COVID-19 cases with delayed absorption of lung lesion

Li, BinBin; Hu, WeiZhen; Bao, ChunMiao

OBJECTIVE: Over 90% of the COVID-19 patients with computed tomographic (CT) manifestations showed radiological improvement on dissipating stage. Cases with refractory pulmonary infiltration were discussed in this study. METHODS: During hospitalization, chest CT scan and reverse transcriptase polymerase chain reaction (RT-PCR) test were repeatedly performed. While drawing parallels to RT-PCR, the impact of delayed absorption of lung lesions on length of hospital stay (LOS) and medical expense was investigated. Features for delayed absorption of lung lesions were identified using cox proportional hazard regression model. RESULTS: Cases with delayed absorption of lung lesions had a prolonged LOS (18.00 ± 4.90 vs 9.25 ± 4.20, p < 0.01) and increased medical expense (9124.55 ± 2421.31 vs 4923.88 ± 2218.56, p < 0.01). Time interval from admission to a negative RT-PCR (ATN) was also prolonged (13.29 ± 4.72 vs 9.25 ± 4.20, p = 0.03). The cox proportional hazard regression model indicated that imported cases bore high risk of delayed absorption of lung lesions (hazard ratio = 2.54, 95% confidence interval 1.05, 6.11, p = 0.04). Sensitivity analysis revealed similar pattern (hazard ratio = 6.64, 95% confidence interval 1.62, 27.18, p = 0.01). CONCLUSION: Imported cases of COVID-19 were more likely to have refractory pulmonary infiltration, which subsequently prolongs LOS and increases medical expense.