Volume 42 Issue 5
May  2021
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Yun-hui YANG, Bo HE, Ding-yun YOU, Jun-tao YANG, Qian GAO. Applications of CT in the Early Prediction of Different Clinical Types of COVID -19 Pneumonia[J]. Journal of Kunming Medical University, 2021, 42(5): 131-137. doi: 10.12259/j.issn.2095-610X.S20210524
Citation: Yun-hui YANG, Bo HE, Ding-yun YOU, Jun-tao YANG, Qian GAO. Applications of CT in the Early Prediction of Different Clinical Types of COVID -19 Pneumonia[J]. Journal of Kunming Medical University, 2021, 42(5): 131-137. doi: 10.12259/j.issn.2095-610X.S20210524

Applications of CT in the Early Prediction of Different Clinical Types of COVID -19 Pneumonia

doi: 10.12259/j.issn.2095-610X.S20210524
  • Received Date: 2021-01-17
    Available Online: 2021-06-03
  • Publish Date: 2021-05-20
  •   Objective  To investigate the clinical and CT image characteristics of COVID-19 pneumonia, and the predictive value of CT in the early stage of different clinical types.  Methods  Chest CT and clinical data of confirmed 143 patients with COVID-19 pneumonia in January to February 2020 were enrolled. According to the diagnosis and treatment of COVID-19 pneumonia(trial version 7), all the patients were classified into the mild (n = 28), common (n = 92), severe (n = 36), and critical (n = 5) type, and their clinical findings and CT findings were analyzed. CT features included lesions' distribution, density, extension, shape, interior/ periphery features, vascular changes. Then the prediction performance of image features were analyzed.  Results  The main clinical manifestations were fever (60/143, 41.9%) and cough (57/143, 39.9%). High fever was more common seen in severe patients. Severe and critical types were more common in elderly patients. And the total number of lymphocytes reduced (0.6±0.2x10^9/L) in critical patients. Except for mild patients, there were 6 cases without the obvious abnormality in the first CT diagnosis. In the remaining 109 cases, the number of pulmonary segments involved in the first CT examination of severe patients was significantly higher than that of common patients (5.88 ± 6)(P < 0.001). Severe and critical COVID-19 showed wedge-shape (59/109, 54.1%) or Ficus crown sign (35/109, 32.1%) lesions more frequently than in common COVID-19 and the thickening of blood vessels (87/109, 79.8%) and vascular clustering signs (65/109, 59.6%) in / around the lesions were more likely to occur in severe and critical types (P < 0.05). There was no significant difference in the number of lesions, lesion density, lesion morphology (round, irregular) and internal/peripheral features of the lesion (crazy-paving sign, halo sign, bronchiectasis)(P > 0.05). Area under the curve (AUC) of the number of involved lung segments, wedge-shape and Ficus crown sign (AUC: 0.769, 0.759, 0.697, respectively) were higher compared with that of thickening of blood vessels and vascular clustering signs (AUC: 0.626, 0.667, respectively). Combined model resulted in a further increased diagnostic performance (AUC: 0.854).  Conclusion  Chest CT findings not only play an important role in the early diagnosis of COVID-19, but also can evaluate the severity and prognosis of patients.
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