Clinical features and chest CT findings in moderate and severe COVID-19 patients: an analysis of 506 cases from Wuhan Huoshenshan Hospital / 中华临床感染病杂志

ABSTRACT

Objective:To investigate the clinical features and chest CT findings in moderate and severe COVID-19 patients.Methods:A total of 506 patients with COVID-19 treated in Wuhan Huoshenshan Hospital during February 9 to March 9, 2020 were enrolled in the study, including 365 moderate cases and 141 severe cases. The clinical features and chest CT findings were retrospectively analyzed. Chi-square test and Fisher’s exact probability were used for data analysis. Results:The proportions of patients with diabetes and hypertension in severe group were significantly higher than those in moderate group ( χ2=9.377 and 15.085, P<0.01). Compared with the severe patients, the white blood cell counts and lymphocyte counts of moderate patients were statistically significant ( χ2=14.816 and 30.097, P<0.01). The protortion of increased CRP in severe patients was higher than that in moderate patients ( χ2=21.639, P<0.01). The cure rate and discharge rate of severe patients were significantly lower than those of moderate patients ( P<0.01). Compared with the moderate cases of COVID-19, the CT images in severe patients mainly showed lesions of diffuse distribution, mixed density, with maximum diameter>10 cm and involved all five lung lobes ( P<0.01). The severe patients had more imaging signs of air bronchogram, bronchovascular thickening, pleural thickening, mediastinal or hilar lymphnodes enlargement, pleural effusion and pericardial effusion than moderate patients ( χ2=33.357, 11.114, 14.580, 5.978, 45.731 and 6.623, P<0.05 or <0.01). Conclusion:There are differences in clinical features and chest CT findings between moderate and severe patients, and chest CT findings can be used as important criteria for clinical classification.