Background To investigate the CT imaging and clinical features of three atypical presentations of coronavirus disease 2019 (COVID-19), namely (1) asymptomatic, (2) CT imaging-negative, and (3) re-detectable positive (RP), during all disease stages. Methods A consecutive cohort of 79 COVID-19 patients was retrospectively recruited from five independent institutions. For each presentation type, all patients were classified into atypical vs. typical groups (i.e., asymptomatic vs.symptomatic, CT imaging-negative vs. CT imaging-positive, and RP and non-RP,respectively). The chi-square test, Student’s t test, and Kruskal-Wallis H test were performed to compare CT imaging and clinical features of atypical vs. typical patients for all three presentation categories. Results In our COVID-19 cohort, we found 12.7% asymptomatic patients, 13.9% CT imaging-negative patients, and 8.9% RP patients. The asymptomatic patients had fewer hospitalization days ( P =0.043), lower total scores for bilateral lung involvement ( P < 0.001), and fewer ground-glass opacities (GGOs) in the peripheral area ( P < 0.001) than symptomatic patients. The CT imaging-negative patients were younger ( P =0.002), had a higher lymphocyte count ( P =0.038), had a higher lymphocyte rate ( P =0.008), and had more asymptomatic infections ( P =0.002) than the CT imaging-positive patients. The RP patients with moderate COVID-19 had lower total scores of for bilateral lung involvement ( P =0.030) and a smaller portion of the left lung affected ( P =0.024) than non-RP patients. Compared to their first hospitalization, RP patients had a shorter hospitalization period ( P < 0.001) and fewer days from the onset of illness to last RNA negative conversion ( P < 0.001) at readmission. Conclusions Significant CT imaging and clinical feature differences were found between atypical and typical COVID-19 patients for all three atypical presentation categories investigated in this study, which may help provide complementary information for the effective management of COVID-19. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-020-05751-8.
【저자키워드】 COVID-19, Asymptomatic, Re-detectable positive, CT imaging negative, Features, 【초록키워드】 coronavirus disease, Coronavirus disease 2019, Hospitalization, lung involvement, lung, Clinical features, Moderate COVID-19, RNA, asymptomatic infections, Lymphocyte count, lymphocyte, ground-glass opacity, Cohort, Ground-glass opacities, Symptomatic patients, Asymptomatic, management, Patient, asymptomatic infection, group, information, asymptomatic patients, patients, clinical feature, asymptomatic patient, readmission, Atypical, COVID-19 patient, complementary, chi-square test, supplementary material, Negative conversion, help, categories, total score, Student’s t test, disease stages, positive, GGOs, Kruskal-Wallis H test, COVID-19 cohort, FIVE, effective, independent, Result, performed, affected, recruited, investigated, category, Significant, had more, patients with moderate, 【제목키워드】 Coronavirus disease 2019,