Analysis of Chest CT Results of Coronavirus Disease 2019 (COVID-19) Patients at First Follow-Up

Abstract

Objective. To investigate the dissipation and outcomes of pulmonary lesions at the first follow-up of patients who recovered from moderate and severe cases of COVID-19. Methods. From January 21 to March 3, 2020, a total of 136 patients with COVID-19 were admitted to our hospital. According to inclusion and exclusion criteria, 52 patients who recovered from COVID-19 were included in this study, including 33 moderate cases and 19 severe cases. Three senior radiologists independently and retrospectively analyzed the chest CT imaging data of 52 patients at the last time of admission and the first follow-up after discharge, including primary manifestations, concomitant manifestations, and degree of residual lesion dissipation. Results. At the first follow-up after discharge, 16 patients with COVID-19 recovered to normal chest CT appearance, while 36 patients still had residual pulmonary lesions, mainly including 33 cases of ground-glass opacity, 5 cases of consolidation, and 19 cases of fibrous strip shadow. The proportion of residual pulmonary lesions in severe cases (17/19) was statistically higher than in moderate cases (19/33) ( χ 2 = 5 . 759 , P < 0.05 ). At the first follow-up, residual pulmonary lesions were dissipated to varying degrees in 47 cases, and lesions remained unchanged in 5 cases. There were no cases of increased numbers of lesions, enlargement of lesions, or appearance of new lesions. The dissipation of residual pulmonary lesions in moderate patients was statistically better than in severe patients (Z = −2.538, P < 0.05 ). Conclusion. Clinically cured patients with COVID-19 had faster dissipation of residual pulmonary lesions after discharge, while moderate patients had better dissipation than severe patients. However, at the first follow-up, most patients still had residual pulmonary lesions, which were primarily ground-glass opacity and fibrous strip shadow. The proportion of residual pulmonary lesions was higher in severe cases of COVID-19, which required further follow-up.

Increased Radiation Dose Exposure in Thoracic Computed Tomography in Patients with Covid-19

“…It was reported that COVID-19 could be divided into four stages according to the pathological course of the disease, namely, the early stage (1-4 days), progressive stage (5-8 days), peak stage (9-13 days) and absorption stage (≥14 days). These stages also conform to the characteristics of chest CT images [8].…”

Effect of COVID-19 on Lungs: Focusing on Prospective Malignant Phenotypes

“…Even though SARS-CoV2, as the pathogen of COVID-19 disease, has not been reported as a causative virus for tumorigenesis, it is also important to find out co-infection with other cancer-related pathogens and/or additional co-factors (such as carcinogens) may facilitate pre-cancerous lesions in the setting of infected host cells and tissues in the long time courses. Although it is not likely to predict that all GGO nodules in the lung due to the infection will persist for a long time, there are several reports providing follow-up CT results (mainly GGO) warning long term sequelae in COVID-19 patients [ 55 , 124 , 125 ]. GGO nodules, if persisting in COVID-19 patients, might have potential to transform into lung cancer in coexistence with specific conditions such as smoking, certain genetic susceptibility, and other risk factors.…”

Post-viral parenchymal lung disease following COVID-19 and viral pneumonitis hospitalisation: A systematic review and meta-analysis

“…A total of 41 studies were included in the quantitative synthesis (Figure 1). Among the manuscripts included, 25 reported infections by SARS-CoV-2; 5,18-41 18 by SARS-CoV; 8,9,42-57 1 by MERS-CoV; 58 16 by Influenza (11 subtype H1N1, 1 subtype H5N1, 1 subtype H3N2, 2 subtype H7N9 and 1 study both H1N1 and H7N9). 59-74 All studies were observational in design and included case reports and case series, with the exception of a single randomised control trial.…”