Chest CT and Clinical Follow-up of Discharged Patients with COVID-19 in Wenzhou City, Zhejiang, China

Link to article at PubMed

Ann Am Thorac Soc. 2020 Jul 21. doi: 10.1513/AnnalsATS.202004-324OC. Online ahead of print.


RATIONALE: Many clinical studies focused on the epidemiological and clinical characteristics of the inpatients with COVID-19. However, there are few reports about clinical follow-up about discharged patients.

OBJECTIVES: This paper aimed to describe the follow-up of patients with COVID-19 in Wenzhou city, Zhejiang, China.

METHODS: We retrospectively reviewed 4-week follow-ups in patients with COVID-19, including CT chest scanning, blood test, and oropharyngeal swab test of SARS-CoV-2 RNA. The chest CT scan and blood test were performed on the last day before discharge, two weeks and four weeks after discharge. The oropharyngeal swab test was performed on both one week and two weeks after the discharge. Fifty-one common COVID-19 patients were enrolled in the study. All the CT and clinical data were collected between January, 23 and March, 28, 2020.

RESULTS: Compared with the last CT scan before discharge, the abnormalities in lungs were gradually absorbed in the first and second follow-ups after discharge. The cases with focal ground-glass opacity (GGO) reduced from 17.7% to 9.8%. The cases with multiple GGO decreased from 80.4% to 23.5%. The cases with consolidation reduced from 49.0% to 2.0%. The cases with interlobular septal thickening reduced from 80.4% to 35.3%. The cases with subpleural lines reduced from 29.4% to 7.8%. The cases with irregular lines reduced from 41.2% to 15.7%. The lung lesions of 25.5% patients were fully absorbed in the first CT scans after discharge and the rate of lung recovery increased to 64.7% after the second follow-up. Nucleic acid tests turned recurrently positive in 17.6% discharged patients, in which only 33.3% patients complained clinical symptoms. There were no differences in the characteristics of the last CT before discharge between the patients with recurrently positive test and patients with negative test. The lung damages were fully absorbed in 55.6% discharged patients with recurrence of positive SARS-CoV-2 RNA.

CONCLUSIONS: The lung damage due to COVID-19 could be reversible for the common COVID-19 patients. A few cases showed recurring positive results of nucleic acid tests after discharge.

PMID:32692945 | DOI:10.1513/AnnalsATS.202004-324OC

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