Abstract
ObjectiveCoronavirus disease 2019 (COVID-19) is currently the most serious infectious disease in the world. An accurate diagnosis of this disease in the clinic is very important. This study aims to improve the differential ability of computed tomography (CT) to diagnose COVID-19 and other community-acquired pneumonias (CAPs) and evaluate the short-term prognosis of these patients.MethodsThe clinical and imaging data of 165 COVID-19 and 118 CAP patients diagnosed in seven hospitals in Anhui Province, China from January 21 to February 28, 2020 were retrospectively analysed. The CT manifestations of the two groups were recorded and compared. A correlation analysis was used to examine the relationship between COVID-19 and age, size of lung lesions, number of involved lobes, and CT findings of patients. The factors that were helpful in diagnosing the two groups of patients were identified based on specificity and sensitivity.ResultsThe typical CT findings of COVID-19 are simple ground-glass opacities (GGO), GGO with consolidation or grid-like changes. The sensitivity and specificity of the combination of age, white blood cell count, and ground-glass opacity in the diagnosis of COVID-19 were 92.7 and 66.1%, respectively. Pulmonary consolidation, fibrous cords, and bronchial wall thickening were used as indicators to exclude COVID-19. The sensitivity and specificity of the combination of these findings were 78.0 and 63.6%, respectively. The follow-up results showed that 67.8% (112/165) of COVID-19 patients had abnormal changes in their lung parameters, and the severity of the pulmonary sequelae of patients over 60 years of age worsened with age.ConclusionsAge, white blood cell count and ground-glass opacity have high accuracy in the early diagnosis of COVID-19 and the differential diagnosis from CAP. Patients aged over 60 years with COVID-19 have a poor prognosis. This result provides certain significant guidance for the diagnosis and treatment of new coronavirus pneumonia.
Highlights
Coronavirus disease-19 (COVID-19) is an acute infectious respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, called 2019-nCoV) [1]
118 patients with community-acquired pneumonia (CAP) were selected from the First Affiliated Hospital of the University of Science and Technology of China for pneumonia during the same period
Groundglass opacities (GGOs) on chest computed tomography (CT) images were found in 140 patients (84.8%) in COVID-19 group
Summary
Coronavirus disease-19 (COVID-19) is an acute infectious respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, called 2019-nCoV) [1]. Infection can lead to pneumonia, severe acute respiratory syndrome, renal failure, and even death. Antibodies against the new coronavirus are still being studied [5, 6], and there is no specific and effective treatment [7]. The early detection of lesions is very important for early isolation and treatment and preventing the spread of the disease. Previous studies have mostly focused on the imaging manifestations and changes in COVID-19 [11,12,13]. The disease needs to be distinguished from many diseases by imaging, especially community-acquired pneumonia (CAP). Comparative studies based on imaging in this area remain lacking
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