贵州省家庭聚集性发病的新型冠状病毒肺炎临床及CT影像特征

Clinical and CT Features of Family Cluster Coronavirus Disease 2019 in Guizhou Province

目的:探讨贵州省家庭聚集性发病新型冠状病毒肺炎(COVID-19)患者的临床及CT影像特征。方法:回顾性分析我院及合作医院经实时荧光RT-PCR核酸确诊新型冠状病毒(SARS-CoV-2)感染6组家庭患者的临床表现、实验室检查及肺部CT表现。结果:6组家庭均有明确的流行病学史和家庭暴露史,部分家庭聚集性发病患者SARS-CoV-2核酸需多次检测确诊。发热10例,无发热4例,干嗽7例,其中2例COVID-19无明显临床症状。肺部CT12例见肺内病灶浸润,早期表现为肺内多发小片状磨玻璃密度影为主,以双肺下叶胸膜下非对称分布为特点;进展期多合并实变影及少许索条状影。2例患者CT肺部未见异常。结论:家庭聚集性发病COVID-19患者需注意密切接触无症状患者也可能成为感染源,临床行胸部CT筛查及早期识别密切接触者至关重要,可能成为疫情控制的关键节点,掌握聚集性发病的临床及胸部CT征像有利于早期诊断并指导临床早期隔离和治疗。

Purpose:To analyze clinical presentations and CT features of family cluster corona virus disease 2019 in Guizhou province.Methods:We retrospectively collected and analyzed data on patients with laboratoryconfirmed SARS-CoV-2 infection by real-time RT-PCR.Clinical physical,laboratory examinations,chest CT and laboratory results of six family cluster corona virus diseases 2019 were collected.Results:Six family cluster corona virus diseases 2019 had a typical history of epidemiological and family exposure.The positive test rate of COVID-19 in the second or third generation of some families was less than that in the first generation.Common symptoms at the onset of illness were fever(10 of 14 patients),cough(7),normal temperature(4),and 2 had no obvious clinical symptoms on admission.Twelve patients had pneumonia with abnormal findings on chest CT.The lesions were more common in ground-glass and consolidation shadows,with multi-lobe involvement in the lungs predominantly,and were characterized by an asymmetrical distribution of the sub-pleural lower lobe.Two patients had normal findings on chest CT.Conclusions:Close contact with asymptomatic COVID-19 patients may also be a source of infection.It is crucial for asymptomatic patient chest CT screening to control an epidemic of COVID-19.Analyzing CT imaging signs of COVID-19 patients are helpful for early diagnosis and treatment isolation.