CT image of novel coronavirus pneumonia: a case report
Identifieur interne : 000290 ( Pmc/Corpus ); précédent : 000289; suivant : 000291CT image of novel coronavirus pneumonia: a case report
Auteurs : Xiangmin Zhang ; Wei Song ; Xingli Liu ; Liang LyuSource :
- Japanese Journal of Radiology [ 1867-1071 ] ; 2020.
Abstract
Knowledge of CT characteristics of COVID-19 pneumonia might be helpful to the early diagnosis and treatment of patients, and to control the spread of infection.
The chest CT images of the patient were collected to describe the CT manifestations and characteristics, and they were compared with the previous studies.
Multiple patchy ground-glass opacities (GGOs) were seen in bilateral lung, mostly in subpleural areas. They progressed within 3 days, and nodular GGOs were also seen together with subpleural patchy GGOs.
Our case of COVID-19 pneumonia showed multiple subpleural GGOs in bilateral lung, rapid progression, and it also accompanied nodular GGOs on chest CT. These findings were consistent with the previous reports, and they might be useful for early detection and evaluation of severity of COVID-19 pneumonia.
Url:
DOI: 10.1007/s11604-020-00945-1
PubMed: NONE
PubMed Central: 7088615
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PMC:7088615Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">CT image of novel coronavirus pneumonia: a case report</title><author><name sortKey="Zhang, Xiangmin" sort="Zhang, Xiangmin" uniqKey="Zhang X" first="Xiangmin" last="Zhang">Xiangmin Zhang</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.414918.1</institution-id><institution>Department of Radiology,</institution><institution>The First People’s Hospital of Yunnan Province,</institution></institution-wrap>No. 157 Jinbi Road, Kunming, 650032 Yunnan China</nlm:aff></affiliation><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.218292.2</institution-id><institution-id institution-id-type="ISNI">0000 0000 8571 108X</institution-id><institution>The Affiliated Hospital Kunming University of Science and Technology,</institution></institution-wrap>Kunming, Yunnan China</nlm:aff></affiliation></author><author><name sortKey="Song, Wei" sort="Song, Wei" uniqKey="Song W" first="Wei" last="Song">Wei Song</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.414918.1</institution-id><institution>Department of Radiology,</institution><institution>The First People’s Hospital of Yunnan Province,</institution></institution-wrap>No. 157 Jinbi Road, Kunming, 650032 Yunnan China</nlm:aff></affiliation><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.218292.2</institution-id><institution-id institution-id-type="ISNI">0000 0000 8571 108X</institution-id><institution>The Affiliated Hospital Kunming University of Science and Technology,</institution></institution-wrap>Kunming, Yunnan China</nlm:aff></affiliation></author><author><name sortKey="Liu, Xingli" sort="Liu, Xingli" uniqKey="Liu X" first="Xingli" last="Liu">Xingli Liu</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.414918.1</institution-id><institution>Department of Radiology,</institution><institution>The First People’s Hospital of Yunnan Province,</institution></institution-wrap>No. 157 Jinbi Road, Kunming, 650032 Yunnan China</nlm:aff></affiliation><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.218292.2</institution-id><institution-id institution-id-type="ISNI">0000 0000 8571 108X</institution-id><institution>The Affiliated Hospital Kunming University of Science and Technology,</institution></institution-wrap>Kunming, Yunnan China</nlm:aff></affiliation></author><author><name sortKey="Lyu, Liang" sort="Lyu, Liang" uniqKey="Lyu L" first="Liang" last="Lyu">Liang Lyu</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.414918.1</institution-id><institution>Department of Radiology,</institution><institution>The First People’s Hospital of Yunnan Province,</institution></institution-wrap>No. 157 Jinbi Road, Kunming, 650032 Yunnan China</nlm:aff></affiliation><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.218292.2</institution-id><institution-id institution-id-type="ISNI">0000 0000 8571 108X</institution-id><institution>The Affiliated Hospital Kunming University of Science and Technology,</institution></institution-wrap>Kunming, Yunnan