ABSTRACT
Background: COVID-19 patients showed certain characteristic features of multiple signs in bilateral lungs. Some patients only had a single pulmonary lobe lesion, which has not been reported previously. Single pulmonary lobe lesions are easily missed or misdiagnosed if they do not receive enough attention. Objective: To study the imaging manifestations, clinical features and outcomes of patients with COVID-19 with only one single pulmonary lobe lesion. Methods: Patient clinical data were collected only from patients with confirmed SARS-CoV-2 infection by RT-PCR, which was confined to only single lobe lesions on chest CT imaging findings at the onset. Which lobe was frequently involved, the imaging manifestations, clinical features and outcomes were also analyzed. Result: From January 1, 2020, to March 14, 2020, a total of 367 inpatients were diagnosed with COVID-19, in which 50 (13.6%) patients were confirmed with only one single pulmonary lobe lesion. The most frequently involved lobe was the right lower lobe (18 patients, 36%, highest). Lesions in the lower lobe easily spread to all lobes of the bilateral lungs (P<0.001, χ2=10.264), especially the left lower lobe, and were less frequent in the right upper lobe. During hospitalization, 2 (4%) patients were admitted to the ICU, 2 (4%) patients died, and 28 (56%) patients developed lesions in other lobes within 6.32±3.71 days. Conclusions: The general pattern of COVID-19 imaging with localized nodules may also cause severe respiratory symptoms of bilateral lung disease, serious complications, or even death in patients with multiple lobe lesions or bilateral lung lesions, which should not be underestimated.
ABSTRACT
Objective: To analyze the epidemiological characteristics of a cluster of 5 confirmed COVIDâ19 cases related with the transmission in incubation period of initial case, and find out the infection source and transmission chain.. Methods: According to "The Prevention and Control Protocol for Coronavirus Disease 2019 (Third Edition)" issued by the National Health Commission, a field epidemiological survey was conducted for the 5 cases in January 2020. Nasopharyngeal swabs and sputum samples were collected from them for the detection of 2019-nCoV by real time RT-PCR. Multi prevention and control measures were taken, such as tracking and screening close contacts, medical isolation observation, investigating the epidemiological link, analyzing transmission chain. Results: Case 1, who had common environmental exposure with other COVIDâ19 cases, got sick on 20 January, 2020 and was confirmed on 1 February. Case 2 became symptomatic on 22 January and was confirmed on 27 January. Case 3 got sick on 25 January and was confirmed on 30 January. Case 4 had illness onset on 20 January and was confirmed on 1 February. Case 5 got sick on 23 January and was confirmed on 31 January. Among the 5 cases, case 2 died and the illness of other cases were effectively controlled. After exclusion of other common exposure factors, case 1 had a 6-hour meeting with case 2 and case 3 on 19 January. Case 2 and case 3 might be infected by case 1 during the incubation period. It is the key point for epidemiological investigation. Conclusion: The epidemiological investigation indicates that the transmission might occur in the incubation period of COVID-19 case, close attention should be paid to it in future COVID-19 prevention and control.
ABSTRACT
Objective: To understand the epidemiological characteristics of COVID-19 cases in different epidemic stages in Gansu province. Methods: Epidemiological investigation was conducted to collect the information of confirmed COVID-19 cases, including demographic, epidemiological and clinical information. Results: As of 25 February 2020, a total of 91 confirmed COVID-19 cases had been reported in Gansu. The epidemic of COVID-19 in Gansu can be divided as three different stages, i.e. imported case stage, imported-case plus indigenous case stage, and indigenous case stage. A total of 63 cases were clustered cases (69.23%), 3 cases were medical staff infected with non-occupational exposure. The initial symptoms included fever (54.95%, 50/91), cough (52.75%, 48/91), or fatigue (28.57%, 26/91), the proportion of each symptom showed a decreasing trend along with the three epidemic stages, but only the differences in proportions of fever (trend χ2=2.20, P<0.05) and fatigue (trend χ2=3.18, P<0.05) among the three epidemic stages were statistically significant. The cases with critical severe symptoms accounted for 42.85% (6/14), 23.73% (14/59) and 16.67% (3/18), respectively, in three epidemic stages, showed a decreasing trend (H=6.45, P<0.05). Also, the incubation period prolonged along with the epidemic stage (F=51.65, P<0.01), but the intervals between disease onset and hospital visit (F=5.32, P<0.01), disease onset and diagnosis (F=5.25, P<0.01) became shorter along with the epidemic stage. Additionally, the basic reproduction number (R0) had decreased from 2.61 in imported case stage to 0.66 in indigenous case stage. Conclusions: The COVID-19 epidemic in Gansu was caused by the imported cases, and about 2/3 cases were clustered ones. No medical worker was observed to be infected by occupational exposure. With the progression of COVID-19 epidemic in Gansu, the change in initial symptom and incubation period suggests, the early screening cannot only depend on body temperature monitoring.