Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19):A multi-center study in Wenzhou city, Zhejiang, China

J Infect. 2020 Apr;80(4):388-393. doi: 10.1016/j.jinf.2020.02.016. Epub 2020 Feb 26.


Background: Little is known about COVID-19 outside Hubei. The aim of this paper was to describe the clinical characteristics and imaging manifestations of hospitalized patients with confirmed COVID-19 infection in Wenzhou, Zhejiang, China.

Methods: In this retrospective cohort study, 149 RT-PCR confirmed positive patients were consecutively enrolled from January 17th to February 10th, 2020 in three tertiary hospitals of Wenzhou. Outcomes were followed up until Feb 15th, 2020.

Findings: A total of 85 patients had Hubei travel/residence history, while another 49 had contact with people from Hubei and 15 had no traceable exposure history to Hubei. Fever, cough and expectoration were the most common symptoms, 14 patients had decreased oxygen saturation, 33 had leukopenia, 53 had lymphopenia, and 82 had elevated C-reactive protein. On chest computed tomography (CT), lung segments 6 and 10 were mostly involved. A total of 287 segments presented ground glass opacity, 637 presented mixed opacity and 170 presented consolidation. Lesions were more localized in the peripheral lung with a patchy form. No significant difference was found between patients with or without Hubei exposure history. Seventeen patients had normal CT on admission of these, 12 had negative findings even10 days later.

Interpretation: Most patients presented with a mild infection in our study. The imaging pattern of multifocal peripheral ground glass or mixed opacity with predominance in the lower lung is highly suspicious of COVID-19 in the first week of disease onset. Nevetheless, some patients can present with a normal chest finding despite testing positive for COVID-19.

Funding: We did not receive any fundings.

Keywords: COVID-19; CT; Infection; Lung; Outside Hubei.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Betacoronavirus*
  • COVID-19
  • COVID-19 Testing
  • China
  • Clinical Laboratory Techniques
  • Cohort Studies
  • Coronavirus Infections / complications
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / diagnostic imaging
  • Coronavirus Infections / physiopathology*
  • Cough
  • Female
  • Fever
  • Humans
  • Lung / diagnostic imaging
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / diagnostic imaging
  • Pneumonia, Viral / physiopathology*
  • Retrospective Studies
  • SARS-CoV-2
  • Tomography, X-Ray Computed