Key Points of Clinical and CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV) Imported Pneumonia Based On 21 Cases Analysis

  1. Z.F. Xu
  2. W.X. Wu
  3. Y.B. Jin
  4. A.Z. Pan

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Abstract

Background and Objective

WHO Director-General declared that the 2019-nCoV outbreak constitutes a Public Health Emergency of International Concern,and the outbreak is still on-going.Chest CT had been a key component of the diagnostic workup for patients with suspected infection. In this retrospective study, we attempt to summarize and analyze the chest CT features of 2019-nCov infections, and to identify the typical features to improved the diagnostic accuracy of new coronavirus pneumonia (NCP).

Methods

Chest CT scans and Clinical data of 21 patients confirmed NCP in our hospital were enrolled.These patients were divided into mild and sever group according to clinical manifestations described by the 6th clinical practice guideline of NCP in China. Main clinical and chest CT features were analyzed and identify.

Results

Fever (85.7%) and cough (80.9%) were the two main symptoms of NCP patients.More significantly higher incidence (85.7%) of shortness of breath in the severe cases. Multiple lesions in both lungs and with incidence of GGO(100%),vascular enlargement (76.5%) and cobblestone/reticular pattern(70.6%) were the major feature.The incidence of consolidation, mixed pattern and vascular enlargement features were up to 100% in the severe group, significantly higher than that of patients in mild group. In addition, the incidence of air-bronchogram, dilated bronchi with thickened wall and fibrosis in the severe group was significantly higher than that in the mild group.

Conclusions

Fever and cough are the typical clinical features of NCP patients, and chest CT mainly manifested as multiple lesions in both lungs, often accompanied by GGO, vascular enlargement and cobblestone/reticular pattern.Changes in these main CT features can indicate development of the disease

Summary

2019 novel Coronavirus (2019-nCov) had typical clinical manifestations (fever and cough), and presented with characteristic chest CT imaging features (multiple lesions in both lungs, often accompanied by GGO, vascular enlargement and cobblestone/reticular pattern), which are helpful to the radiologist in the early detection and diagnosis of this emerging global health emergency. In addition, changes in these main CT features can indicate development of the disease.

Highlights

  • Fever (85.7%) and cough (80.9%) were the two main symptoms of NCP patients.The incidence of shortness of breath was 85.7% in the severe cases, significantly higher than 21.4% in the mild cases.

  • Multiple lesions in both lungs and with incidence of GGO (100%), vascular enlargement (76.5%) and cobblestone/reticular pattern (70.6%) were the major features of NCP patients. 85.7% of cases in serve group displayed 4-5 lobes were involved simultaneously.

  • Changes in these main CT imaging features can indicate development of the disease. About 19.1% of patients (4 of 21) presented with a normal CT.

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    1. ScreenIT

      SciScore for 10.1101/2020.03.03.20030775: (What is this?)

      Please note, not all rigor criteria are appropriate for all manuscripts.

      Table 1: Rigor

      Institutional Review Board StatementIRB: Our institutional review board approved this retrospective study analyzing existing patient data with patient information de-identified and all subjects gave written informed consent.
      Consent: Our institutional review board approved this retrospective study analyzing existing patient data with patient information de-identified and all subjects gave written informed consent.
      Randomizationnot detected.
      Blindingnot detected.
      Power Analysisnot detected.
      Sex as a biological variablenot detected.

      Table 2: Resources

      Software and Algorithms
      SentencesResources
      2.3 Statistical Analysis: We used statistical software SPSS 2.0.
      SPSS
      suggested: (SPSS, RRID:SCR_002865)

      Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

      Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
      4.2 Limitations: The main limitations of this study, firstly, the small number of NCP cases enrolled in this study and additional study cases are needed in the following study. Besides, This study lacks patient follow-up data, so further follow-up is needed to better observe the relationship between CT signs and clinical course.

      Results from TrialIdentifier: No clinical trial numbers were referenced.

      Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

      Results from JetFighter: We did not find any issues relating to colormaps.

      Results from rtransparent:
      • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
      • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
      • No protocol registration statement was detected.

      About SciScore

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    2. Version published to 10.1101/2020.03.03.20030775v1 on medRxiv