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Chest Computed Tomography and Clinical Follow-Up of Discharged Patients with COVID-19 in Wenzhou City, Zhejiang, China.
Ann Am Thorac Soc. 2020 10; 17(10):1231-1237.AA

Abstract

Rationale:

Many clinical studies have focused on the epidemiological and clinical characteristics of inpatients with coronavirus disease (COVID-19). However, there are few reports about the clinical follow-up of discharged patients.

Objectives:

To describe the follow-up of patients with COVID-19 in Wenzhou City, Zhejiang, China.

Methods:

We retrospectively reviewed 4-week follow-ups in patients with COVID-19, including computed tomographic (CT) chest scanning, blood testing, and oropharyngeal-swab testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ribonucleic acid. The chest CT scans and blood tests were performed on the last day before discharge and 2 weeks and 4 weeks after discharge. The oropharyngeal-swab tests were performed at both 1 week and 2 weeks after discharge. Fifty-one patients with common COVID-19 were enrolled in the study. All the CT and clinical data were collected between January 23 and March 28, 2020.

Results:

Compared with the abnormalities found on the the last CT scans before discharge, the abnormalities in the lungs at the first and second follow-ups after discharge had been gradually absorbed. The cases with focal ground-glass opacity were reduced from 17.7% to 9.8% of cases. The cases with multiple ground-glass opacities decreased from 80.4% to 23.5%. The cases with consolidation were reduced from 49.0% to 2.0%. The cases with interlobular septal thickening were reduced from 80.4% to 35.3%. The cases with subpleural lines were reduced from 29.4% to 7.8%. The cases with irregular lines were reduced from 41.2% to 15.7%. The lung lesions of 25.5% patients were shown to be fully absorbed on the first CT scans after discharge, and the rate of lung recovery increased to 64.7% after the second follow-up. Nucleic-acid test results became recurrently positive in 17.6% of discharged patients, of whom only 33.3% complained of clinical symptoms. There were no differences in the characteristics of the last CT scans before discharge between the patients with recurrently positive test results and the patients with negative test results. The lung damage was fully absorbed in 55.6% of discharged patients with recurrence of positive test results for SARS-CoV-2 ribonucleic acid.

Conclusions:

The lung damage due to COVID-19 could be reversible for patients with common COVID-19. A few cases showed recurring positive results of nucleic-acid tests after discharge.

Authors+Show Affiliations

Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.Department of Respiration, Zhongshan Hospital, FuDan University, Shanghai, China.Department of Radiology.Department of Emergency, and.Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.Department of Respiration, and.Department of Radiology.Department of Radiology.Department of Radiology, Ruian Hospital of Traditional Chinese Medicine, Wenzhou, China.Department of Infectious Disease, Ruian People's Hospital, Wenzhou, China; and.Department of Radiology.Department of Respiration, Zhongshan Hospital, FuDan University, Shanghai, China.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32692945

Citation

Liu, Chenbin, et al. "Chest Computed Tomography and Clinical Follow-Up of Discharged Patients With COVID-19 in Wenzhou City, Zhejiang, China." Annals of the American Thoracic Society, vol. 17, no. 10, 2020, pp. 1231-1237.
Liu C, Ye L, Xia R, et al. Chest Computed Tomography and Clinical Follow-Up of Discharged Patients with COVID-19 in Wenzhou City, Zhejiang, China. Ann Am Thorac Soc. 2020;17(10):1231-1237.
Liu, C., Ye, L., Xia, R., Zheng, X., Yuan, C., Wang, Z., Lin, R., Shi, D., Gao, Y., Yao, J., Sun, Q., Wang, X., & Jin, M. (2020). Chest Computed Tomography and Clinical Follow-Up of Discharged Patients with COVID-19 in Wenzhou City, Zhejiang, China. Annals of the American Thoracic Society, 17(10), 1231-1237. https://doi.org/10.1513/AnnalsATS.202004-324OC
Liu C, et al. Chest Computed Tomography and Clinical Follow-Up of Discharged Patients With COVID-19 in Wenzhou City, Zhejiang, China. Ann Am Thorac Soc. 2020;17(10):1231-1237. PubMed PMID: 32692945.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chest Computed Tomography and Clinical Follow-Up of Discharged Patients with COVID-19 in Wenzhou City, Zhejiang, China. AU - Liu,Chenbin, AU - Ye,Ling, AU - Xia,Ruike, AU - Zheng,Xudong, AU - Yuan,Cuiyun, AU - Wang,Zhenguo, AU - Lin,Ruiwu, AU - Shi,Deen, AU - Gao,Yuantong, AU - Yao,Junpu, AU - Sun,Qingfeng, AU - Wang,Xiaoyang, AU - Jin,Meiling, PY - 2020/7/22/pubmed PY - 2020/10/21/medline PY - 2020/7/22/entrez KW - COVID-19 KW - SARS-CoV-2 KW - computed tomographic imaging KW - follow-up KW - recurrently positive SP - 1231 EP - 1237 JF - Annals of the American Thoracic Society JO - Ann Am Thorac Soc VL - 17 IS - 10 N2 - Rationale: Many clinical studies have focused on the epidemiological and clinical characteristics of inpatients with coronavirus disease (COVID-19). However, there are few reports about the clinical follow-up of discharged patients.Objectives: To describe the follow-up of patients with COVID-19 in Wenzhou City, Zhejiang, China.Methods: We retrospectively reviewed 4-week follow-ups in patients with COVID-19, including computed tomographic (CT) chest scanning, blood testing, and oropharyngeal-swab testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ribonucleic acid. The chest CT scans and blood tests were performed on the last day before discharge and 2 weeks and 4 weeks after discharge. The oropharyngeal-swab tests were performed at both 1 week and 2 weeks after discharge. Fifty-one patients with common COVID-19 were enrolled in the study. All the CT and clinical data were collected between January 23 and March 28, 2020.Results: Compared with the abnormalities found on the the last CT scans before discharge, the abnormalities in the lungs at the first and second follow-ups after discharge had been gradually absorbed. The cases with focal ground-glass opacity were reduced from 17.7% to 9.8% of cases. The cases with multiple ground-glass opacities decreased from 80.4% to 23.5%. The cases with consolidation were reduced from 49.0% to 2.0%. The cases with interlobular septal thickening were reduced from 80.4% to 35.3%. The cases with subpleural lines were reduced from 29.4% to 7.8%. The cases with irregular lines were reduced from 41.2% to 15.7%. The lung lesions of 25.5% patients were shown to be fully absorbed on the first CT scans after discharge, and the rate of lung recovery increased to 64.7% after the second follow-up. Nucleic-acid test results became recurrently positive in 17.6% of discharged patients, of whom only 33.3% complained of clinical symptoms. There were no differences in the characteristics of the last CT scans before discharge between the patients with recurrently positive test results and the patients with negative test results. The lung damage was fully absorbed in 55.6% of discharged patients with recurrence of positive test results for SARS-CoV-2 ribonucleic acid.Conclusions: The lung damage due to COVID-19 could be reversible for patients with common COVID-19. A few cases showed recurring positive results of nucleic-acid tests after discharge. SN - 2325-6621 UR - https://www.unboundmedicine.com/medline/citation/32692945/Chest_Computed_Tomography_and_Clinical_Follow_Up_of_Discharged_Patients_with_COVID_19_in_Wenzhou_City_Zhejiang_China_ L2 - https://www.atsjournals.org/doi/10.1513/AnnalsATS.202004-324OC?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -