ISSN 1004-4140
CN 11-3017/P
WANG X, YUAN L B, WANG W, et al. Chest Computed Tomography Findings of Patients with Severe COVID-19 Complicated with Other Pathogens[J]. CT Theory and Applications, 2023, 32(5): 613-620. DOI: 10.15953/j.ctta.2023.054. (in Chinese).
Citation: WANG X, YUAN L B, WANG W, et al. Chest Computed Tomography Findings of Patients with Severe COVID-19 Complicated with Other Pathogens[J]. CT Theory and Applications, 2023, 32(5): 613-620. DOI: 10.15953/j.ctta.2023.054. (in Chinese).

Chest Computed Tomography Findings of Patients with Severe COVID-19 Complicated with Other Pathogens

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  • Received Date: March 13, 2023
  • Revised Date: April 15, 2023
  • Accepted Date: April 15, 2023
  • Available Online: May 03, 2023
  • Published Date: September 21, 2023
  • Objective: To describe the characteristics of chest computed tomography (CT) findings of patients with severe COVID-19 complicated with other pathogens. Method: Chest CT data and outcomes of patients with severe COVID-19 complicated with other pathogens were retrospectively analyzed. Results: Twenty-seven patients were included in the study. Etiological examination showed that bacteria were isolated in 13 patients, fungi in 2 patients, and bacteria and fungi in the remaining 12 patients. Multiple lung lesions were found in the chest CT images of all 27 patients. Excluding the chest CT images of 6 patients with typical novel coronavirus pneumonia features, the remaining 21 cases mostly showed scattered or diffuse ground-glass, mixed density, patchy, and patchy-solid shadows distributed in the lung segments or lobes. Some of them were scattered in nodules or central lobular nodules, with the thickened interlobular septum showing "paving stone sign" and "vascular thickening sign" in the ground glass shadow, and air bronchial air images were visible in the solid shadows. Pleural effusion was found in most cases, with pulmonary air sacs in few cases, and mild lymph node enlargement in scattered cases. According to the outcomes, the patients were grouped into 6 patients who survived and 21 patients who died. The proportion of ground glass shadow and ground glass with solid shadow in the lung of the patients who died was higher than that of the patients who survived, and the other imaging findings were not statistically different. Conclusion: Secondary infections in patients with severe COVID-19 were mainly bacterial and fungal infections, with most infections were mixed pathogens. Chest CT images mainly showed ground glass, mixed density shadow, consolidation shadow, and nodular shadow without specific location distribution, and most cases were accompanied with pleural effusion, a few with lung sacs, and scattered cases with mild enlargement of chest lymph nodes, pavement stone sign, and vascular thickening sign. It showed the diverse imaging features of COVID-19 cases complicated with bacterial and fungal infections.
  • [1]
    CEVIK M, KUPPALLI K, KINDRACHUK J, et al. Virology, transmission, and pathogenesis of SARS-CoV-2[J]. British Medical Journal, 2020, 371: m3862.
    [2]
    韩晶, 史丽霞, 谢祎, 等. 新型冠状病毒肺炎患者继发感染的危险因素分析[J]. 天津医药, 2020,48(10): 916−919. doi: 10.11958/20201043

