CT imaging and clinical course of asymptomatic cases with COVID-19 pneumonia at admission in Wuhan, China

Abstract

Aimed to characterize the CT imaging and clinical course of asymptomatic cases with COVID-19 pneumonia. Methods: Asymptomatic cases with COVID-19 pneumonia confirmed by SARS-COV-2 nucleic acid testing in Renmin Hospital of Wuhan University were retrospectively enrolled. The characteristics of CT imaging and clinical feature were collected and analyzed. Results: 58 asymptomatic cases with COVID-19 pneumonia admitted to our hospital between Jan 1, 2020 and Feb 23, 2020 were enrolled. All patients had history of exposure to SARS-CoV-2. On admission, patients had no symptoms and laboratory findings were normal. The predominant feature of CT findings in this cohort was ground glass opacity (GGO) (55, 94.8%) with peripheral (44, 75.9%) distribution, unilateral location (34, 58.6%) and mostly involving one or two lobes (38, 65.5%), often accompanied by characteristic signs. After short-term follow-up, 16 patients (27.6%) presented symptoms with lower lymphocyte count and higher CRP, mainly including fever, cough and fatigue. The evolution of lesions on CT imaging were observed in 10 patients (17.2%). The average days of hospitalization was19.80 ±10.82 days, and was significantly longer in progression patients (28.60 ±7.55 day). Conclusion: CT imaging of asymptomatic cases with COVID-19 pneumonia has definite characteristics. Since asymptomatic infections as "covert transmitter", and some patients can progress rapidly in the short term. It is essential to pay attention to the surveillance of asymptomatic patients with COVID-19. CT scan has great value in screening and detecting patients with COVID-19 pneumonia, especially in the highly suspicious, asymptomatic cases with negative nucleic acid testing.

Association between clinical characteristics and short-term outcomes in adult male COVID-19 patients with mild clinical symptoms: a single-center observational study

“…Very few patients in our cohort had cough (2 patients) or shortness of breath (2 patients), even though a majority of patients (85, 68.0%) had abnormal chest imaging ndings. This is consistent with a previous report that documented typical abnormal chest imaging ndings in asymptomatic patients with COVID-19 [22]. Therefore, we recommend chest imaging study of all patients with COVID-19, including those with mild symptoms.…”

Asymptomatic SARS-CoV-2 infections: a living systematic review and meta-analysis

“…22 44 Three studies addressed only this review question. 27 37 45 The proportion that develops symptoms is the proportion of people with pre-symptomatic SARS-CoV-2 infection. The findings from the 15 studies were heterogeneous ( Figure S3a), even when categorised according to the method of selection of asymptomatic participants and we did not estimate a summary measure ( Figure 2).…”

Clinical Characteristics of COVID-19 and the Value of Mulbsta Scoring System in Prognosis Evaluation

“…Clinically, we found that some patients with COVID-19 have mild or no symptoms, but they have the same infectivity [6]. At the same time, they also have the possibility of transforming into severe cases, which is the di culty of our epidemic prevention and treatment, so it is particularly important to preliminarily determine the patient's condition change through the disease state at the time of admission.…”