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Novel Coronavirus Disease 2019 (COVID-19) Pneumonia Progression Course in 17 Discharged Patients: Comparison of Clinical and Thin-Section Computed Tomography Features During Recovery.
Clin Infect Dis. 2020 07 28; 71(15):723-731.CI

Abstract

BACKGROUND

Our objective was to retrospectively analyze the evolution of clinical features and thin-section computed tomography (CT) imaging of novel coronavirus disease 2019 (COVID-19) pneumonia in 17 discharged patients.

METHODS

Serial thin-section CT scans of 17 discharged patients with COVID-19 were obtained during recovery. Longitudinal changes of clinical parameters and a CT pattern were documented in all patients during the 4 weeks after admission. A CT score was used to evaluate the extent of the disease.

RESULTS

There were marked improvements of fever, lymphocyte counts, C-reactive proteins, and erythrocyte sedimentation rates within the first 2 weeks after admission. However, the mean CT score rapidly increased from the first to the third week, with a top score of 8.2 obtained in the second week. During the first week, the main CT pattern was ground-glass opacities (GGO; 76.5%). The frequency of GGO (52.9%) decreased in the second week. Consolidation and mixed patterns (47.0%) were noted in the second week. Thereafter, consolidations generally dissipated into GGO, and the frequency of GGO increased in the third week (76.5%) and fourth week (71.4%). Opacities were mainly located in the peripheral (76.5%) and subpleural (47.1%) zones of the lungs; they presented as focal (35.3%) or multifocal (29.4%) in the first week and became more diffuse in the second (47.1%) and third weeks (58.8%), then showed a reduced extent in fourth week (50%).

CONCLUSIONS

The progression course of the CT pattern was later than the progression of the clinical parameters within the first 2 weeks after admission; however, there were synchronized improvements in both the clinical and radiologic features in the fourth week.

Authors+Show Affiliations

Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, The People's Republic of China. Hubei Province Key Laboratory of Molecular Imaging, Wuhan, The People's Republic of China.Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, The People's Republic of China. Hubei Province Key Laboratory of Molecular Imaging, Wuhan, The People's Republic of China.Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, The People's Republic of China. Hubei Province Key Laboratory of Molecular Imaging, Wuhan, The People's Republic of China.Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, The People's Republic of China. Hubei Province Key Laboratory of Molecular Imaging, Wuhan, The People's Republic of China.Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, The People's Republic of China. Hubei Province Key Laboratory of Molecular Imaging, Wuhan, The People's Republic of China.Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, The People's Republic of China. Hubei Province Key Laboratory of Molecular Imaging, Wuhan, The People's Republic of China.Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, The People's Republic of China. Hubei Province Key Laboratory of Molecular Imaging, Wuhan, The People's Republic of China.Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, The People's Republic of China. Hubei Province Key Laboratory of Molecular Imaging, Wuhan, The People's Republic of China.Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, The People's Republic of China. Hubei Province Key Laboratory of Molecular Imaging, Wuhan, The People's Republic of China.Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, The People's Republic of China.Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, The People's Republic of China. Hubei Province Key Laboratory of Molecular Imaging, Wuhan, The People's Republic of China.Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, The People's Republic of China. Hubei Province Key Laboratory of Molecular Imaging, Wuhan, The People's Republic of China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32227091

Citation

Han, Xiaoyu, et al. "Novel Coronavirus Disease 2019 (COVID-19) Pneumonia Progression Course in 17 Discharged Patients: Comparison of Clinical and Thin-Section Computed Tomography Features During Recovery." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 71, no. 15, 2020, pp. 723-731.
Han X, Cao Y, Jiang N, et al. Novel Coronavirus Disease 2019 (COVID-19) Pneumonia Progression Course in 17 Discharged Patients: Comparison of Clinical and Thin-Section Computed Tomography Features During Recovery. Clin Infect Dis. 2020;71(15):723-731.
Han, X., Cao, Y., Jiang, N., Chen, Y., Alwalid, O., Zhang, X., Gu, J., Dai, M., Liu, J., Zhu, W., Zheng, C., & Shi, H. (2020). Novel Coronavirus Disease 2019 (COVID-19) Pneumonia Progression Course in 17 Discharged Patients: Comparison of Clinical and Thin-Section Computed Tomography Features During Recovery. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 71(15), 723-731. https://doi.org/10.1093/cid/ciaa271
Han X, et al. Novel Coronavirus Disease 2019 (COVID-19) Pneumonia Progression Course in 17 Discharged Patients: Comparison of Clinical and Thin-Section Computed Tomography Features During Recovery. Clin Infect Dis. 2020 07 28;71(15):723-731. PubMed PMID: 32227091.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Novel Coronavirus Disease 2019 (COVID-19) Pneumonia Progression Course in 17 Discharged Patients: Comparison of Clinical and Thin-Section Computed Tomography Features During Recovery. AU - Han,Xiaoyu, AU - Cao,Yukun, AU - Jiang,Nanchuan, AU - Chen,Yan, AU - Alwalid,Osamah, AU - Zhang,Xin, AU - Gu,Jin, AU - Dai,Meng, AU - Liu,Jie, AU - Zhu,Wanyue, AU - Zheng,Chuansheng, AU - Shi,Heshui, PY - 2020/02/14/received PY - 2020/03/12/accepted PY - 2020/4/1/pubmed PY - 2020/8/11/medline PY - 2020/4/1/entrez KW - COVID-19 KW - computed tomography KW - novel coronavirus pneumonia KW - viral pneumonia SP - 723 EP - 731 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin. Infect. Dis. VL - 71 IS - 15 N2 - BACKGROUND: Our objective was to retrospectively analyze the evolution of clinical features and thin-section computed tomography (CT) imaging of novel coronavirus disease 2019 (COVID-19) pneumonia in 17 discharged patients. METHODS: Serial thin-section CT scans of 17 discharged patients with COVID-19 were obtained during recovery. Longitudinal changes of clinical parameters and a CT pattern were documented in all patients during the 4 weeks after admission. A CT score was used to evaluate the extent of the disease. RESULTS: There were marked improvements of fever, lymphocyte counts, C-reactive proteins, and erythrocyte sedimentation rates within the first 2 weeks after admission. However, the mean CT score rapidly increased from the first to the third week, with a top score of 8.2 obtained in the second week. During the first week, the main CT pattern was ground-glass opacities (GGO; 76.5%). The frequency of GGO (52.9%) decreased in the second week. Consolidation and mixed patterns (47.0%) were noted in the second week. Thereafter, consolidations generally dissipated into GGO, and the frequency of GGO increased in the third week (76.5%) and fourth week (71.4%). Opacities were mainly located in the peripheral (76.5%) and subpleural (47.1%) zones of the lungs; they presented as focal (35.3%) or multifocal (29.4%) in the first week and became more diffuse in the second (47.1%) and third weeks (58.8%), then showed a reduced extent in fourth week (50%). CONCLUSIONS: The progression course of the CT pattern was later than the progression of the clinical parameters within the first 2 weeks after admission; however, there were synchronized improvements in both the clinical and radiologic features in the fourth week. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/32227091/Novel_Coronavirus_Disease_2019__COVID_19__Pneumonia_Progression_Course_in_17_Discharged_Patients:_Comparison_of_Clinical_and_Thin_Section_Computed_Tomography_Features_During_Recovery_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/ciaa271 DB - PRIME DP - Unbound Medicine ER -