Unmatched clinical presentation and chest CT manifestation in a patient with severe coronavirus disease 2019 (COVID-19)

Posted On 2020-05-10 04:42:37

An ongoing outbreak of a coronavirus disease 2019 (COVID-19) hit major cities of China, Wuhan, late December 2019 and subsequently spread to other areas of China and countries (1). As of February 16, 2020, there were 68594 confirmed cases in mainland China. Among the confirmed cases, approximately 14.0% were severe (2). The mortality rate of severe patients was 6% (3). Herein, we described the clinical characteristics and chest CT follow-up of a severe COVID-19 patient, whose CT appearance was only moderate, and thus represents a case of mismatch between clinical severity and chest imaging severity.

A 39-year-old man presented to the hospital on Jan 24, 2020 with a week of fever, nonproductive cough and fatigue. He lived in Wuhan before onset, with no underlying diseases. On admission, his body temperature elevated to 38.6 °C (101 °F) with rough breathing sounds. Real-time fluorescence polymerase chain reaction (RT-PCR) of the patient’ throat swab was positive for 2019-nCoV nucleic acid. Laboratory findings indicated elevated C-reactive protein of 24.86 mg/L (normal rage, 0–6 mg/L), lactic dehydrogenase of 339 U/L (normal range, 120–250 U/L), and urine protein of 1+ g/L. White blood cell count (3.66×109/L; normal range, 4.0–10.0×109/L) and lymphocyte count (1.31×109/L; normal range, 1.1–3.2×109/L) were normal. Liver function, myocardial enzymes and coagulation function were normal. Electrocardiogram showed sinus tachycardia.

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