Differential diagnosis of coronavirus disease 2019 from community-acquired-pneumonia by computed tomography scan and follow-up
Open Access
- 26 August 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Infectious Diseases of Poverty
- Vol. 9 (1), 1-11
- https://doi.org/10.1186/s40249-020-00737-9
Abstract
ObjectiveCoronavirus disease 2019 (COVID-19) is currently the most serious infectious disease in the world. An accurate diagnosis of this disease in the clinic is very important. This study aims to improve the differential ability of computed tomography (CT) to diagnose COVID-19 and other community-acquired pneumonias (CAPs) and evaluate the short-term prognosis of these patients.MethodsThe clinical and imaging data of 165 COVID-19 and 118 CAP patients diagnosed in seven hospitals in Anhui Province, China from January 21 to February 28, 2020 were retrospectively analysed. The CT manifestations of the two groups were recorded and compared. A correlation analysis was used to examine the relationship between COVID-19 and age, size of lung lesions, number of involved lobes, and CT findings of patients. The factors that were helpful in diagnosing the two groups of patients were identified based on specificity and sensitivity.ResultsThe typical CT findings of COVID-19 are simple ground-glass opacities (GGO), GGO with consolidation or grid-like changes. The sensitivity and specificity of the combination of age, white blood cell count, and ground-glass opacity in the diagnosis of COVID-19 were 92.7 and 66.1%, respectively. Pulmonary consolidation, fibrous cords, and bronchial wall thickening were used as indicators to exclude COVID-19. The sensitivity and specificity of the combination of these findings were 78.0 and 63.6%, respectively. The follow-up results showed that 67.8% (112/165) of COVID-19 patients had abnormal changes in their lung parameters, and the severity of the pulmonary sequelae of patients over 60years of age worsened with age.ConclusionsAge, white blood cell count and ground-glass opacity have high accuracy in the early diagnosis of COVID-19 and the differential diagnosis from CAP. Patients aged over 60years with COVID-19 have a poor prognosis. This result provides certain significant guidance for the diagnosis and treatment of new coronavirus pneumonia.Keywords
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This publication has 23 references indexed in Scilit:
- Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in ChinaJAMA, 2020
- Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, ChinaJAMA, 2020
- Asymptomatic novel coronavirus pneumonia patient outside Wuhan: The value of CT images in the course of the diseaseClinical Imaging, 2020
- Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case seriesBMJ, 2020
- Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor bindingThe Lancet, 2020
- Clinical features of patients infected with 2019 novel coronavirus in Wuhan, ChinaThe Lancet, 2020
- Emerging coronaviruses: Genome structure, replication, and pathogenesisJournal of Medical Virology, 2020
- Recent advances in the detection of respiratory virus infection in humansJournal of Medical Virology, 2020
- [Clinical features and therapy of persistent bacterial bronchitis in 31 children].Published by Ovid Technologies (Wolters Kluwer Health) ,2016