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    Clinical Severity and CT Features of the COVID-19 Pneumonia HP: Focus on CT Score and Laboratory Parameters

    Authors: Jianghui Duan; Kunsong Su; Hongliang Sun; Yanyan Xu; Liangying Liu

    doi:10.21203/rs.3.rs-45453/v1 Date: 2020-07-18 Source: ResearchSquare

    Background: Although CT characteristics of Coronavirus Disease MESHD 2019 (COVID-19) pneumonia HP pneumonia MESHD between patients with mild and severe forms of the disease have already been reported in the literature, there was little attention to the correlation of imaging features and laboratory testing. We aimed to compare the laboratory and chest CT imaging features in patients with COVID-19 pneumonia HP pneumonia MESHD between non-severe cases and severe cases, and to analyze the correlation of CT score and laboratory testing.Methods: This study consecutively included 54 patients with COVID-19 pneumonia HP pneumonia MESHD (26 males TRANS and 28 females TRANS, 26 to 92 years of age TRANS, 43 cases with non-severe and 11 cases with severe group). Clinical, laboratory and image data were collected between two subgroups. A CT score system was used to evaluate the extent of disease. Correlation between the CT score and laboratory data were estimated. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance SERO of CT score and laboratory tests.Results: Compared with non-severe patients, severe patients had showed increased white blood SERO cell count, neutrophil count, neutrophil percentage, the neutrophil-to-lymphocyte ratio (NLR) and decreased lymphocyte percentage (all p < 0.05). Architectural distortion, pleural effusion HP pleural effusion MESHD, air bronchogram and consolidation-dominant pattern were more common in the severe group (all p < 0.05). CT score of the severe group was higher than the non-severe group (p < 0.001). For distribution characters of the lesions, diffuse pattern in the transverse distribution was more often seen in the severe group (p < 0.001). CT score was positively correlated with the white blood SERO cell counts, neutrophil counts, the percent of neutrophil, NLR, alanine aminotransferase, lactate dehydrogenase and C-reactive protein, and was inversely related to the lymphocyte, the percent of lymphocyte. ROC analysis showed that when the optimal threshold of CT score was 13, the area under the curve was the largest, which was 0.855, and the sensitivity SERO and specificity were 100% and 60% respectively for the diagnosis of the severe patients.Conclusion: CT score showed significant correlations with laboratory inflammatory markers, suggesting that chest CT and laboratory examination maybe provide a better reference for clinicians to judge the severity of diseases.

    Analysis of Clinical Imaging Characteristics of Patients with 2019-nCoV

    Authors: Hao Jiang; WEI GUO; Huijie Jiang; Ruoshui Zheng; Ziao Wang; Ru Yi; Baomin Su; Li Sun

    doi:10.21203/rs.3.rs-44768/v1 Date: 2020-07-17 Source: ResearchSquare

    Background: This article retrospectively analyzed the clinical characteristics and CT characteristics of chest CT of 10 patients with coronavirus disease MESHD 2019 (COVID-19) diagnosed in Heilongjiang Province. Methods: A retrospective analysis of 10 COVID-19 patients confirmed by designated hospitals in Heilongjiang Province. Results: The clinical manifestations were mainly fever HP fever MESHD (80%) and cough HP cough MESHD (50%). Laboratory tests showed elevated C-reactive protein (70%) and serum SERO amyloid A (80%). CT mainly manifests as ground-glass opacity (100%) in the lung, more than two lung lobes (90%), and the lesions are mostly located in the right upper lobe (80%), and lobular septum thickening (60%) is common.Conclusions: In this group of patients with COVID-19, the typical CT manifestations are double lung sheet ground-glass opacity, which are mainly distributed in the subpleural area, and the range of involvement is more than or equal to two lung lobes, “paving stones” changes; pulmonary lesions were absorbed and fibrous cord foci were formed during the transition period. It is worth noting that hilum, mediastinal lymphadenopathy HP mediastinal lymphadenopathy MESHD, and pleural effusion HP pleural effusion MESHD are less common. During the study period, follow-up imaging performed by some patients showed mild / moderate disease progression and gradually dissipating.

