Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19):A multi-center study in Wenzhou city, Zhejiang, China
Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19):A multi-center study in Wenzhou city, Zhejiang, China
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DOI：
10.1016/j.jinf.2020.02.016
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发表时间：
2020-04-01
影响因子：
28.2
通讯作者：
Yan, Fuhua
中科院分区：
文献类型：
--
作者：
Yang, Wenjie;Cao, Qiqi;Yan, Fuhua
背景：湖北以外地区对 COVID-19 知之甚少。本文旨在描述中国浙江温州确诊的COVID-19感染住院患者的临床特征和影像学表现。 方法：在这项回顾性队列研究中，于2020年1月17日至2月10日连续入组温州三家三级医院的149例RT-PCR确诊阳性患者。结果随访至2020年2月15日。调查结果：共有85名患者有湖北旅行/居住史，另有49名患者与湖北人有过接触，15名患者无可追溯的湖北接触史。发热、咳嗽和咳痰是最常见的症状，14 名患者出现血氧饱和度降低，33 名患者出现白细胞减少，53 名患者出现淋巴细胞减少，82 名患者出现 C 反应蛋白升高。胸部计算机断层扫描（CT）显示，第 6 和第 10 肺段主要受累。共有 287 个节段呈现磨砂玻璃混浊，637 个节段呈现混合不透明，170 个节段呈现实变。病变更多地集中在肺周围，呈斑片状。有或无湖北暴露史的患者之间没有发现显着差异。 17例入院时CT正常，12例10天后仍呈阴性。解读：在我们的研究中，大多数患者表现为轻度感染。在发病第一周，多灶性周边毛玻璃或混合性混浊（下肺为主）的影像学表现高度可疑为 COVID-19。尽管如此，一些患者尽管 COVID-19 检测呈阳性，但胸部检查结果仍正常。 (C) 2020 英国感染协会。由爱思唯尔有限公司出版。保留所有权利。
Background: Little is known about COVID-19 outside Hubei. The aim of this paper was to describe the clinical characteristics and imaging manifestations of hospitalized patients with confirmed COVID-19 infection in Wenzhou, Zhejiang, China.Methods: In this retrospective cohort study, 149 RT-PCR confirmed positive patients were consecutively enrolled from January 17th to February 10th, 2020 in three tertiary hospitals of Wenzhou. Outcomes were followed up until Feb 15th, 2020.Findings: A total of 85 patients had Hubei travel/residence history, while another 49 had contact with people from Hubei and 15 had no traceable exposure history to Hubei. Fever, cough and expectoration were the most common symptoms, 14 patients had decreased oxygen saturation, 33 had leukopenia, 53 had lymphopenia, and 82 had elevated C-reactive protein. On chest computed tomography (CT), lung segments 6 and 10 were mostly involved. A total of 287 segments presented ground glass opacity, 637 presented mixed opacity and 170 presented consolidation. Lesions were more localized in the peripheral lung with a patchy form. No significant difference was found between patients with or without Hubei exposure history. Seventeen patients had normal CT on admission of these, 12 had negative findings even10 days later.Interpretation: Most patients presented with a mild infection in our study. The imaging pattern of multi-focal peripheral ground glass or mixed opacity with predominance in the lower lung is highly suspicious of COVID-19 in the first week of disease onset. Nevetheless, some patients can present with a normal chest finding despite testing positive for COVID-19. (C) 2020 The British Infection Association. Published by Elsevier Ltd. All rights reserved.