tetano
Editor, Senior Moderator
Clin Infect Dis. 2020 Mar 30. pii: ciaa271. doi: 10.1093/cid/ciaa271. [Epub ahead of print]
Novel Coronavirus Pneumonia (COVID-19) Progression Course in 17 Discharged Patients: Comparison of Clinical and Thin-Section CT Features During Recovery.
Han X[SUP]1,[/SUP][SUP]2[/SUP], Cao Y[SUP]1,[/SUP][SUP]2[/SUP], Jiang N[SUP]1,[/SUP][SUP]2[/SUP], Chen Y[SUP]1,[/SUP][SUP]2[/SUP], Alwalid O[SUP]1,[/SUP][SUP]2[/SUP], Zhang X, Gu J[SUP]1,[/SUP][SUP]2[/SUP], Dai M[SUP]1,[/SUP][SUP]2[/SUP], Liu J[SUP]1,[/SUP][SUP]2[/SUP], Zhu W[SUP]3[/SUP], Zheng C[SUP]1,[/SUP][SUP]2[/SUP], Shi H[SUP]1,[/SUP][SUP]2[/SUP].
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Abstract
BACKGROUND:
To retrospectively analyze the evolution of clinical features and thin-section CT imaging of novel coronavirus pneumonia (COVID-19) in 17 discharged patients.
METHODS:
Serial thin-section CT scans of 17 discharged patients with COVID-19 were obtained during recovery. Longitudinal changes of clinical parameters and CT pattern were documented in all patients during 4 weeks since admission. CT score was used to evaluate the extent of the disease.
RESULTS:
There was a marked improvement of fever, lymphocytes count, C-reactive protein and erythrocyte sedimentation rate within the first two weeks since admission. However, the mean CT score rapidly increased from the 1st to 3rd week, with a top score of 8.2 obtained in the 2nd week. During the 1st week, the main CT pattern was ground-glass opacities (GGO,76.5%). The frequency of GGO (52.9%) decreased in the 2nd week. Consolidation and mixed patterns (47.0%) were noted in the 2nd week. Thereafter, consolidations generally dissipated into GGO and the frequency of GGO increased in the 3rd week (76.5%) and 4th week (71.4%). Opacities were mainly located in the peripheral (76.5%), subpleural (47.1%) zones of the lungs, and presented as focal (35.3%) or multifocal (29.4%) in the 1st week and became more diffuse in the 2nd (47.1%) and 3rd week (58.8%), then showed reduced extent in 4th week (50%).
CONCLUSIONS:
The progression course of CT pattern was later than the clinical parameters within the first two weeks since admission; however, there was a synchronized improvement in both clinical and radiologic features in the 4th week.
? The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
KEYWORDS:
COVID-19; computed tomography; novel coronavirus pneumonia; viral pneumonia
PMID:32227091DOI:10.1093/cid/ciaa271
Novel Coronavirus Pneumonia (COVID-19) Progression Course in 17 Discharged Patients: Comparison of Clinical and Thin-Section CT Features During Recovery.
Han X[SUP]1,[/SUP][SUP]2[/SUP], Cao Y[SUP]1,[/SUP][SUP]2[/SUP], Jiang N[SUP]1,[/SUP][SUP]2[/SUP], Chen Y[SUP]1,[/SUP][SUP]2[/SUP], Alwalid O[SUP]1,[/SUP][SUP]2[/SUP], Zhang X, Gu J[SUP]1,[/SUP][SUP]2[/SUP], Dai M[SUP]1,[/SUP][SUP]2[/SUP], Liu J[SUP]1,[/SUP][SUP]2[/SUP], Zhu W[SUP]3[/SUP], Zheng C[SUP]1,[/SUP][SUP]2[/SUP], Shi H[SUP]1,[/SUP][SUP]2[/SUP].
Author information
Abstract
BACKGROUND:
To retrospectively analyze the evolution of clinical features and thin-section CT imaging of novel coronavirus pneumonia (COVID-19) in 17 discharged patients.
METHODS:
Serial thin-section CT scans of 17 discharged patients with COVID-19 were obtained during recovery. Longitudinal changes of clinical parameters and CT pattern were documented in all patients during 4 weeks since admission. CT score was used to evaluate the extent of the disease.
RESULTS:
There was a marked improvement of fever, lymphocytes count, C-reactive protein and erythrocyte sedimentation rate within the first two weeks since admission. However, the mean CT score rapidly increased from the 1st to 3rd week, with a top score of 8.2 obtained in the 2nd week. During the 1st week, the main CT pattern was ground-glass opacities (GGO,76.5%). The frequency of GGO (52.9%) decreased in the 2nd week. Consolidation and mixed patterns (47.0%) were noted in the 2nd week. Thereafter, consolidations generally dissipated into GGO and the frequency of GGO increased in the 3rd week (76.5%) and 4th week (71.4%). Opacities were mainly located in the peripheral (76.5%), subpleural (47.1%) zones of the lungs, and presented as focal (35.3%) or multifocal (29.4%) in the 1st week and became more diffuse in the 2nd (47.1%) and 3rd week (58.8%), then showed reduced extent in 4th week (50%).
CONCLUSIONS:
The progression course of CT pattern was later than the clinical parameters within the first two weeks since admission; however, there was a synchronized improvement in both clinical and radiologic features in the 4th week.
? The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
KEYWORDS:
COVID-19; computed tomography; novel coronavirus pneumonia; viral pneumonia
PMID:32227091DOI:10.1093/cid/ciaa271