Epidemiological, clinical characteristics of cases of SARS-CoV-2 infection with abnormal imaging findings

Abstract Purpose To investigate the epidemiological, clinical characteristics of COVID-19 patients with abnormal imaging findings. Methods Patients confirmed with SARS-CoV-2 infection of Zhejiang province from Jan 17 to Feb 8 underwent CT or x-ray were enrolled. Epidemiological, clinical data were analyzed between those with abnormal or normal imaging findings. Results Excluding 72 patients with normal images, 230 of 573 patients affected more than two lobes. The median radiograph score was 2.0 and there’s negative correlation between the score and oxygenation index (ρ=-0.657,P < 0.001). Patients with abnormal images were older (46.65 ± 13.82), with higher rate of coexisting condition(28.8%), lower rate of exposure history and longer time between onset and confirmation(5d) than non-pneumonia patients(all P < 0.05). Higher rate of fever, cough, expectoration, and headache, lower lymphocytes, albumin, serum sodium levels and higher total bilirubin, creatine kinase, lactate dehydrogenase and C-reactive protein levels and lower oxygenation index were observed in pneumonia patients (all P < 0.05). Muscle ache, shortness of breath, nausea and vomiting, lower lymphocytes levels and higher serum creatinine and radiograph score at admission were predictive factors for severe/critical subtype. Conclusion Patients with abnormal images have more obvious clinical manifestations and laboratory changes. Combing clinical features and radiograph score can effectively predict severe/critical type.