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Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection.
Radiology. 2020 06; 295(3):200463.R

Abstract

In this retrospective study, chest CTs of 121 symptomatic patients infected with coronavirus disease-19 (COVID-19) from four centers in China from January 18, 2020 to February 2, 2020 were reviewed for common CT findings in relationship to the time between symptom onset and the initial CT scan (i.e. early, 0-2 days (36 patients), intermediate 3-5 days (33 patients), late 6-12 days (25 patients)). The hallmarks of COVID-19 infection on imaging were bilateral and peripheral ground-glass and consolidative pulmonary opacities. Notably, 20/36 (56%) of early patients had a normal CT. With a longer time after the onset of symptoms, CT findings were more frequent, including consolidation, bilateral and peripheral disease, greater total lung involvement, linear opacities, "crazy-paving" pattern and the "reverse halo" sign. Bilateral lung involvement was observed in 10/36 early patients (28%), 25/33 intermediate patients (76%), and 22/25 late patients (88%).

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ncbi.nlm.nih.gov
pubs.rsna.org
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Authors+Show Affiliations

Bernheim A
Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (A.B., M.H., Y.Y., A.J., M.C); BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (X.M); Department of Diagnostic, Molecular and Interventional Radiology, and BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York (Z.A.F); Department of Radiology, The First Affiliated Hospital of Nanchang University, NanChang, JiangXi, China (N.Z); Department of Radiology, West China Hospital, Sichuan University, Chengdu Sichuan, China (K.D); Department of Radiology, The Second Affiliated Hospital of Zhejiang University School Medicine, Hangzhou, China (B.L); Department of Radiology, Nanxishan Hospital, Guangxi Zhuang Autonomous Region, China (X.Z); Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-sen University, New Xiangzhou, Zhuhai, Guangdong Province, China (K.L., S.L., H.S).
Mei X
Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (A.B., M.H., Y.Y., A.J., M.C); BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (X.M); Department of Diagnostic, Molecular and Interventional Radiology, and BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York (Z.A.F); Department of Radiology, The First Affiliated Hospital of Nanchang University, NanChang, JiangXi, China (N.Z); Department of Radiology, West China Hospital, Sichuan University, Chengdu Sichuan, China (K.D); Department of Radiology, The Second Affiliated Hospital of Zhejiang University School Medicine, Hangzhou, China (B.L); Department of Radiology, Nanxishan Hospital, Guangxi Zhuang Autonomous Region, China (X.Z); Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-sen University, New Xiangzhou, Zhuhai, Guangdong Province, China (K.L., S.L., H.S).
Huang M
Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (A.B., M.H., Y.Y., A.J., M.C); BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (X.M); Department of Diagnostic, Molecular and Interventional Radiology, and BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York (Z.A.F); Department of Radiology, The First Affiliated Hospital of Nanchang University, NanChang, JiangXi, China (N.Z); Department of Radiology, West China Hospital, Sichuan University, Chengdu Sichuan, China (K.D); Department of Radiology, The Second Affiliated Hospital of Zhejiang University School Medicine, Hangzhou, China (B.L); Department of Radiology, Nanxishan Hospital, Guangxi Zhuang Autonomous Region, China (X.Z); Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-sen University, New Xiangzhou, Zhuhai, Guangdong Province, China (K.L., S.L., H.S).
Yang Y
Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (A.B., M.H., Y.Y., A.J., M.C); BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (X.M); Department of Diagnostic, Molecular and Interventional Radiology, and BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York (Z.A.F); Department of Radiology, The First Affiliated Hospital of Nanchang University, NanChang, JiangXi, China (N.Z); Department of Radiology, West China Hospital, Sichuan University, Chengdu Sichuan, China (K.D); Department of Radiology, The Second Affiliated Hospital of Zhejiang University School Medicine, Hangzhou, China (B.L); Department of Radiology, Nanxishan Hospital, Guangxi Zhuang Autonomous Region, China (X.Z); Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-sen University, New Xiangzhou, Zhuhai, Guangdong Province, China (K.L., S.L., H.S).
Fayad ZA
Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (A.B., M.H., Y.Y., A.J., M.C); BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (X.M); Department of Diagnostic, Molecular and Interventional Radiology, and BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York (Z.A.F); Department of Radiology, The First Affiliated Hospital of Nanchang University, NanChang, JiangXi, China (N.Z); Department of Radiology, West China Hospital, Sichuan University, Chengdu Sichuan, China (K.D); Department of Radiology, The Second Affiliated Hospital of Zhejiang University School Medicine, Hangzhou, China (B.L); Department of Radiology, Nanxishan Hospital, Guangxi Zhuang Autonomous Region, China (X.Z); Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-sen University, New Xiangzhou, Zhuhai, Guangdong Province, China (K.L., S.L., H.S).
Zhang N
Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (A.B., M.H., Y.Y., A.J., M.C); BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (X.M); Department of Diagnostic, Molecular and Interventional Radiology, and BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York (Z.A.F); Department of Radiology, The First Affiliated Hospital of Nanchang University, NanChang, JiangXi, China (N.Z); Department of Radiology, West China Hospital, Sichuan University, Chengdu Sichuan, China (K.D); Department of Radiology, The Second Affiliated Hospital of Zhejiang University School Medicine, Hangzhou, China (B.L); Department of Radiology, Nanxishan Hospital, Guangxi Zhuang Autonomous Region, China (X.Z); Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-sen University, New Xiangzhou, Zhuhai, Guangdong Province, China (K.L., S.L., H.S).
Diao K
Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (A.B., M.H., Y.Y., A.J., M.C); BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (X.M); Department of Diagnostic, Molecular and Interventional Radiology, and BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York (Z.A.F); Department of Radiology, The First Affiliated Hospital of Nanchang University, NanChang, JiangXi, China (N.Z); Department of Radiology, West China Hospital, Sichuan University, Chengdu Sichuan, China (K.D); Department of Radiology, The Second Affiliated Hospital of Zhejiang University School Medicine, Hangzhou, China (B.L); Department of Radiology, Nanxishan Hospital, Guangxi Zhuang Autonomous Region, China (X.Z); Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-sen University, New Xiangzhou, Zhuhai, Guangdong Province, China (K.L., S.L., H.S).
Lin B
Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (A.B., M.H., Y.Y., A.J., M.C); BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (X.M); Department of Diagnostic, Molecular and Interventional Radiology, and BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York (Z.A.F); Department of Radiology, The First Affiliated Hospital of Nanchang University, NanChang, JiangXi, China (N.Z); Department of Radiology, West China Hospital, Sichuan University, Chengdu Sichuan, China (K.D); Department of Radiology, The Second Affiliated Hospital of Zhejiang University School Medicine, Hangzhou, China (B.L); Department of Radiology, Nanxishan Hospital, Guangxi Zhuang Autonomous Region, China (X.Z); Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-sen University, New Xiangzhou, Zhuhai, Guangdong Province, China (K.L., S.L., H.S).
Zhu X
Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (A.B., M.H., Y.Y., A.J., M.C); BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (X.M); Department of Diagnostic, Molecular and Interventional Radiology, and BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York (Z.A.F); Department of Radiology, The First Affiliated Hospital of Nanchang University, NanChang, JiangXi, China (N.Z); Department of Radiology, West China Hospital, Sichuan University, Chengdu Sichuan, China (K.D); Department of Radiology, The Second Affiliated Hospital of Zhejiang University School Medicine, Hangzhou, China (B.L); Department of Radiology, Nanxishan Hospital, Guangxi Zhuang Autonomous Region, China (X.Z); Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-sen University, New Xiangzhou, Zhuhai, Guangdong Province, China (K.L., S.L., H.S).
Li K
Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (A.B., M.H., Y.Y., A.J., M.C); BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (X.M); Department of Diagnostic, Molecular and Interventional Radiology, and BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York (Z.A.F); Department of Radiology, The First Affiliated Hospital of Nanchang University, NanChang, JiangXi, China (N.Z); Department of Radiology, West China Hospital, Sichuan University, Chengdu Sichuan, China (K.D); Department of Radiology, The Second Affiliated Hospital of Zhejiang University School Medicine, Hangzhou, China (B.L); Department of Radiology, Nanxishan Hospital, Guangxi Zhuang Autonomous Region, China (X.Z); Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-sen University, New Xiangzhou, Zhuhai, Guangdong Province, China (K.L., S.L., H.S).
Li S
Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (A.B., M.H., Y.Y., A.J., M.C); BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (X.M); Department of Diagnostic, Molecular and Interventional Radiology, and BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York (Z.A.F); Department of Radiology, The First Affiliated Hospital of Nanchang University, NanChang, JiangXi, China (N.Z); Department of Radiology, West China Hospital, Sichuan University, Chengdu Sichuan, China (K.D); Department of Radiology, The Second Affiliated Hospital of Zhejiang University School Medicine, Hangzhou, China (B.L); Department of Radiology, Nanxishan Hospital, Guangxi Zhuang Autonomous Region, China (X.Z); Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-sen University, New Xiangzhou, Zhuhai, Guangdong Province, China (K.L., S.L., H.S).
Shan H
Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (A.B., M.H., Y.Y., A.J., M.C); BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (X.M); Department of Diagnostic, Molecular and Interventional Radiology, and BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York (Z.A.F); Department of Radiology, The First Affiliated Hospital of Nanchang University, NanChang, JiangXi, China (N.Z); Department of Radiology, West China Hospital, Sichuan University, Chengdu Sichuan, China (K.D); Department of Radiology, The Second Affiliated Hospital of Zhejiang University School Medicine, Hangzhou, China (B.L); Department of Radiology, Nanxishan Hospital, Guangxi Zhuang Autonomous Region, China (X.Z); Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-sen University, New Xiangzhou, Zhuhai, Guangdong Province, China (K.L., S.L., H.S).
Jacobi A
Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (A.B., M.H., Y.Y., A.J., M.C); BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (X.M); Department of Diagnostic, Molecular and Interventional Radiology, and BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York (Z.A.F); Department of Radiology, The First Affiliated Hospital of Nanchang University, NanChang, JiangXi, China (N.Z); Department of Radiology, West China Hospital, Sichuan University, Chengdu Sichuan, China (K.D); Department of Radiology, The Second Affiliated Hospital of Zhejiang University School Medicine, Hangzhou, China (B.L); Department of Radiology, Nanxishan Hospital, Guangxi Zhuang Autonomous Region, China (X.Z); Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-sen University, New Xiangzhou, Zhuhai, Guangdong Province, China (K.L., S.L., H.S).
Chung M
Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (A.B., M.H., Y.Y., A.J., M.C); BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (X.M); Department of Diagnostic, Molecular and Interventional Radiology, and BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York (Z.A.F); Department of Radiology, The First Affiliated Hospital of Nanchang University, NanChang, JiangXi, China (N.Z); Department of Radiology, West China Hospital, Sichuan University, Chengdu Sichuan, China (K.D); Department of Radiology, The Second Affiliated Hospital of Zhejiang University School Medicine, Hangzhou, China (B.L); Department of Radiology, Nanxishan Hospital, Guangxi Zhuang Autonomous Region, China (X.Z); Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-sen University, New Xiangzhou, Zhuhai, Guangdong Province, China (K.L., S.L., H.S).