China</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmc">7088615</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7088615</idno><idno type="RBID">PMC:7088615</idno><idno type="doi">10.1007/s11604-020-00945-1</idno><idno type="pmid">NONE</idno><date when="2020">2020</date><idno type="wicri:Area/Pmc/Corpus">000290</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000290</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">CT image of novel coronavirus pneumonia: a case report</title><author><name sortKey="Zhang, Xiangmin" sort="Zhang, Xiangmin" uniqKey="Zhang X" first="Xiangmin" last="Zhang">Xiangmin Zhang</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.414918.1</institution-id><institution>Department of Radiology,</institution><institution>The First People’s Hospital of Yunnan Province,</institution></institution-wrap>No. 157 Jinbi Road, Kunming, 650032 Yunnan China</nlm:aff></affiliation><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.218292.2</institution-id><institution-id institution-id-type="ISNI">0000 0000 8571 108X</institution-id><institution>The Affiliated Hospital Kunming University of Science and Technology,</institution></institution-wrap>Kunming, Yunnan China</nlm:aff></affiliation></author><author><name sortKey="Song, Wei" sort="Song, Wei" uniqKey="Song W" first="Wei" last="Song">Wei Song</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.414918.1</institution-id><institution>Department of Radiology,</institution><institution>The First People’s Hospital of Yunnan Province,</institution></institution-wrap>No. 157 Jinbi Road, Kunming, 650032 Yunnan China</nlm:aff></affiliation><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.218292.2</institution-id><institution-id institution-id-type="ISNI">0000 0000 8571 108X</institution-id><institution>The Affiliated Hospital Kunming University of Science and Technology,</institution></institution-wrap>Kunming, Yunnan China</nlm:aff></affiliation></author><author><name sortKey="Liu, Xingli" sort="Liu, Xingli" uniqKey="Liu X" first="Xingli" last="Liu">Xingli Liu</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.414918.1</institution-id><institution>Department of Radiology,</institution><institution>The First People’s Hospital of Yunnan Province,</institution></institution-wrap>No. 157 Jinbi Road, Kunming, 650032 Yunnan China</nlm:aff></affiliation><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.218292.2</institution-id><institution-id institution-id-type="ISNI">0000 0000 8571 108X</institution-id><institution>The Affiliated Hospital Kunming University of Science and Technology,</institution></institution-wrap>Kunming, Yunnan China</nlm:aff></affiliation></author><author><name sortKey="Lyu, Liang" sort="Lyu, Liang" uniqKey="Lyu L" first="Liang" last="Lyu">Liang Lyu</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.414918.1</institution-id><institution>Department of Radiology,</institution><institution>The First People’s Hospital of Yunnan Province,</institution></institution-wrap>No. 157 Jinbi Road, Kunming, 650032 Yunnan China</nlm:aff></affiliation><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.218292.2</institution-id><institution-id institution-id-type="ISNI">0000 0000 8571 108X</institution-id><institution>The Affiliated Hospital Kunming University of Science and Technology,</institution></institution-wrap>Kunming, Yunnan China</nlm:aff></affiliation></author></analytic><series><title level="j">Japanese Journal of Radiology</title><idno type="ISSN">1867-1071</idno><idno type="eISSN">1867-108X</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objective</title><p id="Par1">Knowledge of CT characteristics of COVID-19 pneumonia might be helpful to the early diagnosis and treatment of patients, and to control the spread of infection.</p></sec><sec><title>Methods</title><p id="Par2">The chest CT images of the patient were collected to describe the CT manifestations and characteristics, and they were compared with the previous studies.</p></sec><sec><title>Results</title><p id="Par3">Multiple patchy ground-glass opacities (GGOs) were seen in bilateral lung, mostly in subpleural areas. They progressed within 3 days, and nodular GGOs were also seen together with subpleural patchy GGOs.