Volume 42 Issue 7
Jul.  2021
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Li WU, Yun-hui YANG, Jing ZHANG, Zhang-cong YANG, Yu SU, Yong-jian WEN, Yu-chun WU, Peng WANG, Zhi-peng LI, Wei ZHAO, Dan HAN, Rui-dong WANG, Bo HE. The Correlation between the Imaging Characteristics of Imported COVID-19 at First Diagnosis and Clinical Severity Grading[J]. Journal of Kunming Medical University, 2021, 42(7): 49-56. doi: 10.12259/j.issn.2095-610X.S20210708
Citation: Li WU, Yun-hui YANG, Jing ZHANG, Zhang-cong YANG, Yu SU, Yong-jian WEN, Yu-chun WU, Peng WANG, Zhi-peng LI, Wei ZHAO, Dan HAN, Rui-dong WANG, Bo HE. The Correlation between the Imaging Characteristics of Imported COVID-19 at First Diagnosis and Clinical Severity Grading[J]. Journal of Kunming Medical University, 2021, 42(7): 49-56. doi: 10.12259/j.issn.2095-610X.S20210708

The Correlation between the Imaging Characteristics of Imported COVID-19 at First Diagnosis and Clinical Severity Grading

doi: 10.12259/j.issn.2095-610X.S20210708
  • Received Date: 2021-05-07
  • Publish Date: 2021-07-25
  •   Objective   To investigate the correlation between the imaging characteristics of the first diagnosis of imported novel coronavirus pneumonia (COVID-19) and clinical severity grading.   Methods   A retrospective analysis was performed on the clinical and imaging data of 116 imported COVID - 19 cases (aged 5 ~ 84 years, 59 males and 57 females) confirmed by nucleic acid test on January 21, 2020 (solstice, February 25, 2020) in Yunnan province.Differences in clinical data, laboratory examination and imaging characteristics of patients with different clinical types (light, normal, heavy and critical) were compared. Fisher’ s exact probability method was used for comparison of measurement data, z-test was used for comparison of ppairs, analysis of variance was used for comparison of quantitative data, and mann-whitney test was used for comparison of ppairs.   Results   There was no statistically significant difference in prevalence between male and female patients with 116 cases input COVID-19 (χ2 = 1.288, P = 0.808); There were statistically significant differences among different age groups (χ2 = 19.589, P = 0.006), The prevalence of 21-55 years old is high, about 44.83% (55/116), the second is 51 to 70 years old, about 36.21% (42/116), Severe pneumonia (6/42, 14.29%) was higher in patients aged from 51 to 70 than in patients aged 21 to 50 (3/52(5.17%) (P < 0.05).; Fever/chills (70.8%) and respiratory symptoms (58.4%) were the most common initial symptoms of new crown pneumonia.The average time from symptom onset to the first CT scan was 4.17±1.12 days. The longer the time, the heavier the clinical classification ( F = 2.688, P = 0.049). The differences in total number of leukocytes, total number of lymphocytes, percentage of lymphocytes, lactate dehydrogenase (LDH) and c-reactive protein in different clinical classifications were statistically significant (F = 3.486, 3.640, 5.154, 15.361, 8.195, all P < 0.05). The total number and percentage of lymphocytes of the severe and critical types were significantly lower than that of the light and normal types ( P < 0.05). There were 383 lesions in 116 patients, with an average score of 4.17±2.12 points in total involvement range, and the involvement range of the normal type was smaller than that of the critical type ( F = 62.137, P = 0.000). The lesions mostly involve both lungs, accounting for approximately70/116 (78.26%), The lower lobe 85/116 (37.12%) is more common than the middle lobe 70/116 (30.13%) and the upper lobe 75/116 (32.75%) (χ2 = 10.190, P = 0.021) The subpleural area87/229 (57.24%) is more common than the hilum area 29/229 (19.08%) and the middle lung zone36/229 (23.68%) (χ2 = 5.187, P = 0.018); Round and oval lesions were more common (χ2 = 43.922, P = 0.000), and banded and discoid lesions were more common in severe and critical patients (P < 0.05). Different types of patients have different pathological characteristics ( χ2 = 50.974, P = 0.000), vascular enlargement sign is the highest incidence in GGO, approximately 19.58%, next is cable strip shadow, approximately 13.71% and paving pattern, about13.61%. pure GGO, paving pattern, mixed density, air bronchogram and halo sign are more common in ordinary type (P < 0.05), GGO accompanied by thickening of bronchial wall, fiber cord, and deformation of bronchi were mostly seen in heavy and critical cases ( P < 0.05); Pleural thickening was the most common extrapulmonary lesion ( χ2 = 42.119, P = 0.000), about 73.12%, Heavy pleural effusion is more common than normal type and critical type (P < 0.05).   Conclusion   The clinical data, laboratory examination and imaging findings of input COVID-19 with different clinical typing have certain characteristics. HRCT can provide theoretical basis for early screening, diagnosis and clinical typing of COVID-19 with insufficient nucleic acid detection kits.
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