PMC:7080117 / 8652-12571
Annnotations
Results
This study included 90 patients (39 men and 51 women; median age, 50 years (age range, 18–86 years). Table 1 summarizes patients’ clinical characteristics. Most patients had a history of exposure in Wuhan or to infected patients; exposure history was unknown in 4 (4%) patients. The majority of patients presented with fever and cough. Six (7%) patients were asymptomatic. Half of the patients hold comorbidities. Thirty-eight (42%) patients showed elevated C-reactive protein. Patients with decreased white blood cells were more than those with increased white blood cells.
Table 1 Patient characteristics and laboratory results
Patients (n = 90)
Patient demographics
Median age, years (range) 50 (18–86)
Men 39 (43%)
Women 51 (57%)
Exposure history
Exposure to Wuhan or infected patient 86 (96%)
Unknown exposure 4 (4%)
Comorbid conditions
Any 45 (50%)
Hypertension 17 (19%)
Diabetes 5 (6%)
Cardiovascular disease 3 (3%)
Chronic obstructive pulmonary disease 1 (1%)
Tuberculosis 2 (2%)
Malignancy 2 (2%)
Others 15 (17%)
Signs and symptoms
Fever 70 (78%)
Cough 57 (63%)
Sputum production 11 (12%)
Fatigue weakness 19 (21%)
Myalgia 25 (28%)
Sore throat 23 (26%)
Chills 6 (7%)
Headache 4 (4%)
Diarrhea 5 (6%)
Nausea 5 (6%)
Vomit 2 (2%)
No obvious symptoms 6 (7%)
Laboratory test
C-reactive protein (mg/L; normal range 0–10)
Increased 38 (42%)
Decreased
Normal 0 (0%)
52 (58%)
Leucocytes (×109/L, normal range 3.5–9.5)
Increased 3 (3%)
Decreased 19 (21%)
Normal 68 (76%)
Positive for (SARS-CoV-2) nucleic acid test by
Real-time PCR 90 (100%)
Baseline chest CT showed abnormalities in 69 patients, and 53 (59%) patients had more than two lobes involved. More than half of the patients presented bilateral, multifocal lung lesions, with peripheral distribution. Lesions were inclined to distribute in the lower lobes. Of the 90 patients included, 65 (72%) had ground glass opacification, 12 (13%) had consolidation, and 11 (12%) patients presented with crazy paving pattern. Thirty-three (37%) patients had interlobular thickening, 55 (61%) had combined linear opacities, 7 (8%) showed air bronchogram sign, and 50 (56%) presented adjacent pleura thickening. Pleural effusion, pericardial effusion, cavitation, thoracic lymphadenopathy, and pulmonary emphysema were uncommon imaging findings in these patients (Table 2).
Table 2 Imaging findings of patients with SARS-CoV-2 at presentation
Patients (n = 90)
Distribution
Periphery distribution 46 (51%)
Bilateral involvement 53 (59%)
Multifocal involvement 62 (69%)
Unifocal involvement 7 (8%)
Number of lobes involved
0 21 (23%)
1 12 (13%)
2 4 (4%)
3 13 (14%)
4 8 (9%)
5 32 (36%)
More than two lobes involved 53 (59%)
Lobe of lesion distribution
Left upper lobe 48 (53%)
Left lower lobe 55 (61%)
Right upper lobe 48 (53%)
Right middle lobe 40 (44%)
Right lower lobe 59 (66%)
Bilateral upper lobes 40 (44%)
Bilateral lower lobes 47 (52%)
Patterns of the lesion
Ground glass opacification 65 (72%)
Consolidation 12 (13%)
Crazy paving pattern 11 (12%)
Cavitation 0 (0%)
Other signs in the lesion
Interlobular septal thickening 33 (37%)
Linear opacities combined 55 (61%)
Air bronchogram sign 7 (8%)
Other findings
Adjacent pleura thickening 50 (56%)
Pleural effusion 4 (4%)
Pericardial effusion 1 (1%)
Lymphadenopathy 1 (1%)
Pulmonary emphysema 0 (0%)
Fifty-two patients repeated a chest CT examination after 1–6 days. Among them, 10 patients (19%) had no changes, 4 patients (8%) had disease resolution, and 38 patients (73%) had disease progression (Table 3). In 3 patients (6%) with baseline negative scan, follow-up CT after 3–4 days showed bilateral ground glass opacities.
Table 3 Image change on repeat chest CT in 52 patients
Patients (n = 52)
No change 10 (19%)
Disease resolution 4 (8%)
Disease progression 38 (73%)