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Early Clinical and CT Manifestations of Coronavirus Disease 2019 (COVID-19) Pneumonia.
AJR Am J Roentgenol. 2020 08; 215(2):338-343.AA

Abstract

OBJECTIVE.

The purpose of this study was to investigate early clinical and CT manifestations of coronavirus disease (COVID-19) pneumonia. MATERIALS AND

METHODS.

Patients with COVID-19 pneumonia confirmed by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid test (reverse transcription-polymerase chain reaction) were enrolled in this retrospective study. The clinical manifestations, laboratory results, and CT findings were evaluated.

RESULTS.

One hundred eight patients (38 men, 70 women; age range, 21-90 years) were included in the study. The clinical manifestations were fever in 94 of 108 (87%) patients, dry cough in 65 (60%), and fatigue in 42 (39%). The laboratory results were normal WBC count in 97 (90%) patients and normal or reduced lymphocyte count in 65 (60%). High-sensitivity C-reactive protein level was elevated in 107 (99%) patients. The distribution of involved lobes was one lobe in 38 (35%) patients, two or three lobes in 24 (22%), and four or five lobes in 46 (43%). The major involvement was peripheral (97 patients [90%]), and the common lesion shape was patchy (93 patients [86%]). Sixty-five (60%) patients had ground-glass opacity (GGO), and 44 (41%) had GGO with consolidation. The size of lesions varied from smaller than 1 cm (10 patients [9%]) to larger than 3 cm (56 patients [52%]). Vascular thickening (86 patients [80%]), crazy paving pattern (43 patients [40%]), air bronchogram sign (52 patients [48%]), and halo sign (69 [64%]) were also observed in this study.

CONCLUSION.

The early clinical and laboratory findings of COVID-19 pneumonia are low to midgrade fever, dry cough, and fatigue with normal WBC count, reduced lymphocyte count, and elevated high-sensitivity C-reactive protein level. The early CT findings are patchy GGO with or without consolidation involving multiple lobes, mainly in the peripheral zone, accompanied by halo sign, vascular thickening, crazy paving pattern, or air bronchogram sign.

Authors+Show Affiliations

Department of Radiology, Wuhan No. 1 Hospital, Zhongshan Ave 215, Wuhan, 430022, China.Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Radiology, Wuhan No. 1 Hospital, Zhongshan Ave 215, Wuhan, 430022, China.Department of Radiology, Wuhan No. 1 Hospital, Zhongshan Ave 215, Wuhan, 430022, China.Department of Radiology, Wuhan No. 1 Hospital, Zhongshan Ave 215, Wuhan, 430022, China.Department of Radiology, Wuhan No. 1 Hospital, Zhongshan Ave 215, Wuhan, 430022, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32181672

Citation

Han, Rui, et al. "Early Clinical and CT Manifestations of Coronavirus Disease 2019 (COVID-19) Pneumonia." AJR. American Journal of Roentgenology, vol. 215, no. 2, 2020, pp. 338-343.
Han R, Huang L, Jiang H, et al. Early Clinical and CT Manifestations of Coronavirus Disease 2019 (COVID-19) Pneumonia. AJR Am J Roentgenol. 2020;215(2):338-343.
Han, R., Huang, L., Jiang, H., Dong, J., Peng, H., & Zhang, D. (2020). Early Clinical and CT Manifestations of Coronavirus Disease 2019 (COVID-19) Pneumonia. AJR. American Journal of Roentgenology, 215(2), 338-343. https://doi.org/10.2214/AJR.20.22961
Han R, et al. Early Clinical and CT Manifestations of Coronavirus Disease 2019 (COVID-19) Pneumonia. AJR Am J Roentgenol. 2020;215(2):338-343. PubMed PMID: 32181672.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early Clinical and CT Manifestations of Coronavirus Disease 2019 (COVID-19) Pneumonia. AU - Han,Rui, AU - Huang,Lu, AU - Jiang,Hong, AU - Dong,Jin, AU - Peng,Hongfen, AU - Zhang,Dongyou, Y1 - 2020/03/17/ PY - 2020/3/18/pubmed PY - 2020/8/15/medline PY - 2020/3/18/entrez KW - COVID-19 KW - CT KW - SARS-CoV-2 KW - clinical manifestations KW - coronavirus KW - pneumonia SP - 338 EP - 343 JF - AJR. American journal of roentgenology JO - AJR Am J Roentgenol VL - 215 IS - 2 N2 - OBJECTIVE. The purpose of this study was to investigate early clinical and CT manifestations of coronavirus disease (COVID-19) pneumonia. MATERIALS AND METHODS. Patients with COVID-19 pneumonia confirmed by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid test (reverse transcription-polymerase chain reaction) were enrolled in this retrospective study. The clinical manifestations, laboratory results, and CT findings were evaluated. RESULTS. One hundred eight patients (38 men, 70 women; age range, 21-90 years) were included in the study. The clinical manifestations were fever in 94 of 108 (87%) patients, dry cough in 65 (60%), and fatigue in 42 (39%). The laboratory results were normal WBC count in 97 (90%) patients and normal or reduced lymphocyte count in 65 (60%). High-sensitivity C-reactive protein level was elevated in 107 (99%) patients. The distribution of involved lobes was one lobe in 38 (35%) patients, two or three lobes in 24 (22%), and four or five lobes in 46 (43%). The major involvement was peripheral (97 patients [90%]), and the common lesion shape was patchy (93 patients [86%]). Sixty-five (60%) patients had ground-glass opacity (GGO), and 44 (41%) had GGO with consolidation. The size of lesions varied from smaller than 1 cm (10 patients [9%]) to larger than 3 cm (56 patients [52%]). Vascular thickening (86 patients [80%]), crazy paving pattern (43 patients [40%]), air bronchogram sign (52 patients [48%]), and halo sign (69 [64%]) were also observed in this study. CONCLUSION. The early clinical and laboratory findings of COVID-19 pneumonia are low to midgrade fever, dry cough, and fatigue with normal WBC count, reduced lymphocyte count, and elevated high-sensitivity C-reactive protein level. The early CT findings are patchy GGO with or without consolidation involving multiple lobes, mainly in the peripheral zone, accompanied by halo sign, vascular thickening, crazy paving pattern, or air bronchogram sign. SN - 1546-3141 UR - https://www.unboundmedicine.com/medline/citation/32181672/Early_Clinical_and_CT_Manifestations_of_Coronavirus_Disease_2019__COVID_19__Pneumonia_ L2 - https://www.ajronline.org/doi/10.2214/AJR.20.22961 DB - PRIME DP - Unbound Medicine ER -