Coronavirus disease 2019: initial chest CT findings

Abstract

Objectives To systematically analyze CT findings during the early and progressive stages of natural course of coronavirus disease 2019 and also to explore possible changes in pulmonary parenchymal abnormalities during these two stages. Methods We retrospectively reviewed the initial chest CT data of 62 confirmed coronavirus disease 2019 patients (34 men, 28 women; age range 20-91 years old) who did not receive any antiviral treatment between January 21 and February 4, 2020, in Chongqing, China. Patients were assigned to the early-stage group (onset of symptoms within 4 days) or progressive-stage group (onset of symptoms within 4-7 days) for analysis. CT characteristics and the distribution, size, and CT score of pulmonary parenchymal abnormalities were assessed. Results In our study, the major characteristic of coronavirus disease 2019 was ground-glass opacity (61.3%), followed by ground-glass opacity with consolidation (35.5%), rounded opacities (25.8%), a crazy-paving pattern (25.8%), and an air bronchogram (22.6%). No patient presented cavitation, a reticular pattern, or bronchial wall thickening. The CT scores of the progressive-stage group were significantly greater than those of the early-stage group (p = 0.004). Conclusions Multiple ground-glass opacities with consolidations in the periphery of the lungs were the primary CT characteristic of coronavirus disease 2019. CT score can be used to evaluate the severity of the disease. If these typical alterations are found, then the differential diagnosis of coronavirus disease 2019 must be considered. Key Points • Multiple GGOs with consolidations in the periphery of the lungs were the primary CT characteristic of COVID-19.• The halo sign may be a special CT feature in the early-stage COVID-19 patients.• Significantly increased CT score may indicate the aggravation of COVID-19 in the progressive stage.

Characteristic CT findings distinguishing 2019 novel coronavirus disease (COVID-19) from influenza pneumonia

“…In December 2019, a cluster of pneumonia cases of unknown etiology emerged, now known as novel coronavirus disease , in Wuhan, Hubei, China [1][2][3]. In a recent study [4], five patients in a family cluster who presented with unknown-cause pneumonia after returning to Shenzhen, Guangdong Province, China, from Wuhan and members of another family who did not have any travel or residence history were finally diagnosed with COVID-19, indicating person-to-person transmission of novel coronavirus pneumonia.…”

Incidentally discovered COVID-19 pneumonia: the role of diagnostic imaging

“…In supplementary material, other cases are provided, including one case of detection during breast MRI (S2-4), all preceding clinical signs and/or microbiological documentation of infection. The CT findings included typical features of COVID-19 pneumonia, such as multiple bilateral areas of ground-glass opacities (GGO) with reticulation or consolidation [5,6]. A peripheral and posterior predominance was commonly observed, while in one case (S3), GGO were predominantly located in the central parenchyma.…”

Chest Computed Tomography for the Diagnosis of Patients with Coronavirus Disease 2019 (COVID-19): A Rapid Review and Meta-Analysis

“…On one hand, when COVID-19 cannot be diagnosed by nucleic acid, CT can be used as an auxiliary diagnostic method; on the other hand, CT can show lesions and also plays an important role in patient follow-up. Since February 2020, several case-control studies (8,9), case series (10,11), and case-report (12,13) of CT diagnosis of COVID-19 have been published. However, there is no systematic review and meta-analysis to find out the performance of chest CT in the diagnosis of COVID-19.…”