scholarly journals Combination of chest CT and clinical features for diagnosis of 2019 novel coronavirus pneumonia

Open Medicine ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. 723-727
Author(s):  
Xin Wang ◽  
Peng Wen ◽  
Zhi-Gang Sun ◽  
Chun-Yan Xing ◽  
Yun Li

AbstractIn December 2019, novel coronavirus pneumonia-19 (COVID-19) was discovered in the viral pneumonia cases that occurred in Wuhan, China, and then quickly spread around the world. This report described the clinical course of two COVID-19 patients and the purpose of the study was to discuss the combination of chest CT and clinical features for diagnosis of COVID-19. The first case was a typical COVID-19 case. A 66-year-old female presented to our hospital with a 3-day history of fever. She had contact with a COVID-19 patient. Chest CT showed a typical COVID-19 appearance. She was diagnosed with COVID-19 by a positive nucleic acid test. The second case was a 50-year-old male with a 2-day history of fever. He denied having been to Wuhan. Chest CT also showed typical features of COVID-19 pneumonia. COVID-19 nucleic acid tests were repeated up to seven times and the results remained controversial. Eventually, he was diagnosed with COVID-19. Our study shows that chest CT has high sensitivity for diagnosis of COVID-19 in clinical practice, particularly when the nucleic acid test is negative. The chest CT should be considered as a diagnostic tool for the COVID-19 screening, comprehensive evaluation, and follow-up and patients would benefit from effective treatments in time.

2020 ◽  
Author(s):  
Xin Wang ◽  
Peng Wen ◽  
Zhi-Gang Sun ◽  
Chun-Yan Xing ◽  
Yun Li

Abstract Background: In December 2019, novel coronavirus pneumonia-19 (COVID-19) was discovered in the viral pneumonia cases that occurred in Wuhan, Hubei Province, China; and then quickly spread inside and outside of Wuhan and even other countries. This report describes the clinical course of two patients who had COVID-19.Case presentation: The first case was a typical COVID-19 case. A 66-year-old female presented to our hospital with a 3-day history of fever with coughing, white sputum, runny nose and dizziness. She had contacted with a COVID-19 patient, her daughter-in-law who was diagnosed with COVID-19 two days before. Chest CT showed typical COVID-19 CT imaging. She was diagnosed with COVID-19 by positive nucleic acid test. The second case was a 50-year-old male with a 2-day history of fever and dry coughing. He denied having been to Wuhan. Chest CT also showed typical COVID-19 CT imaging. He accepted COVID-19 nucleic acid test using reverse-transcription polymerase chain reaction of his throat swab sampling 7 times and the test results remained controversial. Eventually, he was diagnosed with COVID-19 after 5 days.Conclusions: Chest CT examination has high sensitivity for diagnosis of COVID-19 clinically, particularly when nucleic acid test is negative. Chest CT should be considered for the COVID-19 screening, comprehensive evaluation and following-up and patients could benefit from effective treatment in time.


2020 ◽  
Author(s):  
Mei Han ◽  
Jingbo Zou ◽  
Wenguang Tian ◽  
Xiaoyu Wei ◽  
Yang Zhou ◽  
...  

Abstract Background: The outbreak of the novel coronavirus in China (COVID-19) represents a significant and urgent threat to global health. We report here five cases of COVID-19 infection patients in our clinical practices who are medically stable and presumed to successfully “cleared” the virus after antiviral treatments. Case presentation: The clinical evaluation depends on the viral nucleic acid test in respiratory specimens by real-time PCR reverse transcription (RT-PCR) assays according to the authorized guidance. We found that the stool samples of these cured patients remain positive in RT-PCR assay while the virus is undetectable in respiratory specimens. RT-PCR molecular diagnostic assay was designed to specifically detect the presence of viral RNA. Thus, the positive result in the fecal specimens implies the existence of viable virions with the patients. Conclusions: This highlights the importance to look closely at the assessment standard of medical treatment, as well as the need for reevaluation of the criteria for the initial screening, prevention, and care of patients with this emerging infection.


