老年新型冠状病毒Delta变异株感染者的胸部CT表现

Chest CT manifestations of the elderly population infected with SARS-CoV-2 variant Delta in Guangzhou

目的探讨老年新型冠状病毒Delta变异株感染者的胸部CT表现及临床特征。方法对56例老年新型冠状病毒Delta变异株感染者行胸部CT扫描,回顾性分析所选病例的影像、临床资料。结果 56例老年新型冠状病毒Delta变异株感染者入院时临床症状主要表现为咳嗽31例(55.4%),咳痰20例(35.7%),发热15例(26.8%),肌肉酸痛及疲乏6例(10.7%),无症状12例(21.4%);实验室检查外周血C反应蛋白升高32例(57.1%),外周血白细胞计数正常48例(85.7%),降低7例(12.5%),淋巴细胞计数正常27例(48.2%),降低29例(51.8%);入院后临床分型为普通型41例(73.2%),重型、危重型15例(26.8%)。CT表现以磨玻璃密度影为主,共52例(92.9%),双肺受累50例(89.3%),单肺受累6例(10.7%);累及上叶44例(78.6%),中叶27例(48.2%),下叶46例(82.1%),其中3个肺叶受累12例(21.4%),4个肺叶受累8例(14.3%),5个肺叶受累24例(42.9%)。结论老年人群感染新型冠状病毒Delta变异株的重症患者比例较高。老年新型冠状病毒Delta变异株感染者的CT表现为双肺多发磨玻璃密度影,以双肺上叶、下叶胸膜下分布为主,且累及多个肺叶;临床表现主要为咳嗽、咳痰及发热,部分确诊患者可表现无症状。

Objective To study the chest CT imaging and clinical features of COVID-19 confirmed patients infected with SARS-CoV-2 variant Delta in the elderly population in Guangzhou. Methods Chest CT scans were performed on 56 confirmed COVID-19 patients infected with variant Delta, and the imaging and clinical data of the selected cases were retrospectively analyzed. Results The main clinical symptoms of COVID-19 patients infected with variant Delta in the elderlies were cough in 31 cases(55.4%), expectoration in 20 cases(35.7%), fever in 15 cases(26.8%), myalgia or fatigue in 6 cases(10.7%) and no symptoms in 12 cases(21.4%). Laboratory examination showed that C-reactive protein in peripheral blood was increased in 32 cases(57.1%);white blood cell count in peripheral blood was normal in 48 cases(85.7%) and decreased in 7 cases(12.5%);and lymphocyte count was normal in 27 cases(48.2%) and decreased in 29 cases(51.8%). There were 41 cases(73.2%) of common type and 15 cases(26.8%) of severe/critical type. The main CT findings was ground-glass opacities in 52 cases(92.9%);50 cases(89.3%) of bilateral lung involvement;6 cases(10.7%) of single lung involvement;44 cases(78.6%) of upper lobe involvement;27 cases(48.2%) of middle lobe and 46 cases(82.1%) of lower lobe involvements. Among 56 elderly patients, 3 lobes were involved in 12 cases(21.4%), 4 lobes in 8 cases(14.3%) and 5 lobes in 24 cases(42.9%). Conclusion The CT imaging findings of COVID-19 patients infected with variant Delta in the elderly population show multiple ground glass opacities in both lungs, mainly distributed in the subpleural regions of upper and lower lobes, and involved multiple lung lobes. The main clinical manifestations are cough, expectoration and fever;though some confirmed patients are asymptomatic. The elderlies infected with variant Delta had a higher proportion of severe type.