Background The pneumonia caused by the 2019 novel coronavirus (SARS-CoV-2, also called 2019-nCoV) recently break out in Wuhan, China, and was named as COVID-19. With the spread of the disease, similar cases have also been confirmed in other regions of China. We aimed to report the imaging and clinical characteristics of these patients infected with SARS-CoV-2 in Guangzhou, China. Methods All patients with laboratory-identified SARS-CoV-2 infection by real-time polymerase chain reaction (PCR) were collected between January 23, 2020, and February 4, 2020, in a designated hospital (Guangzhou Eighth People's Hospital). This analysis included 90 patients (39 men and 51 women; median age, 50 years (age range, 18-86 years). All the included SARS-CoV-2-infected patients underwent non-contrast enhanced chest computed tomography (CT). We analyzed the clinical characteristics of the patients, as well as the distribution characteristics, pattern, morphology, and accompanying manifestations of lung lesions. In addition, after 1-6 days (mean 3.5 days), follow-up chest CT images were evaluated to assess radiological evolution. Findings The majority of infected patients had a history of exposure in Wuhan or to infected patients and mostly presented with fever and cough. More than half of the patients presented bilateral, multifocal lung lesions, with peripheral distribution, and 53 (59%) patients had more than two lobes involved. Of all included patients, COVID-19 pneumonia presented with ground glass opacities in 65 (72%), consolidation in 12 (13%), crazy paving pattern in 11 (12%), interlobular thickening in 33 (37%), adjacent pleura thickening in 50 (56%), and linear opacities combined in 55 (61%). Pleural effusion, pericardial effusion, and lymphadenopathy were uncommon findings. In addition, baseline chest CT did not show any abnormalities in 21 patients (23%), but 3 patients presented bilateral ground glass opacities on the second CT after 3-4 days. Conclusion SARS-CoV-2 infection can be confirmed based on the patient's history, clinical manifestations, imaging characteristics, and laboratory tests. Chest CT examination plays an important role in the initial diagnosis of the novel coronavirus pneumonia. Multiple patchy ground glass opacities in bilateral multiple lobular with periphery distribution are typical chest CT imaging features of the COVID-19 pneumonia.

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Rationale: Previous studies of coronavirus disease 2019 (COVID-19) were mainly focused on cross-sectional analysis. In this study, we sought to evaluate the dynamic changes of immunological and radiographic features, and the association with the outcome of pulmonary lesions in COVID-19 patients. Methods: Peripheral blood samples and radiographic data were collected longitudinally for up to 8 weeks from 158 laboratory-confirmed COVID-19 patients. The chest computed tomography (CT) scans were scored based on a semi-quantification assessment according to the extent of pulmonary abnormalities; the temporal change of the immunological and radiographic features was analyzed. Results: Compared with mild and moderate patients, severe patients had significantly decreased counts of lymphocytes, CD4 + T cells, CD8 + T cells, and CD19 + B cells but dramatically elevated counts of neutrophils and levels of interleukin (IL)-6. Sequential monitoring showed a sustained increase in lymphocytes counts and significantly decreased levels of IL-6 in severe patients during the disease course. Notably, patients with persistent pulmonary lesions (CT score ≥ 5 in week 8) showed high levels of IL-6 during the follow-up period, compared with those with recovery lesions (CT score < 5 in week 8). More importantly, the peak expression of IL-6 prior to the aggravated lung injury was mainly found in patients with persistent lesions, and multivariate analysis showed that IL-6 level upon admission was an independent factor associated with the persistent pulmonary injury. Conclusion: Prolonged elevation of IL-6 is associated with persistent pulmonary lesions in COVID-19 patients. Sequential monitoring and timely intervention of IL-6 may favor the clinical management of COVID-19.

