Clinical and Imaging Evidence of Wuhan-Viral Pneumonia: A Large-Scale Prospective Cohort Study

Background: On December 31st, 2019, the World Health Organization (WHO) reported a large patient population with symptoms resembling those associated with viral pneumonia of unknown cause in Wuhan, China. Using a large – scale prospective cohort study, we have obtained and assessed the clinical and imaging results relating to the Wuhan-viral pneumonia. Methods: From the 1st until the 22nd of January 2020, we prospectively collected and analyzed clinical and imaging data of patients with viral pneumonia, determined by the use of both clinical and CT imaging scan at Wuhan’s largest hospital. Bilateral lung involvement was compared between patients with symptoms and those without them. Five cases describe the whole clinical and imaging spectrum of the Wuhan-viral Pneumonia. Findings: From the 1st until the 22nd of January 2020, 887 patients were identified as having Wuhan-viral pneumonia, constituting 855 (96.40%) outpatients, 32 (3.60%) inpatients, and 5 (0.56%) patients admitted to the intensive care unit (ICU). Median age was 49 years of age (IQR 14 - 90). 20 (2.25%)] infected patients had underlying diseases, including diabetes (2 [0.23%]), mitral valve prolapse (1 [0.11%]), pulmonary nodule/mass (2 [0.23%]), lung cancer (2 [0.23%]), Sjogren's syndrome (1 [0.11%]), hypernatremia (1 [0.11%]), proteinuria (1 [0.11%]), acute pancreatitis (1 [0.11%]), colon cancer (1 [0.11%]), malignant tumor of tongue (1 [0.11%]), after nephrectomy (1 [0.11%]), kidney transplant (1 [0.11%]), demyelinating encephalopathy (1 [0.11%]), lumbar fracture (1 [0.11%]), myasthenia gravis (1 [0.11%]), aortic dissection (1 [0.11%]), autoimmune pancreatitis (1 [0.11%]). Common symptoms at onset of illness were fever (679 [76.55%]), cough (241 [27.17%]), discomfort (32 [3.61%]), less common symptoms were dizziness (3 [0.34%]), fatigue (6 [0.68%]), haemoptysis (5 [0.56%]), chest distress or chest pain (6 [0.68%]), abdominal pain (3 [0.34%]), dyspnoea (3 [0.34%]), back pain (3 [0.34%]), headache (2 [0.23%]), palpitation (1 patient, [0.1%]). 16 [1.80%] infected patients were initially asymptomatic. 4 [0.45%] infected patients had complications included respiratory failure (1 patient [0.11%]), heart failure (1 [0.11%]), shock (1 [0.11%]), and enteritis (1 patient [0.11%]). None of the infected patients died. Abnormalities in chest CT images were detected in all patients. The typical imaging findings were ill-defined ground-glass opacities and subsegmental consolidation. Later findings noted an increase or decrease in the extent of involvement with reticular opacities. 13 [81.25%] asymptomatic patients had bilaterial lung involvement while 740 [84.96%] symptomatic patients had bilaterial lung involvement. No statistically significant difference was found (X2 = 0.16, p = .68 > .05). Interpretation: Although the virus has demonstrated that it is highly contagious and causes infection in both lungs spontaneously, clinical evidence shows that Wuhan-viral pneumonia has a low fatality rate. CT Imaging plays a pivotal role in the screening, diagnosis, isolation plan, treatment, management or prognosis of patients with Wuhan-viral pneumonia. Funding: The work was partially funded by the National Natural Science Foundation of China (NSFC) (# 81171307, 81671656). Declaration of Interest: All authors declare no competing interests. Ethical Approval: This study was approved by the Ethical Committee of Wuhan Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, and written informed consent was provided by all patients before examination.