输入性COVID-19的临床表现及CT分布特征

Clinical manifestations and CT distribution characteristics of imported COVID-19

目的分析上海市浦东新区输入性COVID-19的临床表现及CT分布特征。方法回顾性分析经病毒核酸检查阳性的12例输入性COVID-19患者的临床及影像学资料,CT主要观察病变的数量、分布、形态、密度、边界、纵隔及胸膜等情况。结果11例有疫区接触史,1例不详;10例有发热,9例有咳嗽;10例白细胞计数、中性粒细胞计数、淋巴细胞计数正常,7例单核细胞计数升高,10例嗜酸性粒细胞减低,2例C反应蛋白升高,3例血清淀粉样蛋白升高。CT分布特征:12例均为多发病灶,3例累及单个肺叶,3例累及两个肺叶,6例累及多个肺叶;肺下叶累及为主,有10例累及肺下叶;5例肺外周分布,7例肺外周及中心同时分布;胸膜受累11例,12例患者均未见胸腔积液和纵隔淋巴结增大;伴随征象为晕征1例,小叶间隔增厚2例,铺路石征1例,病变内支气管壁增厚、血管增粗7例,充气支气管征3例。结论COVID-19患者临床表现主要为发热、咳嗽;实验室检查白细胞计数、中性粒细胞计数、淋巴细胞计数多正常,嗜酸性粒细胞计数减低;CT分布特征以肺下叶外周多发磨玻璃样影为主要表现。

Objective To analyze the clinical manifestations and CT distribution characteristics of imported COVID-19 in Pudong,Shanghai.Methods We retrospectivly analyzed the clinical and imaging data of 12 cases of imported COVID-19 patients who were positive for viral nucleic acid examination.The number,distribution,morphology,density,boundary,mediastinum and pleura of the lesions were observed by CT.Results Eleven cases had a history of exposure to the epidemic area and 1 case was unknown.Ten cases had fever and 9 with cough.Leukocyte counts,neutrophil counts and lymphocyte counts were normal in 10 cases.The monocyte counts was elevated in 7 cases,eosinophilia was decreased in 10 cases.Creactive protein was elevated in 2 cases,and serum amyloid was elevated in 3 cases.CT distribution features:all the 12 cases had multiple lesions,including 3 cases involving a single lobe,3 cases involving two lobes,and 6 cases involving multiple lobes.The lower lobe of the lung was mainly involved,including 10 cases.Peripheral distribution was observed in 5 cases and peripheral distribution and central distribution in 7 cases.Pleural involvement in 11 patients,12 patients did not see pleural effusion and mediastinal lymph node enlargement.We found 1 case of halo,2 cases of interlobular septal thickening,1 case of paving stone,7 cases of inner bronchial wall thickening,7 cases of blood vessel thickening,and 3 cases of air bronchogram.Conclusion The clinical manifestations of COVID-19 patients are mainly fever and cough.In the laboratory,the leukocyte counts,neutrophil counts,lymphocyte counts are more normal and eosinophil counts decrease.The CT distribution is characterized by multiple ground hyaline shadows in the periphery of the lower lobe of the lung.