Dynamic changes in clinical and CT characteristics of COVID-19 cases with different exposure histories: a retrospective study

Background: To assess the dynamic changes in clinical and CT characteristics of COVID-19 patients with different epidemiology histories. Methods: : Fifty-three discharged COVID-19 patients were enrolled at Beijing Youan Hospital, Capital Medical University, from Jan 21 to Mar 10, 2020. Spearman correlation analysis was performed between CT scores and laboratory indicators. Patients were divided into Wuhan (lived in/or traveled to Wuhan, 30 cases) and nonWuhan group (close contacts or unknown exposure, 23 cases). The CT and laboratory findings were compared between and within groups during the clinical process. Results: : Fever (88.7%), cough (64.2%), fatigue (34%), and abnormal laboratory indicators, including lymphopenia, reduced albumin, albumin/globulin (A/G), and elevated C-reactive protein (CRP), were mainly observed. Subpleural ground-glass opacities (86.8%) were usually detected at admission. The CT scores were highly correlated with lymphocytes, CRP, albumin, and A/G at initial and follow-ups (all p <0.05). Four days after admission, most patients (66.7% Wuhan, 47.8% nonWuhan) showed progression, and the CT scores of Wuhan significantly increased ( p =0.015). Eight days after admission, the vast majority of patients (69.2% Wuhan, 100% nonWuhan , p =0.006) presented improvement, and the CT scores of nonWuhan were significantly lower than Wuhan ( p =0.006). Pneumonia was completely absorbed in most patients 2-4 weeks after discharge. Conclusions: : CT plays a crucial role in early diagnosis and monitoring changes in COVID-19. Lymphocytes, CRP, albumin, and A/G are expected to predict disease severity and prognosis. Viral pathogenicity in non-endemic areas may be weaker than core-infected areas. Lung lesions can disappear around 4 weeks after discharge in most patients.