    CT features of COVID-19 patients with two consecutive negative RT-PCR tests after treatment

    Authors: Zhao Fu; Ningning Tang; Yanqing Chen; Longbai Ma; Youyong Wei; Yumin Lu; Kun Ye; Hang Liu; Fen Tang; Guangyi Huang; Yingxia Yang; Fan Xu

    doi:10.21203/rs.3.rs-33163/v1 Date: 2020-06-02 Source: ResearchSquare

    Purpose: The objective of this study is to expound the CT features of COVID-19 patients whose nucleic acid tests converted to negative after treatment.Materials and Methods: We retrospectively reviewed 46 COVID-19 patients with two consecutive negative RT-PCR tests after treatment. The cases were divided into moderate group and severe/critical group according to disease severity. Clinical and CT scanning data were collected. CT signs of pulmonary lesions MESHD and the score of long involvement were expounded.Results: 39 moderate cases and 7 severe/critical cases were included. All moderate patients showed peripheral lesions while severe/critical cases exhibited both central and peripheral lesions with all lobes involvement. Ground glass opacity (GGO) and mixed GGO were observed. Aberrant pulmonary interstitium manifested as reticular and thin linear pattern. Thickened blood SERO vessels and pleural thickening HP pleural thickening MESHD were found. Pulmonary fibrosis HP Pulmonary fibrosis MESHD, annular thickening of the bronchial wall, bronchiectasis HP, air bronchogram and small amount of bilateral pleural effusion MESHD pleural effusion HP were observed in severe/critical patients. The severe/critical group showed higher CT score of involvement.Conclusions: Pulmonary lesions persisted even after twice consecutive nucleic acid tests converted to negative. We strongly recommended regular follow-up of CT scans after nucleic acid tests conversion. Evaluation of complete remission should base on chest CT.

    Single-Cell Analysis Reveals Macrophage-Driven T Cell Dysfunction MESHD in Severe COVID-19 Patients

    Authors: Xiaoqing Liu; Airu Zhu; Jiangping He; Zhao Chen; Longqi Liu; Yuanda Xu; Feng Ye; Huijian Feng; Lin Luo; Baomei Cai; Yuanbang Mai; Lihui Lin; Zhekun Zhang; Sibei Chen; Junjie Shi; Lilan Wen; Yuanjie Wei; Jianfen Zhuo; Yingying Zhao; Fang Li; Xiaoyu Wei; Dingbin Chen; Xinmei Zhang; Na Zhong; Yaling Huang; He Liu; Jinyong Wang; Xun Xu; Jie Wang; Ruchong Chen; Xinwen Chen; Nanshan Zhong; Jinxian Zhao; Yimin Li; Jincun Zhao; Jiekai Chen

    doi:10.1101/2020.05.23.20100024 Date: 2020-05-26 Source: medRxiv

    The vastly spreading COVID-19 pneumonia HP pneumonia MESHD is caused by SARS-CoV-2. Lymphopenia HP Lymphopenia MESHD and cytokine levels are tightly associated with disease severity. However, virus-induced immune dysregulation HP at cellular and molecular levels remains largely undefined. Here, the leukocytes in the pleural effusion HP pleural effusion MESHD, sputum, and peripheral blood SERO biopsies from severe and mild patients were analyzed at single-cell resolution. Drastic T cell hyperactivation accompanying elevated T MESHD cell exhaustion was observed, predominantly in pleural effusion HP pleural effusion MESHD. The mechanistic investigation identified a group of CD14+ monocytes and macrophages highly expressing CD163 and MRC1 in the biopsies from severe patients, suggesting M2 macrophage polarization. These M2-like cells exhibited up-regulated IL10, CCL18, APOE, CSF1 (M-CSF), and CCL2 signaling pathways. Further, SARS-CoV-2-specific T cells were observed in pleural effusion HP pleural effusion MESHD earlier than in peripheral blood SERO. Together, our results suggest that severe SARS-CoV-2 infection MESHD causes immune dysregulation HP dysregulation MESHD by inducing M2 polarization and subsequent T cell exhaustion. This study improves our understanding of COVID-19 pathogenesis.

    Clinical Features of Pregnant Women and Neonates with COVID-19 in Wuhan: a paired comparison study

    Authors: Qin Xie; Quan Gan; Jing Hu; Dong Zhou; Shuhan Cai; Lianjiu Su; Yunxiang Li; Yiming Li; Zhiyong Peng

