家庭聚集性早期新型冠状病毒肺炎的临床与CT表现的初步探讨

Clinical features and CT signs of early family clustering corona virus disease 2019

目的初步探讨新型冠状病毒肺炎家庭聚集性发病患者的临床症状、核酸检测和CT表现的时间变化规律。方法回顾性分析西安交通大学第一附属医院2020年1月27日至2月1日收治确诊的3组家庭聚集性发病的新冠肺炎患者(男4例,女3例),对其临床资料和CT表现进行分析。结果3组家庭CT表现均符合早期表现:两肺胸膜下多发磨玻璃密度影(ground-glass opacity,GGO),伴或不伴肺小血管增粗。第1组,首诊两人核酸阳性,妻子无症状,但首诊CT阳性;丈夫有症状,首诊CT阴性,2天后复查CT阳性。第2组,夫妻同时发病,CT和核酸均为阳性。第3组,3人同时起病,CT表现均为阳性,但儿子第3次核酸检测才确诊,其余2人首诊核酸检测阳性。结论新冠肺炎早期阶段的临床症状、核酸检测和CT表现存在时间上的差异,这种差异有可能是疾病传播的重要潜在因素。正确认识这种差异,有利于早期阻断人群聚集的传播途径。

Objective To investigate the temporal variation of the clinical symptoms,nucleic acid detection and CT characteristics of corona virus disease 2019(COVID-19)patients with clustered onset in families.Methods We made a retrospective analysis of the COVID-19 patients(4 males and 3 females)with clustered onset in 3 families diagnosed in The First Affiliated Hospital of Xi'an Jiaotong University from January 27 to February 1,2020.We analyzed the clinical data and CT findings.Results The CT signs in the three groups of families were consistent with early manifestations:multiple ground-glass opacity(GGO),under the pleura in both lungs,with or without thickening of small pulmonary vessels.In the first group,two people were confirmed with positive nucleic acid in the first diagnosis.The wife was asymptomatic,but the CT finding was positive.Her husband was symptomatic,and the first CT result was negative,but the CT was positive two days later.In the second group,the spouses had the onset at the same time,and both CT and nucleic acid were positive.In the third group,all the three people had the onset at the same time,and the CT results were all positive,but the son was diagnosed only after the third nucleic acid test,and the other two were positive at the first diagnosis.Conclusion There are time differences in clinical symptoms,nucleic acid detection,and CT manifestations of COVID-19 in the early stage.These differences may be an important underlying factor for the spread of the disease.Correct understanding of the differences is beneficial to early blocking of the transmission pathways of crowd aggregation.