Coronavirus Disease 2019 (COVID-19) CT Findings: A Systematic Review and Meta-analysis

Abstract

Purpose: To date, considerable knowledge gaps remain regarding the chest CT imaging features of coronavirus disease 2019 . We performed a systematic review and meta-analysis of results from published studies to date to provide a summary of evidence on detection of COVID-19 by chest CT and the expected CT imaging manifestations.Methods: Studies were identified by searching PubMed database for articles published between December 2019 and February 2020. Pooled CT positive rate of COVID-19 and pooled incidence of CT imaging findings were estimated using a random-effect model.Results: A total of 13 studies met inclusion criteria. The pooled positive rate of the CT imaging was 89.76% and 90.35% when only including thin-section chest CT. Typical CT signs were ground glass opacities (83.31%), ground glass opacities with mixed consolidation (58.42%), adjacent pleura thickening (52.46%), interlobular septal thickening (48.46%), and air bronchograms (46.46%). Other CT signs included crazy paving pattern (14.81%), pleural effusion (5.88%), bronchiectasis (5.42%), pericardial effusion (4.55%), and lymphadenopathy (3.38%). The most anatomic distributions were bilateral lung infection (78.2%) and peripheral distribution (76.95%). The incidences were highest in the right lower lobe (87.21%), left lower lobe (81.41%), and bilateral lower lobes (65.22%). The right upper lobe (65.22%), right middle lobe (54.95%), and left upper lobe (69.43%) were also commonly involved. The incidence of bilateral upper lobes was 60.87%. A considerable proportion of patients had three or more lobes involved (70.81%). Conclusions:The detection of COVID-19 chest CT imaging is very high among symptomatic individuals at high risk, especially using thin-section chest CT. The most common CT features in patients affected by COVID-19 included ground glass opacities and consolidation involving the bilateral lungs in a peripheral distribution.

More severe hypercoagulation status, cytokine storm, and disease progression in coronavirus disease 2019 with persistent RT-PCR negative results: a multicenter prospective study

“…Regarding imaging characteristics, ground glass opacity was still the most common imaging manifestation for all COVID-19 patients, similar to what other studies have described [8,[28][29]. However, serology-con rmed patients were more likely to have pleural effusion, implying that pleural involvement of this subgroup of COVID-19 patients was more common than what we found in PCR-con rmed patients [30].…”

Lung Ultrasound in COVID-19 Pneumonia: Correlations with Chest CT on Hospital admission

“…The integration of the clinical and epidemiological context with ultrasound findings is therefore necessary for the differential diagnosis between COVID-19 pneumonia and other conditions with similar ultrasonographic appearance. The detection of pleural effusion, which is rare in COVID-19 (<6% of cases according to a recent meta-analysis of CT findings [38]) and very frequent in congestive heart failure, may represent an important element for the formulation of a correct diagnosis.…”

Clinical, laboratory and radiological characteristics and outcomes of novel coronavirus (SARS-CoV-2) infection in humans: A systematic review and series of meta-analyses

“…GGO was strongly associated with severe disease. In COVID-19 patients, middle, lower and posterior lobes, peripherally and symmetrically, are most commonly affected [ 68 ]. In SARS, GGO is also described predominantly in these regions [ 69 ], suggesting that this pattern of GGO might be a hallmark for coronavirus-related pathologies.…”