Relation entre le Stade Clinique et les Signes Scanographiques de la COVID-19 à l’Hôpital Gynéco-Obstétrique et Pédiatrique de Douala

Yannick Richard Onana, Adamou Dodo Balkissou, Joshua Tambe, Samuel Mbozo’o, Jean-Claude Mballa Amougou, Dominique Djomo Tamchom, Yves Moumbe, Hugues Zanga, Duvalier Meva’a Meva’a, Guy Pascal Ngaba, Jérémie Mbo Amvene, Ba Hamadou, Mathurin Neossi Guena, Pierre Ongolo-Zogo, Emilienne Guegang, Boniface Moifo, Odile Fernande Zeh, Bruno Kastler, Samuel Nko’o Amvene, Emile Telesphore Mboudou

Abstract


RÉSUMÉ
Introduction. Le but de cette étude était de décrire les lésions scanographiques thoraciques associées aux signes cliniques de la maladie à coronavirus 2019 (COVID-19). Matériels et méthodes. Les examens scanographiques de 132 patients atteints de la COVID-19 ont été analysés rétrospectivement par trois radiologues dans notre centre hospitalier, d’Avril à Juillet 2020. Les résultats ont été corrélés aux données cliniques de 50 patients chez qui les dossiers étaient complets. Résultats. Les opacités en « verre dépoli » associées à des condensations parenchymateuses étaient les lésions les plus répandues, notamment chez les patients avec un état clinique modéré à sévère, et chez qui, on retrouvait également aspect de crazy paving. Les atteintes avaient tendance à être bilatérales, périphériques, et inférieures. Parmi les différentes caractéristiques cliniques associées au stade modéré à sévère, la dyspnée était le seul facteur indépendant de sévérité de l’infection par la COVID-19, avec un Odd’s ratio (IC à 95%) de 19,621 (1,776-216,759), p = 0,015. Conclusion. Cette étude préliminaire a permis de relever les principales caractéristiques scanographiques des patients atteints de COVID-19 dans notre milieu, et de discuter une association avec quelques signes cliniques chez certains patients, pouvant ainsi participer à l'évaluation de la gravité de la maladie.
ABSTRACT
Introduction. are the most common in. Chest computed tomography (CT) is useful for the diagnosis pulmonary manifestations of SARS-CoV-2 virus disease due to its high sensitivity and for the follow-up of patients. Given the persistence of this pandemic we conducted this study with aim to describe and compare the clinical stages of SARS-CoV-2 pneumonia with the chest CT features in a referral hospital in Douala. Materials and methods. Chest CT scans of 132 patients tested positive for COVID-19 with RT-PCR were analyzed retrospectively from April to July 2020. CT findings were compared with clinical data from 50 patients with complete records. Results. Of the 132 patients’ records included, 95 (72%) had bilateral lung involvement which were widespread in 81 (61.4%) patients, with a peripheral distribution in 60 (45.5%) patients, and consisted mainly of ground-glass opacities with lung consolidation in 67 (50.8%) cases. CT findings of 28 (21.2%) patients were classified as severe. Dyspnea was associated with CT severity in 33 patients (66.0%) during the univariate and multivariate analyses with odds ratios (95% CI) of 8.4 (2.0-10.8) and 8.2 (1.2-54.7) respectively, p = 0.030. Conclusion. Bilateral peripheral ground-glass opacities and lung consolidation are the most frequent chest CT findings of SARS-CoV-2 pneumonia. Dyspnea was significantly associated with chest CT severity and is therefore an important prognostic factor.


Keywords


SARS-CoV-2 pneumonia, chest CT, clinical stages

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