Clinical and CT features of mild-to-moderate COVID-19 cases after two sequential negative nucleic acid testing results: a retrospective analysis

Abstract

Background The clinical and imaging features of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections that progressed to coronavirus disease 2019 (COVID-19) have been explored in numerous studies. However, little is known about these features in patients who received negative respiratory nucleic acid test results after the infections resolved. In this study, we aim to describe these features in a group of Chinese patients. Methods This retrospective study includes 51 patients with mild-to-moderate COVID-19 (median age: 34.0 years and 47.1% male) between January 31 and February 28, 2020. Demographic, clinical, laboratory, and computed tomography (CT) imaging data were collected before and after two consecutive negative respiratory SARS-CoV-2 tests. Results Following a negative test result, the patients’ clinical symptoms continued to recover, but abnormal imaging findings were observed in all moderate cases. Specifically, 77.4% of patients with moderate COVID-19 exhibited multi-lobar lung involvement and lesions were more frequently observed in the lower lobes. The most common CT imaging manifestations were ground-glass opacities (51.6%) and fibrous stripes (54.8%%). Twelve of the 31 patients with moderate COVID-19 underwent repeated chest CT scans after a negative SARS-CoV-2 test. Among them, the ground-glass opacities decreased by > 60% within 1 week in seven patients (58.3%), but by < 5% in four patients (13.8%). Conclusions Following a positive and subsequent negative SARS-CoV-2 tests, patients with COVID-19 continued to recover despite exhibiting persistent clinical symptoms and abnormal imaging findings.

The efficacy and adverse effects of favipiravir on patients with COVID-19: A systematic review and meta-analysis of published clinical trials and observational studies

“…Chest radiological imaging, which had slower recovery rate ( Rong et al, 2021 ), still showed fibrotic-like changes on more than 1/3 of severe patients with COVID-19 after 6 months ( Han et al, 2021 ), and therefore, in our analysis, this outcome was found to be significantly better after 10 days on chest x-ray and 14-15 days on computerized tomography imaging. This suggested a favorable outcome in the long term for favipiravir groups.…”

A rapid RNA extraction-free lateral flow assay for molecular point-of-care detection of SARS-CoV-2 augmented by chemical probes

“…Currently, three approaches, i.e., reverse-transcription polymerase chain reaction (RT-PCR), serological/immunological antigen-based tests and chest computed tomography (CT), are generally used for COVID-19 diagnosis ( Lukas et al, 2020 ; Udugama et al, 2020 ; Valera et al, 2021 ). Of the above, chest CT is a key screening tool for patients with COVID-19 symptoms ( Cai et al, 2020 ; Rong et al, 2021 ). Despite being widely available in cities, CT facilities typically do not reliably detect COVID-19 infection in its early stages, making them unsuitable for intensive patient surveillance.…”

Chest Computed Tomography (CT) and Clinical Findings Among COVID-19 Patients of Tertiary Hospital in Bangladesh

“…Most patients have a fever (91.3%) and cough (76 %), similar to another study that reported that 93.3% of cases had a fever and 86.1% had a cough. Another study reported admission symptoms of mild-to-moderate cases which is in contrast to a Bangladesh study that included many non-critical patients who had a fever (79%), weakness (68%), cough (45%), altered sensation of taste or smell (35%), headache (32%) and body ache (32%) (Rong et al, 2021).…”

“…A chest CT scan was frequently used in the diagnosis and disease prognosis of COVID-19 (Ai et al, 2020;Dey et al, 2020;Islam et al, 2020). The COVID-19 diagnosis involves a combination of epidemiological history, clinical manifestations, early chest CT examinations, and RT-PCR, with a particular emphasis on definite epidemiological history and early chest CT findings when positive RT-PCR tests lag, or test results are negative but clinically positive signs are shown (Ai et al, 2020;Rong et al, 2021). Only a few studies were conducted on a limited number of chest CT image findings among Bangladeshi COVID-19 patients (Biswas et al, 2021;Clump et al, 2020).…”