2020 ◽  
Vol 71 (15) ◽  
pp. 756-761 ◽  
Author(s):  
Dahai Zhao ◽  
Feifei Yao ◽  
Lijie Wang ◽  
Ling Zheng ◽  
Yongjun Gao ◽  
...  

Abstract Background A novel coronavirus (COVID-19) has raised world concern since it emerged in Wuhan, China in December 2019. The infection may result in severe pneumonia with clusters of illness onsets. Its impacts on public health make it paramount to clarify the clinical features with other pneumonias. Methods Nineteen COVID-19 and 15 other patients with pneumonia (non-COVID-19) in areas outside of Hubei were involved in this study. Both COVID-19 and non-COVID-19 patients were confirmed to be infected using throat swabs and/or sputa with/without COVID-2019 by real-time RT-PCR. We analyzed the demographic, epidemiological, clinical, and radiological features from those patients, and compared the differences between COVID-19 and non-COVID-19. Results All patients had a history of exposure to confirmed cases of COVID-19 or travel to Hubei before illness. The median (IQR) duration was 8 (6–11) and 5 (4–11) days from exposure to onset in COVID-19 and non-COVID-19 cases, respectively. The clinical symptoms were similar between COVID-19 and non-COVID-19. The most common symptoms were fever and cough. Fifteen (78.95%) COVID-19 but 4 (26.67%) non-COVID-19 patients had bilateral involvement while 17 COVID-19 patients (89.47%) but 1 non-COVID-19 patient (6.67%) had multiple mottling and ground-glass opacity on chest CT images. Compared with non-COVID-19, COVID-19 presents remarkably more abnormal laboratory tests, including AST, ALT, γ-GT, LDH, and α-HBDH. Conclusions The COVID-19 infection has onsets similar to other pneumonias. CT scan may be a reliable test for screening COVID-19 cases. Liver function damage is more frequent in COVID-19 than non-COVID-19 patients. LDH and α-HBDH may be considerable markers for evaluation of COVID-19.


2020 ◽  
Author(s):  
Cheng Xi ◽  
Tang Li ◽  
Zhou Maotian ◽  
Wang Guoyan

Abstract The dynamics of research are a prism that reflects interactions between science, the societal environment, and government policies. Against the backdrop of the ongoing global COVID-19 pandemic, this study explored the changes in, and development of, COVID-19 research in the period from December 30, 2019 to April 27, 2020. The study observes a salient change in research content: an earlier focus on “all patients”, “common symptoms”, and “nucleic acid test” was gradually replaced by a focus on “children”, “pregnant patients”, “severe symptoms”, and a combination of “nucleic acid test” and “antibody assay”. Some topics such as “vaccine R&D”, “knowledge, attitude, and practice” (KAP), and “mental health” were persistent throughout the recent history of China’s COVID-19 research. This study also reveals a correlation between the evolution of COVID-19 policies and the dynamic development of COVID-19 research. In the early stage of the outbreak in China, the formulation of COVID-19 policies followed a rapidly-progressing co-evolutionary model (CEM). The results of this study apply more broadly to the formulation of policies in public health emergencies, especially in the early stages.


2020 ◽  
Author(s):  
Le Yang

An outbreak of novel coronavirus(2019-nCoV) that began in Wuhan, China, is rapidly spreading to all over China, and gradually to multiple countries. Regarding to put the epidemic prevention and spread under the control, early identification and diagnosis play a critical role. Patients with initially no or mild symptoms of Novel Coronavirus Pneumonia (2019-nCoV), namely stealth infection, often lack of typical clinical evidence to establish the diagnosis. Based on the clinical analysis of 4 cases in stealth infection, the results of this study highlight that early diagnosis requires a combination of epidemiological history, clinical manifestations, early chest CT examination, and 2019-nCoV RNA test (nucleic acid test), with particular emphasis on definite epidemiological history and early chest CT findings when positivenucleicacidtestslagbehind.


2020 ◽  
Author(s):  
Yaoyong Wang ◽  
Xinjian Chang ◽  
Jianguo Ren ◽  
Dongyan Li ◽  
Changfei Wang ◽  
...  