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Background: This study aims to provide clues for the preoperative and prognostic assessment of hepatocellular carcinoma (HCC) patients with human immunodeficiency virus (HIV) by comparing the imaging characteristics, immunohistochemistry and prognosis of HCC patients with and without HIV infection.Methods: The study reviewed two databases, one for HIV-HCC patients and the other for HCC patients who were not infected with HIV. The inclusion criteria were surgically resected and pathologically diagnosed hepatocellular carcinoma patients from October 2013 to August 2016. This study collected 11 HIV-HCC patients (11 men; median age 45 years old, age range 33~71 years) and 11 HCC patients without HIV infection (11 men; median age 50 years old, age range 42~61 years). The image characteristics of HCC were analysed by computed tomography (CT) imaging. In addition, samples were obtained from resected specimens for immunohistochemical analysis, and the expression of glypican-3 (GPC-3), CD34 and Ki-67 were measured. The independent-samples t test, Fisher exact test and Wilcoxon test were used for comparisons. Kaplan-Meier plots were used for postoperative recurrence-free survival analysis.Results: The median diameter of the largest nodule was significantly larger in the HIV-HCC patients than in the HCC group (P=0.027). In addition, the HIV-HCC patients presented significantly higher CD34 and GPC-3 expression than the HCC patients (P=0.031, 0.007, respectively). Moreover, the postoperative recurrence-free survival time was significantly shorter in the HIV-HCC patients than in the HCC patients (Log-Rank test, c2=6.076, P=0.014), with respective median durations of 4 months and 28 months, respectively. Multivariate Cox model analysis revealed that GPC-3 expression and tumour size were independent prognosis factors in the HCC patients (HR = 4.506, 95% CI :1.247-16.278, P= 0.022; HR = 1.479, 95% CI :1.137-1.923, P = 0.022, respectively).Conclusion: Compared to HCC patients with non-HIV infection, HIV-HCC patients frequently present a larger tumour size and high expression of CD34 and GPC-3, which result in shorter postoperative recurrence-free survival. Observing the tumour expression of CD34, GPC-3, and Ki-67 and imaging characteristics could be helpful in providing a basis for the choice of treatment strategies and the prognosis evaluation of patients.

To determine changes in clinical and radiologic findings associated with Coronavirus disease 2019 (COVID-19) from diagnosis to recovery, we retrospectively reviewed the diagnosis and treatment records of the first patient cured of COVID-19 in Guangzhou. A 55-year-old woman from Wuhan was admitted to the hospital isolation ward with the chief complaint of "cough for 11 days and once fever 8 days ago" on January 22, 2020. COVID-19 was laboratory confirmed by reverse transcription polymerase chain reaction (RT-PCR) assay, and she received conventional antiviral therapy, such as moxifloxacin, traditional Chinese medicine, and arbidol. Repeat chest-computed tomography (CT) scans were performed on days 13 and 19 of her illness. The former showed radiologic findings, including ground-glass opacities (GGOs), which revealed viral pneumonia; the latter revealed that the previous lesions had been significantly absorbed. The lesions on CT scans were consistent with the changes in the course of disease. Some drugs, such as traditional Chinese medicine and arbidol, might play an important role in the recovery of COVID-19 patients. This study provides some new insights into the formulation of a timely and effective diagnostic and therapeutic strategy to cure patients with COVID-19. Keywords Coronavirus disease 2019 • Severe acute respiratory syndrome coronavirus 2 • Radiologic features • First cured patient Dear Editor, Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread worldwide [1], with 5,934,936 confirmed cases as of May 31, 2020 [2]. We would describe the clinical and radiologic features of the first cured case of COVID-19 in Guangzhou, a city with hundreds of confirmed cases. On January 22, 2020, a 55-year-old woman from Wuhan was admitted to the hospital with the chief complaint of "cough for 11 days and once fever 8 days ago" on her visit in Guangzhou (Fig. 1). She reported a visit history to an elderly man with fever of unknown origin in Wuhan on January 11. After that, she had initial symptoms of dry cough, sore throat, and fatigue on January 12 (day 1 of the illness). On day 3 of the illness, she had a fever of 38 °C and went to

The pandemic of coronavirus disease 2019 is “not over,” in fact, the “dynamic clearing” policy for SARS-CoV-2 control and prevention in China has been firmly enforced. This study aimed to analyze the clinical symptoms and dynamic viral RNA changes in 2021 at Guangzhou Eighth People’s Hospital. This study showed that 31.4% of the patients (695/2212) tested negative for viral RNA from admission to the final release from quarantine. Of all negative cases, 86.5% (601/695) remained in the hospital for no more than 5 days and were asymptomatic or mild. Among the remaining 402 patients who stayed for no more than 5 days, 76.4% (307/402) were viral RNA retest positive during the isolation stage. However, 96.4% of the peak viral RNA (296/307) was over Ct = 33 cycles during the isolation stage.