</p></sec><sec><title>Conclusion</title><p id="Par4">Our case of COVID-19 pneumonia showed multiple subpleural GGOs in bilateral lung, rapid progression, and it also accompanied nodular GGOs on chest CT. These findings were consistent with the previous reports, and they might be useful for early detection and evaluation of severity of COVID-19 pneumonia.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Lei, J" uniqKey="Lei J">J Lei</name></author><author><name sortKey="Li, J" uniqKey="Li J">J Li</name></author><author><name sortKey="Li, X" uniqKey="Li X">X Li</name></author><author><name sortKey="Qi, X" uniqKey="Qi X">X Qi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pan, Y" uniqKey="Pan Y">Y Pan</name></author><author><name sortKey="Guan, H" uniqKey="Guan H">H Guan</name></author><author><name sortKey="Zhou, S" uniqKey="Zhou S">S Zhou</name></author><author><name sortKey="Wang, Y" uniqKey="Wang Y">Y Wang</name></author><author><name sortKey="Li, Q" uniqKey="Li Q">Q Li</name></author><author><name sortKey="Zhu, T" uniqKey="Zhu T">T Zhu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ji, W" uniqKey="Ji W">W Ji</name></author><author><name sortKey="Wang, W" uniqKey="Wang W">W Wang</name></author><author><name sortKey="Zhao, X" uniqKey="Zhao X">X Zhao</name></author><author><name sortKey="Zai, J" uniqKey="Zai J">J Zai</name></author><author><name sortKey="Li, X" uniqKey="Li X">X Li</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Huang, C" uniqKey="Huang C">C Huang</name></author><author><name sortKey="Wang, Y" uniqKey="Wang Y">Y Wang</name></author><author><name sortKey="Li, X" uniqKey="Li X">X Li</name></author><author><name sortKey="Ren, L" uniqKey="Ren L">L Ren</name></author><author><name sortKey="Zhao, J" uniqKey="Zhao J">J Zhao</name></author><author><name sortKey="Hu, Y" uniqKey="Hu Y">Y Hu</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Lu, H" uniqKey="Lu H">H Lu</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Jpn J Radiol</journal-id><journal-id journal-id-type="iso-abbrev">Jpn J Radiol</journal-id><journal-title-group><journal-title>Japanese Journal of Radiology</journal-title></journal-title-group><issn pub-type="ppub">1867-1071</issn><issn pub-type="epub">1867-108X</issn><publisher><publisher-name>Springer Japan</publisher-name><publisher-loc>Tokyo</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmc">7088615</article-id><article-id pub-id-type="publisher-id">945</article-id><article-id pub-id-type="doi">10.1007/s11604-020-00945-1</article-id><article-categories><subj-group subj-group-type="heading"><subject>Special Report</subject></subj-group></article-categories><title-group><article-title>CT image of novel coronavirus pneumonia: a case report</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Zhang</surname><given-names>Xiangmin</given-names></name><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Song</surname><given-names>Wei</given-names></name><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Liu</surname><given-names>Xingli</given-names></name><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Lyu</surname><given-names>Liang</given-names></name><address><email>lyuliang0720@hotmail.com</email></address><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff2">2</xref></contrib><aff id="Aff1"><label>1</label><institution-wrap><institution-id institution-id-type="GRID">grid.414918.1</institution-id><institution>Department of Radiology,</institution><institution>The First People’s Hospital of Yunnan Province,</institution></institution-wrap>No. 157 Jinbi Road, Kunming, 650032 Yunnan China</aff><aff id="Aff2"><label>2</label><institution-wrap><institution-id institution-id-type="GRID">grid.218292.2</institution-id><institution-id institution-id-type="ISNI">0000 0000 8571 108X</institution-id><institution>The Affiliated Hospital Kunming University of Science and Technology,</institution></institution-wrap>Kunming, Yunnan China</aff></contrib-group><pub-date pub-type="epub"><day>18</day><month>3</month><year>2020</year></pub-date><fpage>1</fpage><lpage>2</lpage><history><date date-type="received"><day>14</day><month>2</month><year>2020</year></date><date date-type="accepted"><day>2</day><month>3</month><year>2020</year></date></history><permissions><copyright-statement>© Japan Radiological Society 2020</copyright-statement><license><license-p>This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.