Abstract
COVID-19 is “public enemy number one” and has placed an enormous burden on health authorities across the world. Given the wide clinical spectrum of COVID-19, understanding the factors that can predict disease severity will be essential since this will help frontline clinical staff to stratify patients with increased confidence. To investigate the diagnostic value of the temporal radiographic changes, and the relationship to disease severity and viral clearance in COVID-19 patients. In this retrospective cohort study, we included 99 patients admitted to the Renmin Hospital of Wuhan University, with laboratory confirmed moderate or severe COVID-19. Temporal radiographic changes and viral clearance were explored using appropriate statistical methods. Radiographic features from HRCT scans included ground-glass opacity, consolidation, air bronchogram, nodular opacities and pleural effusion. The HRCT scores (peak) during disease course in COVID-19 patients with severe pneumonia (median: 24.5) were higher compared to those with pneumonia (median: 10) (p = 3.56 × 10 −12), with more frequency of consolidation (p = 0.025) and air bronchogram (p = 7.50 × 10−6). The median values of days when the peak HRCT scores were reached in pneumonia or severe pneumonia patients were 12 vs. 14, respectively (p = 0.048). Log-rank test and Spearman’s Rank-Order correlation suggested temporal radiographic changes as a valuable predictor for viral clearance. In addition, follow up CT scans from 11 pneumonia patients showed full recovery. Given the values of HRCT scores for both disease severity and viral clearance, a standardised HRCT score system for COVID-19 is highly demanded.
Highlights
In December 2019, a pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China
We identified consecutive patients with moderate or severe COVID-19 discharged from the general wards of Renmin Hospital of Wuhan University between 5 February 2020 to 14 March 2020
99 patients (61 pneumonia and 38 severe pneumonia) with key information in their medical records were included in this study
Summary
In December 2019, a pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. The COVID-19 outbreak was declared a Public Health Emergency of International Concern on 30 January 2020 and was characterized as a pandemic on 11 March 2020. It has placed an enormous burden on health authorities across the world, including more than 200 countries and territories. Zhou and colleagues reported older age, high Sequential Organ Failure Assessment (SOFA) score, and d-dimer greater than 1 μg/L as potential risk factors for mortality[7]. To www.nature.com/scientificreports our knowledge, at present, there is limited standardised method to predict which infected patient will remain moderately symptomatic and which will progress to more severe disease as well as viral clearance. We aim to describe the temporal radiographic changes, and the relationship to disease severity and viral clearance in COVID-19 patients
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