Abstract
BackgroundIn December 2019, the outbreak of a disease subsequently termed COVID-19 occurred in Wuhan, China. The number of cases increased rapidly and spread to six continents. However, there is limited information on the chest computed tomography (CT) results of affected patients. Chest CT can assess the severity of COVID-19 and has sufficient sensitivity to assess changes in response to glucocorticoid therapy.ObjectiveAnalyze COVID-19 patients to determine the relationships of clinical characteristics, chest CT score, and levels of inflammatory mediators.MethodsThis retrospective, single-center case series of 108 consecutive hospitalized patients with confirmed COVID-19 at Tongji Hospital, Tongji Medical College of HUST (Wuhan, China) examined patients admitted from January 28 to February 20, 2020. Patient demographics, comorbidities, clinical findings, chest CT results, and CT scores of affected lung parenchyma were recorded. The relationships between chest CT score with levels of systemic inflammatory mediators were determined.ResultsAll patients exhibited signs of significant systemic inflammation, including increased levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin, chest CT score, and a decreased lymphocyte (LY) count. Chest CT score had positive associations with white blood cell (WBC) count, CRP, ESR, procalcitonin, and abnormal coagulation function, and a negative association with LY count. Treatment with a glucocorticoid increased the LY count, reduced the CT score and CRP level, and improved coagulation function.ConclusionsCOVID-19 infection is characterized by a systemic inflammatory response that affects the lungs, blood, digestive system, and circulatory systems. The chest CT score is a good indicator of the extent of systemic inflammation. Glucocorticoid treatment appears to reduce systemic inflammation in these patients.
Highlights
In December 2019, the outbreak of a disease subsequently termed COVID-19 occurred in Wuhan, China
COVID-19 infection is characterized by a systemic inflammatory response that affects the lungs, blood, digestive system, and circulatory systems
The chest computed tomography (CT) score is a good indicator of the extent of systemic inflammation
Summary
In December 2019, the outbreak of a disease subsequently termed COVID-19 occurred in Wuhan, China. The disease ( termed COVID-19) spread rapidly from Wuhan to other areas. On January 3, 2020, this novel coronavirus ( termed SARS-CoV-2) was identified in samples of bronchoalveolar lavage fluid from a patient in Wuhan and confirmed as the cause of this disease [6]. During the early stages of this pneumonia, there were severe acute respiratory symptoms (SARS), and some patients rapidly developed acute respiratory distress syndrome (ARDS), acute respiratory failure, and other serious complications [7]. Some patients with COVID-19 progressed from severe pneumonia to pulmonary edema, acute respiratory distress syndrome, multiple organ failure, and death [11, 12]
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