普通型COVID-19与轻症甲型H1N1流感肺炎病人的临床特征和CT表现比较

目的分析普通型新型冠状病毒肺炎(COVID-19)和轻症甲型H1N1流感病人临床特征和CT表现的异同。方法回顾性分析25例普通型COVID-19病人(COVID-19组)平均(36.44±14.68)岁]和20例轻症甲型H1N1流感肺炎病人(H1N1组)平均(51.45±22.72)岁]的临床和CT影像特征,包括病变密度、直径、部位及受累肺叶,以及病变内部特征、肺外表现的发生率及数量。采用卡方检验或Fisher确切概率法或t检验比较2组间临床资料和CT影像特征的发生率;采用Mann-Whitney U检验比较2组间不同特征的病灶数量。结果 COVID-19组病人首次CT检查时间较H1N1组短(分别为2.52±2.40、4.20±3.14 d,P<0.05),平均年龄、体温、外周血中性粒细胞计数及C反应蛋白(CRP)均低于H1N1组(均P<0.05)。2组病人CT影像均以GGO或GGO伴实变影表现为主,COVID-19胸部CT显示肺内实变影发生率及数量均低于H1N1组(均P<0.05),但外周混合磨玻璃影、直径为1~3 cm的病灶数量多于H1N1组(均P<0.05)。2组病人其他临床及CT影像特征的差异均无统计学意义(均P>0.05)。结论普通型COVID-19和甲型轻症H1N1流感病人的发病年龄和发热温度有一定差异,普通型COVID-19的CT影像上更多见1~3 cm的病变,多见分布于肺野外周的混合GGO,实变影少见。

Comparative study of clinical courses and CT findings of patients with pneumonia due to mild type swine influenza H1N1 and general type COVID-19

Objective To analyze similarities and differences in the clinical course and CT characteristics between patients with general type COVID-19 and mild type influenza A H1N1 pneumonia.Methods Retrospective analysis was performed on 25 patients(age,36.44±14.68 years)with general type COVID-19(COVID-19 group),and 20 patients(age,51.45±22.72 years)with mild influenza A H1N1 pneumonia(H1N1 group).The clinical characteristics and CT imaging characteristics(lesion density,diameter,location and involved pulmonary lobes,internal features,and pulmonary manifestations)of the 2 groups were recorded.Chi-square test or Fisher’s exact probability test or t test was used to compare clinical data and incidence of qualitative CT features,and Mann-Whitney U test was used to compare the number of lesions with different characteristics between the two groups.Results The time from onset to the first CT examination of the COVID-19 group was shorter than that of the H1N1 group(2.52±2.40 vs.4.20±3.10 days,P<0.05).The mean age,body temperature,peripheral blood neutrophil count and C-reactive protein(CRP)were lower in the COVID-19 group than in the H1N1 group(all P<0.05).Chest CT mainly showed ground-glass opacity(GGO)or GGO with consolidation in the both groups.The incidence and number of lung consolidation were lower(all P<0.05),but the number of lesions with mixed peripheral GGO and the number of lesions with maximum diameter range from 1 to 3 cm were higher in the COVID-19 group than in the H1N1 group(all P<0.05).There was no statistically significant difference in other clinical and CT features between the two groups(all P>0.05).Conclusions There is a certain difference in onset age and fever temperature between patients with general COVID-19 and mild influenza A H1N1 pneumonia.On CT images,the lesions with the maximum diameter range from 1 to 3 cm,mixed GGO distributed around the peripheral lung field,and rare consolidation are commonly seen in patients with general COVID-19.