    HAN J, SHI L X, XIE Y, et al. Analysis of risk factors for subsequent infection in patient with COVID-19[J]. Tianjin Medical Journal, 2020, 48(10): 916−919. (in Chinese). doi: 10.11958/20201043
    [3]
    ROSALINO V, SANDRA G S, JUAN J J V, et al. Acinetobacter baumannii resistance: A real challenge for clinicians[J]. Anyinioyics, 2020, 9(4): 205.
    [4]
    GRUPPER M, SPRECHER H, MASHIACH T, et al. Attributable mortality of nosocomial acinetobacter bacteremia[J]. Infection Control and Hospital Epidemiology, 2007, 28(3): 293−298. doi: 10.1086/512629
    [5]
    SUNENSHINE R H, WRIGHT M O, MARAGAKIS L L, et al. Multidrug-resistant acinetobacter infection mortality rate and length of hospitalization[J]. Emerging Infectious Diseases, 2007, 13(1): 97−103. doi: 10.3201/eid1301.060716
    [6]
    JOSÉ R J, BROWN J S. Opportunistic and fungal infections of the lung[J]. Medicine, 2012, 40(6): 335−339.
    [7]
    Van WOLFSWINKEL M E, VLIEGENTHART-JONGBLOED K, de MENDONFIA MELO M, et al. Predictive value of lymphocytopenia and the neutrophil-lymphocyte count ratio for severe imported malaria[J]. Malaria Journal, 2013, 12: 101. doi: 10.1186/1475-2875-12-101
    [8]
    JIA H P, LOOK D C, SHI L, et al. ACE2 receptor expression and severe acute respiratory syndrome. coronavirus infection depend on differentiation of human airway epithelia[J]. Journal of Virology, 2005, 79(23): 14614−14621. doi: 10.1128/JVI.79.23.14614-14621.2005
    [9]
    HAMMING I, TIMENS W, BULTHUIS M L, et al. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus: A first step in understanding SARS pathogenesis[J]. The Journal of Pathology, 2004, 203(2): 631−637. doi: 10.1002/path.1570
    [10]
    XU H, ZHONG L, DENG J, et al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa[J]. International Journal of Oral Science, 2020, 12(1): 8. doi: 10.1038/s41368-020-0074-x
    [11]
    PUROHIT D, AHIRWAR A K, SAKARDE A, et al. COVID-19 and lung pathologies[J]. Hormone Molecular Biology and Clinical Investigation, 2021, 42(4): 435−443. doi: 10.1515/hmbci-2020-0096
    [12]
    刘玉建, 仲建全, 冯浩, 等. 新型冠状病毒肺炎患者的高分辨率CT影像学特征[J]. 医疗装备, 2022,35(11): 1−4. doi: 10.3969/j.issn.1002-2376.2022.11.001

    LIU Y J, ZHONG J Q, FENG H, et al. Imaging characteristics of high resolution CT for patients with corona virus disease 2019[J]. Medical Equipment, 2022, 35(11): 1−4. (in Chinese). doi: 10.3969/j.issn.1002-2376.2022.11.001
    [13]
    CHUNG M, BERNHEIM A, MEI X, et al. CT imaging features of 2019 novel coronavirus (2019-nCoV)[J]. Radiology, 2020, 295(1): 202−207. doi: 10.1148/radiol.2020200230
    [14]
    TAY M Z, POH C M, RÉNIA L, et al. The trinity of COVID19: Immunity, infiammation and intervention[J]. Nature Reviews. Immunology, 2020, 20(6): 363−374. doi: 10.1038/s41577-020-0311-8
    [15]
    DEBRAY M P, CARETTE M F, LOUBET P, et al. CT features of community-acquired pneumonia at the emergency department[J]. Respiratory Medicine and Research, 2022, 81: 100892. doi: 10.1016/j.resmer.2022.100892
    [16]
    曹玉芳, 王小智, 谢晓红, 等. 新型冠状病毒、细菌和病毒性肺炎患者胸部影像学特征分析[J]. 中华危重病急救医学, 2023,35(1): 28−31. doi: 10.3760/cma.j.cn121430-20210318-00394

    CAO Y F, WANG X Z, XIE X H, et al. Analysis of chest imaging features of novel coronavirus pneumonia, bacterial pneumonia and viral pneumonia[J]. Chinese Critical Care Medicine, 2023, 35(1): 28−31. (in Chinese). doi: 10.3760/cma.j.cn121430-20210318-00394
    [17]
    窦艳云, 黄葵, 蓝珂, 等. 艾滋病合并细菌性肺炎的影像学及临床特点分析[J]. 新发传染病电子杂志, 2019,4(1): 20−23.

    DOU Y Y, HUANG K, LAN K, et al. Analysis of clinical characteristics of AIDS complicated with bacterial pneumonia[J]. Electronic Journal of Emerging Infectious Diseases, 2019, 4(1): 20−23. (in Chinese).
    [18]
    袁彩云, 陶毅, 陈令金, 等. 多层螺旋 CT 在老年真菌性肺炎中的诊断价值[J]. 影像研究与医学应用, 2021,5(18): 116−117. doi: 10.3969/j.issn.2096-3807.2021.18.056
    [19]
    KOVÁCS A, PALÁSTI P, VERÉB D, et al. The sensitivity and specificity of chest CT in the diagnosis of COVID-19[J]. 2021, 31(5): 2819-2824.
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