Abstract Background: With the emergence of coronavirus disease 2019 in many places around the world, the main medical resources currently focus on the treatment of confirmed patients and the screening of suspected cases. Asymptomatic patients are difficult to detect, but they may be contagious, which makes epidemic control more difficult. We found a case of asymptomatic patient with positive urine coronavirus nucleic acid test, and we hope to attract attention of all circles.Case presentation: An asymptomatic patient with novel coronavirus infection was found in an epidemiological investigation of patients with confirmed coronavirus disease 2019. The patient was admitted to the hospital on February 24, 2020. She had no clinical manifestations such as fever, dry cough, and fatigue, and no abnormal signs. The examination showed that her throat swab was negative for nucleic acid but the urine was positive for nucleic acid. She was given antiviral and symptomatic supportive treatment. On February 26, her throat swab was checked for nucleic acid positive. On March 3 and 5, her throat swab and urine nucleic acid were negative. On March 9 and 12, her throat swab nucleic acid were negative. The patient was discharged from the hospital on March 13 and continued to be isolated and observed outside the hospital. Follow-up was conducted on March 26, the patient did not have any discomfort, the throat swab nucleic acid test was negative, and the isolation was lifted.Conclusion: There are asymptomatic patients with coronavirus disease 2019, and their urine may be one of the sources of infection.


Author(s):  
Yang Zhou ◽  
Le Yang ◽  
Ming Han ◽  
Mingqiang Huang ◽  
Xuedong Sun ◽  
...  

An outbreak of novel coronavirus(2019-nCoV) that began in Wuhan, China, is rapidly spreading to all over China, and gradually to multiple countries. Regarding to put the epidemic prevention and spread under the control, early identification and diagnosis play a critical role. Patients with initially no or mild symptoms of Novel Coronavirus Pneumonia (2019-nCoV), namely “stealth” infection, often lack of typical clinical evidence to establish the diagnosis. Based on the clinical analysis of 4 cases in stealth infection, the results of this study highlight that early diagnosis requires a combination of epidemiological history, clinical manifestations, early chest CT examination, and 2019-nCoV RNA test (nucleic acid test), with particular emphasis on definite epidemiological history and early chest CT findings when positive nucleic acid tests lag behind.


2020 ◽  
Author(s):  
Ying Zhao ◽  
Jingbo Du ◽  
Qi Leng ◽  
Zhenwu Li

Abstract Background: As a new infectious disease, coronavirus disease 2019 (COVID-19) is not fully understood. During January - July 2020, there were two clusters infections in Beijing, China. This study was to analyze the features of the two COVID-19 infections in Beijing.Methods: In this retrospective single-center study, 89 cases with the positive novel coronavirus nucleic acid test were collected from January to July 2020 in Beijing. They were divided into January-March group and June-July group. Two groups of data were compared.Results: The eighty-nine cases, 47 males and 42 females, mean age (41±14 years), were used for our study. The most common symptoms were fever (46/89, 52%) and cough (34/89, 38%). The clinical classification were moderate type (56/89,63%), mild type (24/89, 27%), severe type (4/89, 4%), critical type (0), respectively. Ground glass opacity (GGO) (47%) was the majority CT pattern. The frequency of involvement of lower lobe was higher than that of upper lobe (P<0.01). In January - March group, there were 5 patients (18%) exposure to Wuhan, 15 patients (54%) family clusters, 5 patients (18%) colleague clusters, 3 patients (11%) imported cases. In June-July group, 41 patients (68%) had an exposure to Xinfadi market of Beijing, 6 patients (10%) family clusters, and 14 patients (23%) colleague clusters. The number of patients with fever, cough, chest CT severity score and the number of lesion lung lobes in January-March group was higher than that in June-July group (P<0.05).Conclusions: Two COVID-19 clusters were dominated moderate and mild type, but few severe types. Patients in June-July group had less symptoms, imaging and family clusters than that in January-March group. This suggested that closely monitoring, early quarantined, nucleic acid test of COVID-19 and chest CT were important measures to prevent epidemic.


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