Early clinical manifestations and pulmonary imaging analysis of patients with novel coronavirus pneumonia / 中华急诊医学杂志

ABSTRACT

Objective:To investigate the early clinical characteristics and radiographic changes in confirmed novel coronavirus pneumonia (COVID-19) and COVID-19 excluded patients.Methods:Twenty-four patients with suspected COVID-19 admitted to Shanghai Jiaotong University Affiliated Sixth People’s Hospital and Jinshan Branch Hospital between January and February, 2020 were enrolled in this research. Early clinical features and radiographic changes were analyzed in 10 confirmed COVID-19 patients and 14 COVID-19 excluded patients.Results:In the early stage, all 24 suspected patients had minor symptoms, and had normal blood gas analysis results. Of 10 confirmed COVID-19 patients, 5 patients were male. All the 10 patients had fever and fatigue, with body temperature between 37.5 and 38.5 °C. Only 1 patient had hacking cough. Two patients had no clear epidemiological exposure history, the other 8 had clear epidemiological exposure history, with a possible incubation period of 1-10 days. From CT imaging, lesions were characterized as ground glass shadow ( n=9), which could be unilateral ( n=1) or bilateral ( n=9), and were mainly close to the pleura ( n=9), with nodule shadow ( n=1) and without focal necrosis, and could combined with pleural effusion ( n=1). Among the COVID-19 excluded patients, all 14 patients had clear history of epidemic exposure, with an onset time of 1 to 13 days. Twelve patients had fever, including 4 patients with body temperature > 38.5 °C, 8 patients with body temperature bwteen 37.3-38.5 °C, and 2 patients without fever. All patients had fatigue, 7 patients had hacking cough and 2 patients had chest pain. From CT imaging, ground glass shadow appeared in 4 patients, lesions were unilateral in 10 patients and bilateral in 4 patients, and the lesions were relatively sporadic, without necrosis or pleural effusion. Conclusions:Not all patients with COVID-19 have a direct epidemiology exposure history, some patients may be infected unknowingly. According to CT imaging, COVID-19 seems to have no special manifestations being different from other viral pneumonia. COVID-19 is more common among middle-aged people.