Clinical Study On Epidemiology And CT Three-dimensional Imaging Characteristics Of COVID-19 Patients-single Center Study

Objectives:To describe the epidemiological and clinical characteristics of COVID-19 patients in Zengdu district,the surrounding area of Wuhan,and provide decision-making reference for epidemic prevention in similar areas.To compare the difference in the glasses-wearing rate between COVID-19 patients and general population,and explore the possibility of wearing glasses to reduce the risk of COVID-19 eye infection.Explore the use of 3D-CT to quantitatively analyze the lung lesions of COVID-19 patients,and evaluate its effectiveness in predicting the severity of COVID-19.Methods:This study included all patients diagnosed with COVID-19 by RT-PCR in Zengdu Hospital from January 27 to March 11,2020.Extracting age,underlying diseases,contact history,clinical symptoms,laboratory examinations,radiological manifestations and clinical outcomes from the medical records.According to the sixth edition of COVID-19 diagnosis and treatment guidelines,COVID-19 patients are divided into severe and non-severe two groups,the characteristics of two groups are described and differences are compared.Collecting the data about eyesight and length daily wearing glasses through face-to-face inquiry or telephone contact,estimate the myopia rate of local population from the report of a large-scale population survey,comparing whether it is different in rate of glasses-wearing between COVID-19 patients and local population.In addition,chest CT of COVID-19 patient with propensity score matching were performed into three-dimensional reconstruction,and lung lesions volume were quantitatively analyzed,and the ROC curve analysis was used to evaluate the effect of these 3D-CT quantitative parameters in predicting prognosis of COVID-19.Results:1.A total of 276 hospitalized COVID-19 patients(median age: 51.0 years),including 262 non-sever patients and 14 sever patients.The proportion of elderly patients over 60 years old in the severe group(78.6%)was significantly higher than that in the non-severe group(18.7%,P<0.01).About a quarter of the patients(24.6%)had at least one underlying disease,which in severe group(85.7%)was higher than non-severe group(21.4%,p<0.01).The median treatment days for virus were 14.0 days,the hospital stay was 18.0 days.2.All those people who wear glasses more than 8 hours a day have myopia,and16 of 276 patients have myopia(5.8%;95% CI,3.04%-8.55%).According to a previous study,the proportion of myopia patients in Hubei Province was 31.5%,which is much higher than the proportion of myopia in COVID-29 patients in this study.3.After propensity score matching,a total of 118 chest CT 3D models were reconstructed from 12 severe patients and 12 non-severe patients.Quantitative analysis calculated GGO volume percentage,consolidation volume percentage,total lesion volume percentage,GGO Volume change rate,consolidation volume change rate,total lesion volume change rate and many other quantitative parameters,ROC analysis shows that the total lesion volume change rate performs best in predicting prognosis(area under ROC(AUC)= 0.96,95%Cl: 0.89-1.00).Conclusion:1.Most COVID-19 patients in Zengdu District are non-severe.Elderly patients with underlying diseases are at higher risk of developing severe.The length of hospitalization and antiviral treatment for COVID-19 are slightly longer than that of Wuhan.Understanding the clinical characteristics of COVID-19 patients in surrounding areas of core outbreak can provide decision-making reference for the prevention and control of the epidemic in such special geographical areas.2.Among hospitalized patients with COVID-19,the proportion of wearing glasses for a long time every day(>8h/d)is lower than that of general population,which indicates that wearing glasses may reduce the risk of COVID-19 transmission through the eyes.3.With 3D-CT quantitative analysis describe the changes in pulmonary lesions of COVID-19 patients more specifically,dynamic quantitative parameters have a good predictive effect on the severity of COVID-19,which can be used to stratify risk for COVID-19 patients and instruct medical staff to take more active monitoring and medical interventions for high-risk patients.