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Chest CT study of fifteen COVID-19 patients with positive RT-PCR retest results after discharge

Chenxi Li, Fan Luo, Liqiu Xie, Yueqin Gao, Na Zhang, Bing Wu

2020Quantitative Imaging in Medicine and Surgery20 citationsDOIOpen Access PDF

Abstract

BACKGROUND: Our hospital is a designated institution for COVID-19 patients in Chengdu, China. This study aimed to analyze the clinical and chest CT features of 15 COVID-19 patients with positive reverse transcription-polymerase chain reaction (RT-PCR) retest results after discharge. Patients who met the current standards of discharge could still carry the SARS-CoV-2 virus. METHODS: Clinical manifestations, laboratory data, and chest CT images were retrospectively reviewed and analyzed. RESULTS: The most common symptoms at Covid-19COVID-19 initial onset were fever (12/15, 80%) and cough (11/15, 73.3%). Most of the patients had a normal white blood cells (12/15, 80%), neutrophils (12/15, 80%), and lymphocytes count (13/15, 86.7%); some patients had increased C-reactive protein (CRP) (5/15, 33.3%), and increased lactate dehydrogenase (LDH) (4/15, 26.7%) during first admission. Five patients (33.3%) had a cough before their first discharge. The average interval from the first discharge to re-admission was 17 days (range, 9-30 days). At re-admission, two (13.3%) patients presented with cough, and one (6.6%) had chest pain with anxiety. At re-admission, all patients had normal clinical results except five (33.3%) patients had increased CRP compared with first discharging, two (13.3%) patients had increased neutrophils count, and one (6.6%) had increased CRP. The majority of patients had normal procalcitonin. Ground glass opacities (GGOs) and reticulation in the peripheral and subpleural areas were the most common CT manifestations, and six patients (40%) showed a transformation from reticulation to GGOs when re-admitted. CONCLUSIONS: There may be no specific clinical characteristics to predict the re-detectability of the virus. A regular medical observation and a bi-monthly follow-up is recommended.

Topics & Concepts

MedicineProcalcitoninInternal medicineChest painGastroenterologyWhite blood cellLactate dehydrogenaseCoronavirus disease 2019 (COVID-19)DiseaseInfectious disease (medical specialty)SepsisEnzymeBiochemistryChemistryCOVID-19 Clinical Research StudiesLong-Term Effects of COVID-19Dermatological and COVID-19 studies