    doi:10.21203/rs.3.rs-31339/v1 Date: 2020-05-26 Source: ResearchSquare

    Background Our study aimed to find symptoms unique in pregnancy and to help the early diagnosis in pregnant women and to evaluate the impact of COVID-19 in postpartum women and their newborns.Methods Clinical data were reviewed and collected for 11 pregnant women with laboratory-confirmed COVID-19 who were consecutively admitted to Zhongnan Hospital of Wuhan University and Women and Children’s Hospital of Hubei Province, from Jan 26 to Feb 26, 2020.Results All the confirmed women didn’t have any exposure history and their early symptoms were mildly elevated temperate and fatigue HP fatigue MESHD. The chest CT scans of confirmed women can be atypical manifestations, such as bilateral pleural effusions MESHD pleural effusions HP and slightly increased densities. Eight of eleven confirmed women did not feel anything unusual until abnormalities were found on chest CT scans on admission screening test. All three groups had elevated white blood SERO cell count, neutrophil count and lactate dehydrogenase, and reduced total protein.The infection did not increase the risk for premature delivery, premature rupture of membrane HP, or comorbidities in pregnancy.Conclusions Pregnant women were often asymptomatic TRANS and accidentally detected abnormalities MESHD on chest CT scan on admission which emphasize the importance of CT scan in prevalent areas of the COVID-19. Even after the laboratory confirmation, the manifestation of the CT scan could be atypical, which alerted the necessity of protection for healthcare workers. The COVID-19 did not increase the risk of complications in pregnant women and their neonates.Trial registration: This case series was approved by the institutional ethics board of Zhongnan Hospital of Wuhan University (No. 2020020) and Women and Children’s Hospital of Hubei Province(NO. LW035).

    Distinguishing COVID-19 from influenza pneumonia HP pneumonia MESHD in the early stage through CT imaging and clinical features

    Authors: Zhiqi Yang; Daiying Lin; Xiaofeng Chen; Jinming Qiu; Shengkai Li; Ruibin Huang; Hongfu Sun; Yuting Liao; Jianning Xiao; Yanyan Tang; Guorui Liu; Renhua Wu; Xiangguang Chen; Zhuozhi Dai

    doi:10.1101/2020.04.17.20061242 Date: 2020-04-22 Source: medRxiv

    Purpose: To identify differences in CT imaging and clinical features between COVID-19 and influenza pneumonia HP pneumonia MESHD in the early stage, and to identify the most valuable features in the differential diagnosis. Materials and Method: A consecutive cohort of 73 COVID-19 and 48 influenza pneumonia HP pneumonia MESHD patients were retrospectively recruited from five independent institutions. The courses of both diseases were confirmed to be in the early stages (mean 2.66 (SD 2.62) days for COVID-19 and mean 2.19 (SD 2.10) days for influenza pneumonia MESHD pneumonia HP after onset). The chi-square test, student`s t-test, and Kruskal-Wallis H-test were performed to compare CT imaging and clinical features between the two groups. Spearman or Kendall correlation tests between feature metrics and diagnosis outcomes were also assessed. The diagnostic performance SERO of each feature in differentiating COVID-19 from influenza pneumonia HP pneumonia MESHD was evaluated with univariate analysis. The corresponding area under the curve (AUC), accuracy, specificity, sensitivity SERO and threshold were reported. Results: The ground-glass opacification (GGO) was the most common imaging feature in COVID-19, including pure-GGO (75.3%) and mixed-GGO (78.1%), mainly in peripheral distribution. For clinical features, most COVID-19 patients presented normal white blood SERO cell (WBC) count (89.04%) and neutrophil count (84.93%). Twenty imaging features and 6 clinical features were identified to be significantly different between the two diseases. The diagnosis outcomes correlated significantly with the WBC count (r=-0.526, P<0.001) and neutrophil count (r=-0.500, P<0.001). Four CT imaging features had absolute correlations coefficients higher than 0.300 (P<0.001), including crazy-paving pattern, mixed-GGO in peripheral area, pleural effusions HP pleural effusions MESHD, and consolidation. Conclusions: Among a total of 1537 lesions and 62 imaging and clinical features, 26 features were demonstrated to be significantly different between COVID-19 and influenza pneumonia MESHD pneumonia HP. The crazy-paving pattern was recognized as the most powerful imaging feature for the differential diagnosis in the early stage, while WBC count yielded the highest diagnostic efficacy in clinical manifestations.

    A Mini Review on Current Clinical and Research Findings for Children TRANS Suffering from COVID-19

    Authors: Xiao Li; Kun Qian; Ling-ling Xie; Xiu-juan Li; Min Cheng; Li Jiang; Bjoern W. Schuller

