ABSTRACT
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.
Subject(s)
COVID-19ABSTRACT
Abstract: Background: The COVID-19 outbreak caused by the SARS-Cov-2 virus has been sustained in China since December 2019, and could become a pandemic if we do not contain it. The mental health of frontline medical staff is a concern. In this study, we aimed to identify the influencing factors on medical worker anxiety in China during the COVID-19 outbreak. Methods: We conducted a cross-sectional study to estimate the prevalence of anxiety among medical staff from 10th February 2020 to 20th February 2020 in China using the Zung Self-rating Anxiety Scale (SAS) to assess anxiety, using the criteria of normal ([≤]49), mild (50-59), moderate (60-70) and severe anxiety ([≥]70). We used multivariable linear regression to determine the factors (e.g., having direct contact treating infected patients, being a medical staff worker from Hubei province, being a suspect case) for anxiety. We also used adjusted models to confirm independent factors for anxiety after adjusting for gender, age, education and marital status. Results: Of 512 medical staff from China, 164 healthcare workers (32.03%) had had direct contact by treating infected patients. The prevalence of anxiety was 12.5%, with 53 workers suffering from mild (10.35%), seven workers from moderate (1.36%) and four workers from severe anxiety (0.78%). After adjusting for sociodemographic characteristics (gender, age, education and marital status), medical staff who had had direct contact treating infected patients saw higher anxiety scores than those who had not had direct contact ({beta}value=2.33, CI: 0.65 -4.00; p=0.0068). Similar things were observed in medical staff from Hubei province, compared with those from other parts of China ({beta}value=3.67, CI: 1.44 -5.89; p=0.0013). The most important variable was suspect cases with high anxiety scores, compared to non-suspect cases ({beta}value=4.44, CI: 1.55 -7.33; p=0.0028). Conclusion: Our results highlight that government authorities should make early detection of the high risk of anxiety among medical staff a priority, and implement appropriate psychological intervention programs, to prevent medical staff from developing psychological disorders that could potentially exert an adverse effect on combating the COVID-19 epidemic.
Subject(s)
COVID-19 , Anxiety Disorders , Sexual Dysfunctions, Psychological , InfectionsABSTRACT
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.