International Journal of Infectious Diseases (May 2020)

Epidemiological, clinical characteristics of cases of SARS-CoV-2 infection with abnormal imaging findings

  • Xiaoli Zhang,
  • Huan Cai,
  • Jianhua Hu,
  • Jiangshan Lian,
  • Jueqing Gu,
  • Shanyan Zhang,
  • Chanyuan Ye,
  • Yingfeng Lu,
  • Ciliang Jin,
  • Guodong Yu,
  • Hongyu Jia,
  • Yimin Zhang,
  • Jifang Sheng,
  • Lanjuan Li,
  • Yida Yang

Journal volume & issue
Vol. 94
pp. 81 – 87

Abstract

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Purpose: To investigate the epidemiological and clinical characteristics of COVID-19 patients with abnormal imaging findings. Methods: Patients confirmed with SARS-CoV-2 infection in Zhejiang province from January 17 to February 8 who had undergone CT or X-ray were enrolled. Epidemiological and clinical data were analyzed among those with abnormal or normal imaging findings. Results: Excluding 72 patients with normal images, 230 of 573 patients showed abnormalities affecting more than two lung lobes. The median radiographic score was 2.0, and there was a negative correlation between that score and the oxygenation index (ρ = −0.657, P < 0.001). Patients with abnormal images were older (46.65 ± 13.82), with a higher rate of coexisting condition (28.8%), a lower rate of exposure history, and longer time between onset and confirmation (5 days) than non-pneumonia patients (all P < 0.05). A higher rate of fever, cough, expectoration and headache, a lower level of lymphocytes, albumin, and serum sodium levels and a higher total bilirubin, creatine kinase, lactate dehydrogenase, and C-reactive protein levels and a lower oxygenation index were observed in pneumonia patients (all P < 0.05). Muscle ache, shortness of breath, nausea and vomiting, lower lymphocytes levels, and higher serum creatinine and radiographic score at admission were predictive factors for the severe/critical subtype. Conclusion: Patients with abnormal images have more obvious clinical manifestations and laboratory changes. Combing clinical features and radiographic scores can effectively predict severe/critical types.

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