普通型与重型/危重型COVID-19病人的CT表现及临床特征比较

目的探讨新型冠状病毒肺炎(COVID-19)不同临床分型的CT影像表现及临床特征。方法回顾性分析2020年1月24日-2月17日确诊的189例COVID-19病人的临床及首诊CT影像资料,男91例,女98例,平均(46.5±16.6)岁。全部病人分为普通组(普通型,153例)和重症组(重型/危重型,36例)。采用卡方检验或t检验比较2组临床特征及CT影像表现间的差异。结果与普通组相比,重症组的男性占比(72.2%)、平均年龄(55.9±15.4)岁]更高(均P<0.05),合并高血压、糖尿病的比例以及头晕、头痛、全身酸痛、气促及高热的发生率也更高(均P<0.05),白细胞、淋巴细胞及中性粒细胞异常的比率均高于普通组(均P<0.05)。重症组病人全部表现为双肺受累,累及范围达10个肺段以上,人均病灶数量大于普通组(24.8±13.5∶12.3±8.8,P<0.05)。重症组出现单纯实变影、胸膜下线的比例高于普通组(均P<0.05)。结论普通型与重型/危重型COVID-19病人的临床症状、实验室检查及CT影像表现方面均存在差异,了解和掌握这些差异性,有助于临床及影像科医生对COVID-19病人进行病情评估。

Comparison of CT and clinical features between common and severe/critical type of COVID-19 patients

Objective To investigate the CT findings and clinical features of COVID-19 patients with different clinical subtypes.Methods Retrospective analysis was performed on the clinical and the initial CT imaging data of 189 COVID-19 patients(91 males and 98 females,mean age 46.5±16.6 years)from January 24 to February 17,2020.They were divided into common group(common type,153 cases)and severe group(severe or critical type,36 cases).Chi-square test or t test was used to compare the clinical features and CT findings between the two groups.Results The proportion of males(72.2%),age(55.9±15.4 years),incidences of hypertension,diabetes,dizziness,headache,aches and pains,shortness of breath and high fever,and rate of abnormal leukocyte,lymphocyte and neutrophil were higher in the severe group than in the commin group(all P<0.05).The lesions involved bilateral lungs,more than 10 lung segments in all patients in the severe group.The number of lesions(24.8±13.5 vs 12.3±8.8)and rates of simple consolidation shadow and subpleural effusionin were higher in the severe group than in the common group(all P<0.05).Conclusion There are significant differences in clinical symptoms,laboratory examination and CT findings between patients with common COVID-19 and patients with severe/critical COVID-19.Understanding and mastering these differences is helpful for clinicians and radiologists in severity assessment of COVID-19 patients.