</license-p></license></permissions><abstract id="Abs1"><sec><title>Objective</title><p id="Par1">Knowledge of CT characteristics of COVID-19 pneumonia might be helpful to the early diagnosis and treatment of patients, and to control the spread of infection.</p></sec><sec><title>Methods</title><p id="Par2">The chest CT images of the patient were collected to describe the CT manifestations and characteristics, and they were compared with the previous studies.</p></sec><sec><title>Results</title><p id="Par3">Multiple patchy ground-glass opacities (GGOs) were seen in bilateral lung, mostly in subpleural areas. They progressed within 3 days, and nodular GGOs were also seen together with subpleural patchy GGOs.</p></sec><sec><title>Conclusion</title><p id="Par4">Our case of COVID-19 pneumonia showed multiple subpleural GGOs in bilateral lung, rapid progression, and it also accompanied nodular GGOs on chest CT. These findings were consistent with the previous reports, and they might be useful for early detection and evaluation of severity of COVID-19 pneumonia.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>COVID-19 pneumonia</kwd><kwd>Ground-glass opacities</kwd><kwd>CT</kwd></kwd-group></article-meta></front><body><sec id="Sec2"><title>Case report</title><p id="Par5">A 64-year-old man had fever repeatedly after catching a cold for 6 days. He felt better after taking the antifebrile agents. One day before visiting the hospital, he had fever again, dizziness and headache, the four limbs ache, but no cough, shivering, chest tightness, chest pain, nausea and vomiting, diarrhea, etc. Recently, the patient traveled from Wuhan to Kunming. He denied medical history of hepatitis, tuberculosis, typhia, contacting with poultry and mosquito bites. He was hospitalized in our hospital on January 21 2020, and still had fever after admission, with the highest temperature of 39.2 ℃. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR was positive. The possibility of combined infection with other pathogens were microbiologically excluded. CT features of the case are similar to the case report by Lei [<xref ref-type="bibr" rid="CR1">1</xref>] and a large series by Pan et al. [<xref ref-type="bibr" rid="CR2">2</xref>] (Fig. <xref rid="Fig1" ref-type="fig">1</xref>).<fig id="Fig1"><label>Fig. 1</label><caption><p><bold>a</bold> Chest CT on admission shows multiple ground-glass opacities in bilateral lungs, mainly in the subpleural areas. <bold>b</bold>: CT image of 3 days later shows marked progression of multiple ground-glass opacities in subpleural areas. <bold>c</bold>, <bold>d</bold> High resolution CT images at the same period of <bold>a</bold> and b, respectively. They show nodular ground-glass opacities in the subpleural areas in upper lobe of left lung, and they significantly progressed within 3 days</p></caption><graphic xlink:href="11604_2020_945_Fig1_HTML" id="MO1"></graphic></fig></p><p id="Par6">COVID-19 pneumonia is infected by seventh known coronaviruses, named 2019-nCoV. 2019-ncov is a kind of virus which has homologous recombination between bat coronavirus and unknown source coronavirus. Its recombination takes place in spike protein S, which can recognize cell surface receptors, and get into cells to proliferation by membrane fusion [<xref ref-type="bibr" rid="CR3">3</xref>]. Fever is the main clinical symptom of COVID-19 pneumonia patients, followed by dry cough, muscle ache or fatigue. Besides these, headache, and hemoptysis and diarrhea may occur in some cases. The incubation is required in some patients, and it takes about 7–10 days, and the severe patients can progress to ARDS [<xref ref-type="bibr" rid="CR4">4</xref>]. The clinical symptoms of COVID-19 pneumonia are the same as the common upper respiratory tract infection, but the chest CT has certain specificity [<xref ref-type="bibr" rid="CR1">1</xref>, <xref ref-type="bibr" rid="CR2">2</xref>]. As medical evidence, CT diagnosis was written in “Diagnosis and Treatment of Pneumonia Infected by 2019-nCoV (trial implementation 5th Edition)” published by National Health Commission of the People’s Republic of China [<xref ref-type="bibr" rid="CR5">5</xref>]. However, it is difficult to distinguish COVID-19 pneumonia from other viral pneumonia on CT findings alone. It is still necessary to clear and definite the epidemiological history, and it should be diagnosed by real-time RT-PCR. There is no specific drug for the treatment of NCP patients. Based on past experience in the treatment of SARS and MERS, some antiviral drugs such as Lopinavir and Ritonavir may play a positive effect in the treatment of NCP patients, while the curative effect still needs further research [<xref ref-type="bibr" rid="CR6">6</xref>].