image findings were collected, and the association of radiologic findings with mortality of patients was evaluated. 27 patients included 12 men and 15 women, with median age of 60 years (IQR 47-69). 17 patients discharged in recovered condition and 10 patients died in hospital. The median age of mortality group was higher compared to survival group (68 (IQR 63-73) vs 55 (IQR 35-60), P = 0.003). The comorbidity rate in mortality group was significantly higher than in survival group (80% vs 29%, P = 0.018). The predominant CT characteristics consisted of ground glass opacity (67%), bilateral sides involved (86%), both peripheral and central distribution (74%), and lower zone involvement (96%). The median CT score of mortality group was higher compared to survival group (30 (IQR 7-13) vs 12 (IQR 11-43), P = 0.021), with more frequency of consolidation (40% vs 6%, P = 0.047) and air bronchogram (60% vs 12%, P = 0.025). An optimal cutoff value of a CT score of 24.5 had a sensitivity of 85.6% and a specificity of 84.5% for the prediction of mortality. 2019-nCoV was more likely to infect elderly people with chronic comorbidities. CT findings of NCIP were featured by predominant ground glass opacities mixed with consolidations, mainly peripheral or combined peripheral and central distributions, bilateral and lower lung zones being mostly involved. A simple CT scoring method was capable to predict mortality.