    doi:10.1101/2020.03.30.20044545 Date: 2020-04-04 Source: medRxiv

    Background: As the novel coronavirus triggering COVID-19 has broken out in Wuhan, China and spread rapidly worldwide, it threatens the lives of thousands of people and poses a global threat on the economies of the entire world. However, infection MESHD with COVID-19 is currently rare in children TRANS. Objective To discuss the latest findings and research focus on the basis of characteristics of children TRANS confirmed with COVID-19, and provide an insight into the future treatment and research direction. Methods: We searched the terms "COVID-19 OR coronavirus OR SARS-CoV-2" MESHD AND "Pediatric OR children TRANS" on PubMed, Embase, Cochrane library, NIH, CDC, and CNKI. The authors also reviewed the guidelines published on Chinese CDC and Chinese NHC. Results: We included 25 published literature references related to the epidemiology, clinical manifestation, accessary examination, treatment, and prognosis of pediatric patients with COVID-19. Conclusion: The numbers of children TRANS with COVID-19 pneumonia HP pneumonia MESHD infection are small, and most of them come from family aggregation. Symptoms are mainly mild or even asymptomatic TRANS, which allow children TRANS to be a risk factor for transmission TRANS. Thus, strict epidemiological history screening is needed for early diagnosis and segregation. This holds especially for infants, who are more susceptible to infection MESHD than other age groups TRANS in pediatric age TRANS, but have most likely subtle and unspecific symptoms. They need to be paid more attention to. CT examination is a necessity for screening the suspected cases, because most of the pediatric patients are mild cases, and plain chest X-ray do not usually show the lesions or the detailed features. Therefore, early chest CT examination combined with pathogenic detection is a recommended clinical diagnosis scheme in children TRANS. The risk factors which may suggest severe or critical progress for children TRANS are: Fast respiratory rate and/or; lethargy HP and drowsiness HP mental state and/or; lactate progressively increasing and/or; imaging showed bilateral or multi lobed infiltration, pleural effusion HP pleural effusion MESHD or rapidly expending of lesions in a short period of time and/or; less than 3 months old or those who underly diseases. For those critical pediatric patients with positive SARS-CoV-2 diagnosis, polypnea may be the most common symptom. For treatment, the elevated PCT seen in children TRANS in contrast to adults TRANS suggests that the underlying coinfection/ secondary infection MESHD may be more common in pediatric patients and appropriate antibacterial treatment should be considered. Once cytokine storm is found in these patients, anti-autoimmune or blood SERO-purifying therapy should be given in time. Furthermore, effective isolation measures and appropriate psychological comfort need to be provided timely.

    A preliminary study on the ultrasonic manifestations of peripulmonary lesions of non-critical novel coronavirus pneumonia MESHD pneumonia HP (COVID-19) 

    Authors: Yi Huang; Sihan Wang; Yue Liu; Yaohui Zhang; Chuyun Zheng; Yu Zheng; Chaoyang Zhang; Weili Min; Ming Yu; Mingjun Hu

    doi:10.21203/rs.2.24369/v1 Date: 2020-02-21 Source: ResearchSquare

    Background: Ultrasound is used to observe the imaging manifestations of COVID-19 in order to provide reference for real-time bedside evaluation.Purpose: To explore the ultrasonic manifestations of peripulmonary lesions of non-critical COVID-19, so as to provide reference for clinical diagnosis and efficacy evaluation.Materials and Methods: The clinical and ultrasonic data of 20 patients with clinically diagnosed non-critical COVID-19 treated in Xi'an Chest Hospital during January and February 2020 were retrospectively analyzed. Conventional two-dimensional ultrasound and color Doppler ultrasound were used to observe the characteristics of lesions. Results: All 20 patients (40 lungs and 240 lung areas) had a history of travel TRANS, residence or close contact TRANS in/with Wuhan, and 5 of them caught COVID-19 after family gatherings. Lesions tended to occur in both lungs. Lesions in the lung areas: 14 in L1+R1 area (14/40), 17 in L2+R2 area (17/40), 17 in L3+R3 area (17/40), 17 in L4+R4 area (17/40), 20 in L5+R5 area (20/40), and 28 in L6+R6 area (28/40). L esion MESHDtypes: rough and discontinuous p leural MESHDline (36/240), subpleural consolidation (53/240), air bronchogram sign or air bronchiologram sign in subpleural peripleural consolidation (37/240), visible B lines (91/240), localized pleural thickening HP leural MESHDthickening (19/240), localized pleural effusion HP leural effusion MESHD(24/240), poor blood SERO flow in the consolidation detected by color Doppler ultrasound (50/53).Conclusion: The non-critical COVID-19 has characteristic ultrasonic manifestations, which are visible in the posterior and inferior areas of the lung. The lesions are mainly characterized by a large number of B lines, s ubpleural pulmonary consolidation MESHDand poor blood SERO flow. Lung ultrasound can provide reference for the clinical diagnosis and efficacy evaluation. Chinese Clinical Trial Registry: ChiCTR2000030032Approval for Scientific Research Project: No. 2020-S0001

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MeSH Disease
Human Phenotype

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