CT manifestations of the coronavirus disease 2019 in patients outside Wuhan: with a history of exposure to Wuhan vs. with second-generation infection (preprint)

Objective: To explore discrepancy in CT manifestations of coronavirus disease 2019 (COVID-19) in patients outside Wuhan between cases with a history of exposure to Wuhan and with the second-generation infection.Methods: Twenty-two patients with confirmed COVID-19 from two hospitals in Nanchong outside Wuhan were enrolled. All patients underwent initial and follow-up computed tomography after admission, and were divided into two groups. Group A and B were composed of 15 patients with a history of exposure to Wuhan and 7 with the second-generation infection in Nanchong, respectively. Initial CT features including extent score and density score between groups were statistically compared.Results: All patients in group A had abnormal CT findings while 3 of 7 patients in group B had. Patients with abnormal CT findings were more frequent in group A than in group B (P < 0.05). On initial CT, pure ground glass opacity (GGO), and GGO with consolidation and/or other abnormalities were found in 20% (3/15) and 80% (12/15) patients in group A, respectively, while 1 (14.3%), 2 (28.6%) and 4 (57.1%) had pure GGO, GGO with focal consolidation, and normal CT appearances in Group B, respectively. Patients with extent and density scores of ≥5 were more frequent in group A than in group B (Ps < 0.01). Additionally, 3 of 4 (75%) patients with normal initial CT findings had focal pure GGO lesions on follow-up CT.Conclusion: The COVID-19 in patients with a history of exposure to Wuhan can be severer than with the second-generation infection on CT.

CT Manifestations and Clinical Features of the 2019 Novel Coronavirus Pneumonia Infected by Cluster Transmission Within a Family: Case Report (preprint)

Background: In December 2019, a cluster of patients associated with a seafood wholesale market was confirmed having infected the 2019 novel coronavirus (2019-nCoV) in Wuhan, China. As of Feb 11, 2020, 43144 cases of the 2019-nCoV infection have been confirmed in the world, and person-to-person transmission has been recognized. To our knowledge, there are no reports regarding the 2019-nCoV pneumonia infected by cluster transmission within a family. The amount of close contact suspect was increasing. We reported cases of family cluster transmission of the 2019-nCoV infection, showing the differences in computed tomography (CT) manifestations and symptoms between patients with and without history of exposure to the epidemic area (Wuhan).Case Presentation: A 48-year-old man was presented to the hospital in Jan 30, 2020 with a 2-day history of low fever and chill. He had traveled to Wuhan City of Hubei Province of China 12 days before, and was confirmed having the 2019-nCoV infection based on his positive CT manifestations, clinical signs, and real-time fluorescence polymerase chain reaction results. The other three members of his family without history of exposure to the epidemic area (Wuhan) were subsequently identified having the 2019-nCoV transmissive infection based on the positive findings of real-time fluorescence polymerase chain reaction, but they did not have abnormal CT manifestations and clinical signs.Conclusion: For patients who have history of exposure to the epidemic area (Wuhan), the 2019-nCoV infected pneumonia can be identified by real-time fluorescence polymerase chain reaction testing and chest CT together with the symptoms. But for patients without exposure to the epidemic area, the 2019-nCoV infection can be confirmed by real-time fluorescence polymerase chain reaction testing and history of close contact with confirmed patients who have history of exposure to the epidemic area.