</p><p id="Par7">In conclusion, our case of COVID-19 pneumonia showed multiple subpleural GGOs in bilateral lung, rapid progression, and it also accompanied nodular GGOs on chest CT. These findings were consistent with the previous reports, and they might be useful for early detection and evaluation of severity of COVID-19 pneumonia.</p></sec></body><back><fn-group><fn><p><bold>Publisher's Note</bold></p><p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p></fn></fn-group><notes notes-type="ethics"><title>Compliance with ethical standards</title><notes notes-type="COI-statement"><title>Conflict of interest</title><p id="Par8">The authors declare that they have no conflict of interest.</p></notes><notes><title>Ethical statement</title><p id="Par9">All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.</p></notes><notes><title>Informed consent</title><p id="Par10">Informed consent was obtained from all individual participants included in the study.</p></notes></notes><ref-list id="Bib1"><title>References</title><ref id="CR1"><label>1.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lei</surname><given-names>J</given-names></name><name><surname>Li</surname><given-names>J</given-names></name><name><surname>Li</surname><given-names>X</given-names></name><name><surname>Qi</surname><given-names>X</given-names></name></person-group><article-title>CT Imaging of the 2019 Novel Coronavirus (2019-nCoV) Pneumonia</article-title><source>Radiology</source><year>2020</year><pub-id pub-id-type="doi">10.1148/radiol.2020200236</pub-id><pub-id pub-id-type="pmid">32049600</pub-id></element-citation></ref><ref id="CR2"><label>2.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Pan</surname><given-names>Y</given-names></name><name><surname>Guan</surname><given-names>H</given-names></name><name><surname>Zhou</surname><given-names>S</given-names></name><name><surname>Wang</surname><given-names>Y</given-names></name><name><surname>Li</surname><given-names>Q</given-names></name><name><surname>Zhu</surname><given-names>T</given-names></name><etal></etal></person-group><article-title>Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China</article-title><source>J Eur Radiol</source><year>2020</year><pub-id pub-id-type="doi">10.1007/s00330-020-06731-x</pub-id></element-citation></ref><ref id="CR3"><label>3.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ji</surname><given-names>W</given-names></name><name><surname>Wang</surname><given-names>W</given-names></name><name><surname>Zhao</surname><given-names>X</given-names></name><name><surname>Zai</surname><given-names>J</given-names></name><name><surname>Li</surname><given-names>X</given-names></name></person-group><article-title>Homologous recombination within the spike glycoprotein of the newly identified coronavirus may boost cross-species transmission from snake to human</article-title><source>J Med Virol.</source><year>2020</year><pub-id pub-id-type="doi">10.1002/jmv.25682</pub-id><pub-id pub-id-type="pmid">31967321</pub-id></element-citation></ref><ref id="CR4"><label>4.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Huang</surname><given-names>C</given-names></name><name><surname>Wang</surname><given-names>Y</given-names></name><name><surname>Li</surname><given-names>X</given-names></name><name><surname>Ren</surname><given-names>L</given-names></name><name><surname>Zhao</surname><given-names>J</given-names></name><name><surname>Hu</surname><given-names>Y</given-names></name><etal></etal></person-group><article-title>Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China</article-title><source>Lancet</source><year>2020</year><pub-id pub-id-type="doi">10.1016/S0140-6736(20)30183-5</pub-id></element-citation></ref><ref id="CR5"><label>5.</label><mixed-citation publication-type="other">National Health Commission of the People’s Republic of China. 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