Clinical and baseline computed tomography features of patients infected with the B.1.617.2 (Delta) variant of severe acute respiratory syndrome coronavirus 2

Haixia Mao, J. Xu, Shengbin Gong, Hongwei Chen, Xiangming Fang
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Abstract

PURPOSE: The purpose of this study was to investigate the clinical and baseline computed tomography (CT) features and their correlation in patients infected with the B.1.617.2 (Delta) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). MATERIALS AND METHODS: Clinical and chest baseline CT data of patients infected with the Delta variant of SARS-CoV-2 from July to August 2021 were collected. First, the correlation between the clinical data and baseline CT results was analyzed according to CT positivity or negativity. Then, subgroup analysis was performed between different age distributions and clinical characteristics. Next, the CT characteristics and clinical data of all baseline CT-positive patients were collected, and the correlations between CT characteristics and age, vaccination status, and chronic disease were analyzed. Lesions in patients with baseline CT positivity were evaluated by semi-quantitative scoring to analyze the correlations between the semi-quantitative scores and vaccination status and age distribution. RESULTS: A total of 221 nucleic acid-positive patients with the SARS-CoV-2 Delta variant were included, of whom 107 patients were baseline CT positive and 114 were baseline CT negative. Baseline CT positivity was associated with age distribution, and baseline CT positivity was most common in patients aged >60 years (P < 0.001), but not with vaccination status or gender. The results of the subgroup analysis according to age distribution indicated that different age distribution subgroups had different vaccination statuses, and the majority of patients aged <18 years and >60 years were unvaccinated (90.5%, 19/21, and 57.3%, 63/110, respectively). In contrast, most patients aged 18–60 years had received two doses of the vaccine (61.1%, 55/90) (P < 0.001). Different age distribution subgroups had different clinical infection types. Asymptomatic and mild cases were most common in patients aged ≤60 years, and moderate and severe or critical cases were most common in patients aged >60 years. For baseline CT-positive patients, the extent of lung involvement was associated with age, vaccination status, and chronic disease. The number of involved lobes was higher in patients who were unvaccinated or who had received one injection, who were aged >60 years or had chronic disease. There was a statistical difference in CT semi-quantitative scores between the different age subgroups. Compared with patients aged < 60 years, patients aged >60 years had higher semi-quantitative scores (P < 0.001). However, there was no statistical difference between the different vaccination groups. CONCLUSIONS: Age had a large effect on baseline CT positivity, CT characteristics, and semi-quantitative CT scores in patients infected with the Delta variant.
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严重急性呼吸综合征冠状病毒B.1.617.2 (Delta)变异感染患者的临床和基线计算机断层扫描特征
目的:探讨严重急性呼吸综合征冠状病毒2型(SARS-CoV-2) B.1.617.2 (Delta)变异感染患者的临床和基线计算机断层扫描(CT)特征及其相关性。材料与方法:收集2021年7月至8月SARS-CoV-2 δ型感染患者的临床和胸部基线CT资料。首先,根据CT阳性或阴性分析临床资料与基线CT结果的相关性。然后对不同年龄分布与临床特征进行亚组分析。接下来,收集所有基线CT阳性患者的CT特征和临床资料,分析CT特征与年龄、疫苗接种情况、慢性病的相关性。采用半定量评分法对基线CT阳性患者的病变进行评估,分析半定量评分与疫苗接种状况和年龄分布的相关性。结果:共纳入221例核酸阳性的SARS-CoV-2 δ变型患者,其中基线CT阳性107例,基线CT阴性114例。基线CT阳性与年龄分布有关,基线CT阳性在>60岁的患者中最常见(P < 0.001),但与疫苗接种状况或性别无关。按年龄分布进行亚组分析结果显示,不同年龄分布亚组的疫苗接种情况不同,60岁患者中未接种者占绝大多数(分别为90.5%(19/21)和57.3%(63/110))。相比之下,大多数18-60岁的患者接种了两剂疫苗(61.1%,55/90)(P < 0.001)。不同年龄分布亚组临床感染类型不同。年龄≤60岁的患者以无症状和轻度病例多见,年龄>60岁的患者以中、重度或危重型病例多见。对于基线ct阳性患者,肺部受累程度与年龄、疫苗接种状况和慢性疾病有关。未接种疫苗或只注射过一针、年龄>60岁或患有慢性疾病的患者受损伤脑叶的数量更高。不同年龄亚组CT半定量评分差异有统计学意义。与< 60岁的患者相比,>60岁患者的半定量评分更高(P < 0.001)。然而,不同疫苗接种组之间没有统计学差异。结论:年龄对Delta变异感染患者的基线CT阳性、CT特征和半定量CT评分有很大影响。
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