Temporal radiographic changes in COVID-19 patients: relationship to disease severity and viral clearance
Temporal radiographic changes in COVID-19 patients: relationship to disease severity and viral clearance
COVID-19 is “public enemy number one” and has placed an enormous burden on health authorities across the world. Given the wide clinical spectrum of COVID-19, understanding the factors that can predict disease severity will be essential since this will help frontline clinical staff to stratify patients with increased confidence. To investigate the diagnostic value of the temporal radiographic changes, and the relationship to disease severity and viral clearance in COVID-19 patients. In this retrospective cohort study, we included 99 patients admitted to the Renmin Hospital of Wuhan University, with laboratory confirmed moderate or severe COVID-19. Temporal radiographic changes and viral clearance were explored using appropriate statistical methods. Radiographic features from HRCT scans included ground-glass opacity, consolidation, air bronchogram, nodular opacities and pleural effusion. The HRCT scores (peak) during disease course in COVID-19 patients with severe pneumonia (median: 24.5) were higher compared to those with pneumonia (median: 10) (p = 3.56 × 10
−12), with more frequency of consolidation (p = 0.025) and air bronchogram (p = 7.50 × 10
−6). The median values of days when the peak HRCT scores were reached in pneumonia or severe pneumonia patients were 12 vs. 14, respectively (p = 0.048). Log-rank test and Spearman’s Rank-Order correlation suggested temporal radiographic changes as a valuable predictor for viral clearance. In addition, follow up CT scans from 11 pneumonia patients showed full recovery. Given the values of HRCT scores for both disease severity and viral clearance, a standardised HRCT score system for COVID-19 is highly demanded.
Liu, Xiaofan
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Zhou, Hong
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Zhou, Yilu
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Wu, Xiaojun
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Zhao, Yang
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Lu, Yang
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Tan, Weijun
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Yuan, Mingli
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Ding, Xuhong
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Zou, Jinjing
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Li, Ruiyun
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Li, Hailing
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Ewing, Robert
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Hu, Yi
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Nie, Hanxiang
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Wang, Yihua
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1 December 2020
Liu, Xiaofan
63ada03c-0c3f-4743-b427-b28fa491c522
Zhou, Hong
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Zhou, Yilu
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Wu, Xiaojun
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Zhao, Yang
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Lu, Yang
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Tan, Weijun
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Yuan, Mingli
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Ding, Xuhong
5ea70763-16de-48b0-8e55-1b085ba5c11b
Zou, Jinjing
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Li, Ruiyun
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Li, Hailing
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Ewing, Robert
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Hu, Yi
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Nie, Hanxiang
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Wang, Yihua
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Liu, Xiaofan, Zhou, Hong, Zhou, Yilu, Wu, Xiaojun, Zhao, Yang, Lu, Yang, Tan, Weijun, Yuan, Mingli, Ding, Xuhong, Zou, Jinjing, Li, Ruiyun, Li, Hailing, Ewing, Robert, Hu, Yi, Nie, Hanxiang and Wang, Yihua
(2020)
Temporal radiographic changes in COVID-19 patients: relationship to disease severity and viral clearance.
Scientific Reports, 10 (1), [10263].
(doi:10.1038/s41598-020-66895-w).
Abstract
COVID-19 is “public enemy number one” and has placed an enormous burden on health authorities across the world. Given the wide clinical spectrum of COVID-19, understanding the factors that can predict disease severity will be essential since this will help frontline clinical staff to stratify patients with increased confidence. To investigate the diagnostic value of the temporal radiographic changes, and the relationship to disease severity and viral clearance in COVID-19 patients. In this retrospective cohort study, we included 99 patients admitted to the Renmin Hospital of Wuhan University, with laboratory confirmed moderate or severe COVID-19. Temporal radiographic changes and viral clearance were explored using appropriate statistical methods. Radiographic features from HRCT scans included ground-glass opacity, consolidation, air bronchogram, nodular opacities and pleural effusion. The HRCT scores (peak) during disease course in COVID-19 patients with severe pneumonia (median: 24.5) were higher compared to those with pneumonia (median: 10) (p = 3.56 × 10
−12), with more frequency of consolidation (p = 0.025) and air bronchogram (p = 7.50 × 10
−6). The median values of days when the peak HRCT scores were reached in pneumonia or severe pneumonia patients were 12 vs. 14, respectively (p = 0.048). Log-rank test and Spearman’s Rank-Order correlation suggested temporal radiographic changes as a valuable predictor for viral clearance. In addition, follow up CT scans from 11 pneumonia patients showed full recovery. Given the values of HRCT scores for both disease severity and viral clearance, a standardised HRCT score system for COVID-19 is highly demanded.
Text
COVID19- CT features - SR
- Accepted Manuscript
More information
Accepted/In Press date: 29 May 2020
e-pub ahead of print date: 24 June 2020
Published date: 1 December 2020
Additional Information:
Funding Information:
This project was funded by a Key Project of Science and Technology on COVID-19 of Hubei Province [No. 2020FCA002] and partly by Medical Research Council (UK) [MR/S025480/1]. Y.Z. was supported by an Institute for Life Sciences (University of Southampton) PhD Studentship. We acknowledge all the patients involved in this study, and appreciate all the frontline medical and nursing staff involved in the diagnosis and treatment of patients in Wuhan. We thank Prof Donna Davies and Dr Mark G. Jones for critical reading. The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The corresponding authors (Y.H., H.N. and Y.W.) had full access to all the data in the study and had final responsibility for the decision to submit for publication.
Publisher Copyright:
© 2020, The Author(s).
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Local EPrints ID: 441091
URI: http://eprints.soton.ac.uk/id/eprint/441091
ISSN: 2045-2322
PURE UUID: a3826d5c-43bf-4e7f-97c8-39e25bc0546e
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Date deposited: 01 Jun 2020 16:30
Last modified: 17 Mar 2024 03:39
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Contributors
Author:
Xiaofan Liu
Author:
Hong Zhou
Author:
Xiaojun Wu
Author:
Yang Zhao
Author:
Yang Lu
Author:
Weijun Tan
Author:
Mingli Yuan
Author:
Xuhong Ding
Author:
Jinjing Zou
Author:
Ruiyun Li
Author:
Hailing Li
Author:
Yi Hu
Author:
Hanxiang Nie
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