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Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19):A multi-center study in Wenzhou city, Zhejiang, China.
J Infect. 2020 04; 80(4):388-393.JI

Abstract

BACKGROUND

Little is known about COVID-19 outside Hubei. The aim of this paper was to describe the clinical characteristics and imaging manifestations of hospitalized patients with confirmed COVID-19 infection in Wenzhou, Zhejiang, China.

METHODS

In this retrospective cohort study, 149 RT-PCR confirmed positive patients were consecutively enrolled from January 17th to February 10th, 2020 in three tertiary hospitals of Wenzhou. Outcomes were followed up until Feb 15th, 2020.

FINDINGS

A total of 85 patients had Hubei travel/residence history, while another 49 had contact with people from Hubei and 15 had no traceable exposure history to Hubei. Fever, cough and expectoration were the most common symptoms, 14 patients had decreased oxygen saturation, 33 had leukopenia, 53 had lymphopenia, and 82 had elevated C-reactive protein. On chest computed tomography (CT), lung segments 6 and 10 were mostly involved. A total of 287 segments presented ground glass opacity, 637 presented mixed opacity and 170 presented consolidation. Lesions were more localized in the peripheral lung with a patchy form. No significant difference was found between patients with or without Hubei exposure history. Seventeen patients had normal CT on admission of these, 12 had negative findings even10 days later.

INTERPRETATION

Most patients presented with a mild infection in our study. The imaging pattern of multifocal peripheral ground glass or mixed opacity with predominance in the lower lung is highly suspicious of COVID-19 in the first week of disease onset. Nevetheless, some patients can present with a normal chest finding despite testing positive for COVID-19.

FUNDING

We did not receive any fundings.

Authors+Show Affiliations

Department of Radiology, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, No.197 Ruijin Er Road, Shanghai 200025, China.Department of Radiology, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, No.197 Ruijin Er Road, Shanghai 200025, China.Department of Radiology, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, No.197 Ruijin Er Road, Shanghai 200025, China.Department of Radiology, Ruian People's Hospital, Ruian 325200, Zhejiang province, China.Department of Radiology, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, No.197 Ruijin Er Road, Shanghai 200025, China.Department of Radiology, Yueqing People's Hospital, Yueqing 325600, Zhejiang province, China.Department of Infectious Diseases, Wenzhou Central Hospital, Wenzhou 325000, Zhejiang province, China.Department of Infectious Diseases, Ruian People's Hospital, Ruian 325200, Zhejiang province, China.Department of Infectious Diseases, Wenzhou Central Hospital, Wenzhou 325000, Zhejiang province, China.Department of Respiratory and Critical Care Medicine, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, No.197 Ruijin Er Road, Shanghai 200025, China. Electronic address: jmqu0906@163.com.Department of Radiology, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, No.197 Ruijin Er Road, Shanghai 200025, China. Electronic address: yanfuhua@yahoo.com.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

32112884

Citation

Yang, Wenjie, et al. "Clinical Characteristics and Imaging Manifestations of the 2019 Novel Coronavirus Disease (COVID-19):A Multi-center Study in Wenzhou City, Zhejiang, China." The Journal of Infection, vol. 80, no. 4, 2020, pp. 388-393.
Yang W, Cao Q, Qin L, et al. Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19):A multi-center study in Wenzhou city, Zhejiang, China. J Infect. 2020;80(4):388-393.
Yang, W., Cao, Q., Qin, L., Wang, X., Cheng, Z., Pan, A., Dai, J., Sun, Q., Zhao, F., Qu, J., & Yan, F. (2020). Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19):A multi-center study in Wenzhou city, Zhejiang, China. The Journal of Infection, 80(4), 388-393. https://doi.org/10.1016/j.jinf.2020.02.016
Yang W, et al. Clinical Characteristics and Imaging Manifestations of the 2019 Novel Coronavirus Disease (COVID-19):A Multi-center Study in Wenzhou City, Zhejiang, China. J Infect. 2020;80(4):388-393. PubMed PMID: 32112884.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19):A multi-center study in Wenzhou city, Zhejiang, China. AU - Yang,Wenjie, AU - Cao,Qiqi, AU - Qin,Le, AU - Wang,Xiaoyang, AU - Cheng,Zenghui, AU - Pan,Ashan, AU - Dai,Jianyi, AU - Sun,Qingfeng, AU - Zhao,Fengquan, AU - Qu,Jieming, AU - Yan,Fuhua, Y1 - 2020/02/26/ PY - 2020/02/20/received PY - 2020/02/21/accepted PY - 2020/3/1/pubmed PY - 2020/4/9/medline PY - 2020/3/1/entrez KW - COVID-19 KW - CT KW - Infection KW - Lung KW - Outside Hubei SP - 388 EP - 393 JF - The Journal of infection JO - J. Infect. VL - 80 IS - 4 N2 - BACKGROUND: Little is known about COVID-19 outside Hubei. The aim of this paper was to describe the clinical characteristics and imaging manifestations of hospitalized patients with confirmed COVID-19 infection in Wenzhou, Zhejiang, China. METHODS: In this retrospective cohort study, 149 RT-PCR confirmed positive patients were consecutively enrolled from January 17th to February 10th, 2020 in three tertiary hospitals of Wenzhou. Outcomes were followed up until Feb 15th, 2020. FINDINGS: A total of 85 patients had Hubei travel/residence history, while another 49 had contact with people from Hubei and 15 had no traceable exposure history to Hubei. Fever, cough and expectoration were the most common symptoms, 14 patients had decreased oxygen saturation, 33 had leukopenia, 53 had lymphopenia, and 82 had elevated C-reactive protein. On chest computed tomography (CT), lung segments 6 and 10 were mostly involved. A total of 287 segments presented ground glass opacity, 637 presented mixed opacity and 170 presented consolidation. Lesions were more localized in the peripheral lung with a patchy form. No significant difference was found between patients with or without Hubei exposure history. Seventeen patients had normal CT on admission of these, 12 had negative findings even10 days later. INTERPRETATION: Most patients presented with a mild infection in our study. The imaging pattern of multifocal peripheral ground glass or mixed opacity with predominance in the lower lung is highly suspicious of COVID-19 in the first week of disease onset. Nevetheless, some patients can present with a normal chest finding despite testing positive for COVID-19. FUNDING: We did not receive any fundings. SN - 1532-2742 UR - https://www.unboundmedicine.com/medline/citation/32112884/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0163-4453(20)30099-2 DB - PRIME DP - Unbound Medicine ER -