Chest computed tomography imaging features in patients with coronavirus disease 2019 (COVID-19)

Abstract

Objective To analyze computed tomography (CT) features of symptomatic patients with coronavirus disease 2019 (COVID-19). Methods Ninety-five symptomatic patients with COVID-19 confirmed by reverse-transcription polymerase chain reaction from 1 May to 14 July 2020 were retrospectively enrolled. Follow-up CT findings and their distributions were analyzed and compared from symptom onset to late-stage disease. Results Among all patients, 15.8% had unilateral lung disease and 84.2% had bilateral disease with slight right lower lobe predilection (47.4%). Regarding lesion density, 49.4% of patients had pure ground glass opacity (GGO) and 50.5% had GGO with consolidation. Typical early-stage patterns were bilateral lesions in 73.6% of patients, diffuse lesions (41.0%), and GGO (65.2%). Pleural effusion occurred in 13.6% and mediastinal lymphadenopathy in 11.5%. During intermediate-stage disease, 47.4% of patients showed GGO as the disease progressed; however, consolidation was the predominant finding (52.6%). Conclusion COVID-19 pneumonia manifested on lung CT scans with bilateral, peripheral, and right lower lobe predominance and was characterized by diffuse bilateral GGO progressing to or coexisting with consolidation within 1 to 3 weeks. The most frequent CT lesion in the early, intermediate, and late phases was GGO. Consolidation appeared in the intermediate phase and gradually increased, ending with reticular and lung fibrosis-like patterns.

The Multifaceted COVID-19: CT Aspects of Its Atypical Pulmonary and Abdominal Manifestations and Complications in Adults and Children. A Pictorial Review

“…Zhou [11] et al described pleural effusion in 3.2% of COVID-19 patients while Grassi et al [9] observed it in 14.3% of cases. Darwish et al [12] found that during the first week of infection pleural effusion occurs only in 13.6% of patients. Xiao li et al [10], in regard to pleural effusion, reported a frequency of 14.3% and concluded that it was not significantly associated with COVID-19 pneumonia.…”

Characteristic patterns of SARS-CoV-2 on chest CT suggests a hematologic pathway for viral entry into the lung

“… 5 Darwish also found peripheral, and right lower lobe predominance of ground-glass opacity progressing to consolidation. 6 Al-Umairi included over 4000 patients in a meta-analysis with the most frequent finding of ground glass and consolidative pulmonary opacities in a lower lobe peripheral distribution. 7 Karimian described peripheral opacities in 70% and peripheral and central opacities in 30% of 4598 COVID-19 infected patients.…”