Clinical and CT characteristics which indicate timely radiological reexamination
in patients with COVID-19: A retrospective study in Beijing, China
#MMPMID32835066
Li X
; Pan Z
; Xia Z
; Li R
; Wang X
; Zhang R
; Li H
Radiol Infect Dis
2020[Jun]; 7
(2
): 62-70
PMID32835066
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OBJECTIVE: Chest CT is useful in assessing the disease course of coronavirus
disease-19 (COVID-19). This study aims to identify the characteristics of
patients in whom imaging progression occurred while clinical symptoms were
relieved and to guide radiological reexamination. METHODS: This retrospective
study included 73 patients with reverse transcription-polymerase chain reaction
(RT-PCR) confirmed severe acute respiratory syndrome-2 (SARS-CoV-2) infection.
All patients received CT reexaminations within 24 h after symptomatic remission.
We divided patients into two groups according to the matching degree between
clinical and imaging outcomes. RESULTS: 21 patients displayed imaging progression
while symptoms relieved. Patients with imaging progression were prone to be
advanced in age [years: 60 (46-65) v 47 (37-60.75), P = 0.030]; lymphopenia
(66.7% v 40.4%, P = 0.042) and low level of C-reactive protein [mg/L: 5.7
(1.9-20.2) v 18.9 (6.7-38.9), P = 0.038]. An age over 50 was an independent risk
factor for imaging progression (OR = 3.41, 95%CI 1.14-10.20, P = 0.028). In CT
images, they were inclined to present lesions with clear border (94.7% v 64.7%,
P = 0.012), pure peripheral distribution (89.5% v 39.2%, P < 0.001), without
bilateral lungs involved (57.9% v 29.4%, P = 0.028) especially with left lung
involved only (42.1% v 17.6%, P = 0.034). CONCLUSION: In order to improve the
therapeutic effect, the interval before radiological follow-up should be
shortened appropriately especially in patients over the age of 50. It is
essential to proceed to CT reexamination before symptomatic remission.
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