28 patients travel history in the epidemic area,2 patients had the history of contact with confirmed patients. As of Feb 25, 2020, 8 patients were undergoing treatment, and 22 patients have a good recovery and discharged. The interval time from the onset of symptoms to the first CT scan was 1-16 days, the median average was (4 days). Most of the patient present fever, dry cough, Myalgia or fatigue. 47% of patients experienced varying degrees of decline in lymphocyte counts.
Of all patients, only one patient had a negative CT image. The most common CT manifestations were GGO, followed by mix GGO and consolidation (Figure 1). A few patients present pleural effusion. Consolidation (10/30), mix GGO and consolidation (14/30), fibrous stripes (7/30), solid nodules (1/30), solid nodules with halo signs ( 9/30), Reversed halo pattern (2/30), crazy paving (14/30), bronchial wall thickening (7/30), traction bronchiectasis (1/30) as showed in Table 2.
From the perspective of the distribution of the lesions, multi-lobe and segment involvement was predominant, with the lower lobe of the two lungs being the most commonly affected place (Figure 2). 21 of the 30 patients (70%) involved the left lower lobe, and 16 affected the left upper lobe (53%), 17 cases involved the right upper lobe (57%), 9 cases involved the right middle lobe (30%), and 21 cases involved the right lower lobe (70%). Of the 30 patients, only one lung segment was affected in 8 patients (8/30), and the remaining patients (22/30) were affected by two or more lung segments. The whole lung was involved in 9 patients (9/30). Each patient had an average of 3 segmental involvement. Lesion distribution: inner middle band (1/30), subpleural distribution (29/30); the lower lung involvement (28/30) is shown in Table 2.
Lesion severity: The average score of lung involvement severity in 30 patients was 3.5 points (range 0-8, standard deviation 2.3). There were 2 cases of interlobular pleural effusion (2/30) (a small amount of right effusion). Lymphadenopathy, cavities, and “tree in buds” sign were not found in all patients.
During the study period, 21 patients underwent a CT rescan, and the median average time between first chest CT and follow-up was 4.5 days (1-8 days). Of these, 10 patients underwent twice CT follow-ups and 5 patients underwent three times CT follow-up, five patients performed four times CT follow-ups, and one patient performed five CT follow-ups. There were 4 cases present mild exacerbation in CT image during the follow-up, the imaging findings were consistent with clinical symptoms, the patient experienced significant dyspnea and decreased oxygen saturation. 12 cases present continuous improvement, and 5 cases present no significant change (Table 2). One patient had small amount of pleural effusion on the initial CT examination, and disappeared after the second CT examination. One patient had five times of CT examinations. The first CT scan showed solid nodules with halo signs in both lungs. During the second scan, the solid nodules became mixed GGO and consolidation. or GGO, the range increased, and right pleural effusion appeared. The third scan did not change much, the fourth scan showed the infected lesions increased slightly, and the pleural effusion also increased. The fifth scan, pulmonary infection became better, pleural effusion disappeared and the patient discharged with good prognosis (Figure 3). One lung cancer patient underwent a second scan after the initial CT examination, from the thickening of the bronchial wall at the first time to the presence of mixed GGO and consolidation in both lungs at the second time, and the GGO in the left upper lung increased, and the remaining lesions became lighter and smaller at the third time scan (Figure 4).