PDF(Pubmed)
Abstract：
We systematically reviewed radiological abnormalities in patients with prolonged SARS-CoV-2 infection, defined as persistently positive polymerase chain reaction (PCR) results for SARS-CoV-2 for > 21 days, with either persistent or relapsed symptoms. We extracted data from 24 patients (median age, 54.5 [interquartile range, 44-64 years]) reported in the literature and analyzed their representative CT images based on the timing of the CT scan relative to the initial PCR positivity. Our analysis focused on the patterns and distribution of CT findings, severity scores of lung involvement on a scale of 0-4, and the presence of migration. All patients were immunocompromised, including 62.5% (15/24) with underlying lymphoma and 83.3% (20/24) who had received anti-CD20 therapy within one year. Median duration of infection was 90 days. Most patients exhibited typical CT appearance of coronavirus disease 19 (COVID-19), including ground-glass opacities with or without consolidation, throughout the follow-up period. Notably, CT severity scores were significantly lower during ≤ 21 days than during > 21 days (P < 0.001). Migration was observed on CT in 22.7% (5/22) of patients at ≤ 21 days and in 68.2% (15/22) to 87.5% (14/16) of patients at > 21 days, with rare instances of parenchymal bands in previously affected areas. Prolonged SARS-CoV-2 infection usually presents as migrating typical COVID-19 pneumonia in immunocompromised patients, especially those with impaired B-cell immunity.
摘要：
我们系统地回顾了长期SARS-CoV-2感染患者的放射学异常，定义为SARS-CoV-2持续21天的持续阳性聚合酶链反应（PCR）结果，持续或复发症状。我们从24名患者中提取数据(中位年龄，54.5[四分位数间距，44-64年]）在文献中进行了报道，并根据相对于初始PCR阳性的CT扫描时间分析了它们的代表性CT图像。我们的分析集中在CT表现的模式和分布上，肺受累的严重程度评分为0-4，并且存在迁移。所有患者免疫功能低下,包括62.5%(15/24)的基础淋巴瘤和83.3%(20/24)的患者在一年内接受过抗CD20治疗。感染的中位持续时间为90天。大多数患者表现出典型的冠状病毒病19（COVID-19）的CT表现，包括有或没有固结的毛玻璃混浊，在整个随访期间。值得注意的是,≤21天的CT严重程度评分明显低于>21天（P<0.001）。在≤21天的患者中，有22.7％（5/22）的患者在CT上观察到迁移，在>21天的患者中，有68.2％（15/22）至87.5％（14/16）的患者在CT上观察到迁移。在先前受影响的区域出现罕见的实质带。长期的SARS-CoV-2感染通常表现为免疫功能低下患者的迁移典型COVID-19肺炎，尤其是那些B细胞免疫受损的人.
