Epidemiological, clinical characteristics of cases of SARS-CoV-2 infection with abnormal imaging findings

Xiaoli Zhang, Huan Cai, Jianhua Hu, Jiangshan Lian, Jueqing Gu, Shanyan Zhang, Chanyuan Ye, Yingfeng Lu, Ciliang Jin, Guodong Yu, Hongyu Jia, Yimin Zhang, Jifang Sheng, Lanjuan Li, Yida Yang, Xiaoli Zhang, Huan Cai, Jianhua Hu, Jiangshan Lian, Jueqing Gu, Shanyan Zhang, Chanyuan Ye, Yingfeng Lu, Ciliang Jin, Guodong Yu, Hongyu Jia, Yimin Zhang, Jifang Sheng, Lanjuan Li, Yida Yang

Abstract

Purpose: To investigate the epidemiological and clinical characteristics of COVID-19 patients with abnormal imaging findings.

Methods: Patients confirmed with SARS-CoV-2 infection in Zhejiang province from January 17 to February 8 who had undergone CT or X-ray were enrolled. Epidemiological and clinical data were analyzed among those with abnormal or normal imaging findings.

Results: Excluding 72 patients with normal images, 230 of 573 patients showed abnormalities affecting more than two lung lobes. The median radiographic score was 2.0, and there was a negative correlation between that score and the oxygenation index (ρ = -0.657, P < 0.001). Patients with abnormal images were older (46.65 ± 13.82), with a higher rate of coexisting condition (28.8%), a lower rate of exposure history, and longer time between onset and confirmation (5 days) than non-pneumonia patients (all P < 0.05). A higher rate of fever, cough, expectoration and headache, a lower level of lymphocytes, albumin, and serum sodium levels and a higher total bilirubin, creatine kinase, lactate dehydrogenase, and C-reactive protein levels and a lower oxygenation index were observed in pneumonia patients (all P < 0.05). Muscle ache, shortness of breath, nausea and vomiting, lower lymphocytes levels, and higher serum creatinine and radiographic score at admission were predictive factors for the severe/critical subtype.

Conclusion: Patients with abnormal images have more obvious clinical manifestations and laboratory changes. Combing clinical features and radiographic scores can effectively predict severe/critical types.

Keywords: Clinical; Epidemiological; Imaging findings; Predictive factors; SRAS-CoV-2.

Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Figures

Figure 1
Figure 1
The total radiographic score was significantly correlated with the oxygenation index.

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Source: PubMed

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