Early clinical and CT features of COVID-19 and community-acquired pneumonia from a fever observation ward in Ningbo, China

Singapore Med J. 2022 Apr;63(4):219-224. doi: 10.11622/smedj.2021004. Epub 2021 Jan 21.

Abstract

Introduction: We aimed to compare the early clinical manifestations, laboratory results and chest computed tomography (CT) images of COVID-19 patients with those of other community-acquired pneumonia (CAP) patients to differentiate CAP from COVID-19 before reverse transcription-polymerase chain reaction results are obtained.

Methods: The clinical and laboratory data and chest CT images of 51 patients were assessed in a fever observation ward for evidence of COVID-19 between January and February 2020.

Results: 24 patients had laboratory-confirmed COVID-19, whereas 27 individuals had negative results. No statistical difference in clinical features was found between COVID-19 and CAP patients, except for diarrhoea. There was a significant difference in lymphocyte and eosinophil counts between COVID-19 and CAP patients. In total, 22 (91.67%) COVID-19 patients had bilateral involvement and multiple lesions according to their lung CT images; the left lower lobe (87.50%) and right lower lobe (95.83%) were affected most often, and all lesions were located in the peripheral zones of the lung. The most common CT feature of COVID-19 was ground-glass opacity, found in 95.83% of patients, compared to 66.67% of CAP patients.

Conclusion: Diarrhoea, lymphocyte counts, eosinophil counts and CT findings (e.g. ground-glass opacity) could help to distinguish COVID-19 from CAP at an early stage of infection, based on findings from our fever observation ward.

Keywords: COVID-19; SARS-CoV-2; clinical features; high-resolution CT; pneumonia.

MeSH terms

  • COVID-19* / diagnostic imaging
  • China
  • Community-Acquired Infections* / diagnostic imaging
  • Diarrhea / pathology
  • Fever
  • Humans
  • Lung / diagnostic imaging
  • Retrospective Studies
  • SARS-CoV-2
  • Tomography, X-Ray Computed / methods