Asymptomatic novel coronavirus pneumonia patient outside Wuhan: The value of CT images in the course of the disease

Abstract

Background: To assess the dynamic changes in clinical and CT characteristics of COVID-19 patients with different epidemiology histories. Methods: Fifty-three discharged COVID-19 patients were enrolled at Beijing Youan Hospital, Capital Medical University, from Jan 21 to Mar 10, 2020. Spearman correlation analysis was performed between CT scores and laboratory indicators. Patients were divided into Wuhan (lived in/or traveled to Wuhan, 30 cases) and nonWuhan group (close contacts or unknown exposure, 23 cases). The CT and laboratory findings were compared between and within groups during the clinical process. Results: Fever (88.7%), cough (64.2%), fatigue (34%), and abnormal laboratory indicators, including lymphopenia, reduced albumin, albumin/globulin (A/G), and elevated C-reactive protein (CRP), were mainly observed. Subpleural ground-glass opacities (86.8%) were usually detected at admission. The CT scores were highly correlated with lymphocytes, CRP, albumin, and A/G at initial and follow-ups (all p<0.05). Four days after admission, most patients (66.7% Wuhan, 47.8% nonWuhan) showed progression, and the CT scores of Wuhan significantly increased (p=0.015). Eight days after admission, the vast majority of patients (69.2% Wuhan, 100% nonWuhan, p=0.006) presented improvement, and the CT scores of nonWuhan were significantly lower than Wuhan (p=0.006). Pneumonia was completely absorbed in most patients 2-4 weeks after discharge. Conclusions: CT plays a crucial role in early diagnosis and monitoring changes in COVID-19. Lymphocytes, CRP, albumin, and A/G are expected to predict disease severity and prognosis. Viral pathogenicity in non-endemic areas may be weaker than core-infected areas. Lung lesions can disappear around 4 weeks after discharge in most patients. Background In December 2019, there was an outbreak of novel viral pneumonia in Wuhan, China, which was proved to be associated with severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) [1] and later named by World Health Organization (WHO) as the corona virus disease (COVID-19). COVID-19 initially affected mainly the person who worked or lived around the Huanan seafood market (Wuhan, China)[2, 3]. Then, the number of infected individuals soared and rapidly spread across all number BMU2018MX027]; Capital medical university research and incubation funding [grant number PYZ19162]; and Beijing Excellent Talent Plan [grant number 2018000021469G290]. The funders and sponsors had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The researchers confirm their independence.

Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients

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C-reactive protein levels in the early stage of COVID-19

“…The CT scan can sometimes predict the prognosis of patients [15]. Studies by Chen Lin et al all suggested the value of the CT scan in the diagnosis and evaluation of COVID-19 [2]. Shortcomings of CT scan are the additional special protection required by medical personnel during examination of COVID-19 patients, the cost of protective equipment, and risks associated with the transportation and examination of critical patients.…”

“…Clinical monitoring and appropriate treatment strategies were essential to improve case fatality. CT scan played an important role in assessing the disease [2]. Other sensitive indicators able to reflect lung lesion changes and disease severity had to be explored.…”

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“…COVID-19 is diagnosed via RT-PCR [12,13,25]. Multiple sources found that a normal to slightly reduced leukocyte count occurred in patients with COVID-19 (98%) [12,25].…”

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