tetano
Editor, Senior Moderator
BMC Infect Dis
. 2021 Jan 29;21(1):127.
doi: 10.1186/s12879-020-05751-8.
Atypical presentations of coronavirus disease 2019 (COVID-19) from onset to readmission
Zhiqi Yang[SUP] #[/SUP][SUP] 1 [/SUP], Xiaofeng Chen[SUP] #[/SUP][SUP] 1 [/SUP], Ruibin Huang[SUP] #[/SUP][SUP] 2 [/SUP], Shengkai Li[SUP] 3 [/SUP], Daiying Lin[SUP] 4 [/SUP], Zhijian Yang[SUP] 5 [/SUP], Hongfu Sun[SUP] 6 [/SUP], Guorui Liu[SUP] 7 [/SUP], Jinming Qiu[SUP] 7 [/SUP], Yanyan Tang[SUP] 7 [/SUP], Jianning Xiao[SUP] 4 [/SUP], Yuting Liao[SUP] 8 [/SUP], Xianheng Wu[SUP] 4 [/SUP], Renhua Wu[SUP] 7 [/SUP], Xiangguang Chen[SUP] 9 [/SUP], Zhuozhi Dai[SUP] 10 [/SUP]
Affiliations
Abstract
Background: To investigate the CT imaging and clinical features of three atypical presentations of coronavirus disease 2019 (COVID-19), namely (1) asymptomatic, (2) CT imaging-negative, and (3) re-detectable positive (RP), during all disease stages.
Methods: A consecutive cohort of 79 COVID-19 patients was retrospectively recruited from five independent institutions. For each presentation type, all patients were classified into atypical vs. typical groups (i.e., asymptomatic vs.symptomatic, CT imaging-negative vs. CT imaging-positive, and RP and non-RP,respectively). The chi-square test, Student's t test, and Kruskal-Wallis H test were performed to compare CT imaging and clinical features of atypical vs. typical patients for all three presentation categories.
Results: In our COVID-19 cohort, we found 12.7% asymptomatic patients, 13.9% CT imaging-negative patients, and 8.9% RP patients. The asymptomatic patients had fewer hospitalization days (P=0.043), lower total scores for bilateral lung involvement (P< 0.001), and fewer ground-glass opacities (GGOs) in the peripheral area (P< 0.001) than symptomatic patients. The CT imaging-negative patients were younger (P=0.002), had a higher lymphocyte count (P=0.038), had a higher lymphocyte rate (P=0.008), and had more asymptomatic infections (P=0.002) than the CT imaging-positive patients. The RP patients with moderate COVID-19 had lower total scores of for bilateral lung involvement (P=0.030) and a smaller portion of the left lung affected (P=0.024) than non-RP patients. Compared to their first hospitalization, RP patients had a shorter hospitalization period (P< 0.001) and fewer days from the onset of illness to last RNA negative conversion (P< 0.001) at readmission.
Conclusions: Significant CT imaging and clinical feature differences were found between atypical and typical COVID-19 patients for all three atypical presentation categories investigated in this study, which may help provide complementary information for the effective management of COVID-19.
Keywords: Asymptomatic; COVID-19; CT imaging negative; Features; Re-detectable positive.
. 2021 Jan 29;21(1):127.
doi: 10.1186/s12879-020-05751-8.
Atypical presentations of coronavirus disease 2019 (COVID-19) from onset to readmission
Zhiqi Yang[SUP] #[/SUP][SUP] 1 [/SUP], Xiaofeng Chen[SUP] #[/SUP][SUP] 1 [/SUP], Ruibin Huang[SUP] #[/SUP][SUP] 2 [/SUP], Shengkai Li[SUP] 3 [/SUP], Daiying Lin[SUP] 4 [/SUP], Zhijian Yang[SUP] 5 [/SUP], Hongfu Sun[SUP] 6 [/SUP], Guorui Liu[SUP] 7 [/SUP], Jinming Qiu[SUP] 7 [/SUP], Yanyan Tang[SUP] 7 [/SUP], Jianning Xiao[SUP] 4 [/SUP], Yuting Liao[SUP] 8 [/SUP], Xianheng Wu[SUP] 4 [/SUP], Renhua Wu[SUP] 7 [/SUP], Xiangguang Chen[SUP] 9 [/SUP], Zhuozhi Dai[SUP] 10 [/SUP]
Affiliations
- PMID: 33514323
- DOI: 10.1186/s12879-020-05751-8
Abstract
Background: To investigate the CT imaging and clinical features of three atypical presentations of coronavirus disease 2019 (COVID-19), namely (1) asymptomatic, (2) CT imaging-negative, and (3) re-detectable positive (RP), during all disease stages.
Methods: A consecutive cohort of 79 COVID-19 patients was retrospectively recruited from five independent institutions. For each presentation type, all patients were classified into atypical vs. typical groups (i.e., asymptomatic vs.symptomatic, CT imaging-negative vs. CT imaging-positive, and RP and non-RP,respectively). The chi-square test, Student's t test, and Kruskal-Wallis H test were performed to compare CT imaging and clinical features of atypical vs. typical patients for all three presentation categories.
Results: In our COVID-19 cohort, we found 12.7% asymptomatic patients, 13.9% CT imaging-negative patients, and 8.9% RP patients. The asymptomatic patients had fewer hospitalization days (P=0.043), lower total scores for bilateral lung involvement (P< 0.001), and fewer ground-glass opacities (GGOs) in the peripheral area (P< 0.001) than symptomatic patients. The CT imaging-negative patients were younger (P=0.002), had a higher lymphocyte count (P=0.038), had a higher lymphocyte rate (P=0.008), and had more asymptomatic infections (P=0.002) than the CT imaging-positive patients. The RP patients with moderate COVID-19 had lower total scores of for bilateral lung involvement (P=0.030) and a smaller portion of the left lung affected (P=0.024) than non-RP patients. Compared to their first hospitalization, RP patients had a shorter hospitalization period (P< 0.001) and fewer days from the onset of illness to last RNA negative conversion (P< 0.001) at readmission.
Conclusions: Significant CT imaging and clinical feature differences were found between atypical and typical COVID-19 patients for all three atypical presentation categories investigated in this study, which may help provide complementary information for the effective management of COVID-19.
Keywords: Asymptomatic; COVID-19; CT imaging negative; Features; Re-detectable positive.