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. 2020 May:94:81-87.
doi: 10.1016/j.ijid.2020.03.040. Epub 2020 Mar 20.

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

Xiaoli Zhang  1 , Huan Cai  1 , Jianhua Hu  1 , Jiangshan Lian  1 , Jueqing Gu  1 , Shanyan Zhang  1 , Chanyuan Ye  1 , Yingfeng Lu  1 , Ciliang Jin  1 , Guodong Yu  1 , Hongyu Jia  1 , Yimin Zhang  1 , Jifang Sheng  2 , Lanjuan Li  3 , Yida Yang  4
Affiliations

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

Xiaoli Zhang et al. Int J Infect Dis. 2020 May.

Abstract

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.

Keywords: Clinical; Epidemiological; Imaging findings; Predictive factors; SRAS-CoV-2.

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Figures

Figure 1
Figure 1
The total radiographic score was significantly correlated with the oxygenation index.
See this image and copyright information in PMC

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