MeSH

AdolescentAdultAgedAged, 80 and overBetacoronavirusCOVID-19Coronavirus InfectionsFemaleHumansLungLung DiseasesMaleMiddle AgedPandemicsPneumonia, ViralRadiography, ThoracicRetrospective StudiesSARS-CoV-2Tomography, X-Ray ComputedYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32077789

Clinical Trial Links

International Lung UltraSound Analysis (ILUSA) Study
Lung CT Scan Analysis of SARS-CoV2 Induced Lung Injury
Surgery and Lung Ultrasound in COVID-19 Infection

Citation

Bernheim, Adam, et al. "Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection." Radiology, vol. 295, no. 3, 2020, p. 200463.
Bernheim A, Mei X, Huang M, et al. Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection. Radiology. 2020;295(3):200463.
Bernheim, A., Mei, X., Huang, M., Yang, Y., Fayad, Z. A., Zhang, N., Diao, K., Lin, B., Zhu, X., Li, K., Li, S., Shan, H., Jacobi, A., & Chung, M. (2020). Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection. Radiology, 295(3), 200463. https://doi.org/10.1148/radiol.2020200463
Bernheim A, et al. Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection. Radiology. 2020;295(3):200463. PubMed PMID: 32077789.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection. AU - Bernheim,Adam, AU - Mei,Xueyan, AU - Huang,Mingqian, AU - Yang,Yang, AU - Fayad,Zahi A, AU - Zhang,Ning, AU - Diao,Kaiyue, AU - Lin,Bin, AU - Zhu,Xiqi, AU - Li,Kunwei, AU - Li,Shaolin, AU - Shan,Hong, AU - Jacobi,Adam, AU - Chung,Michael, Y1 - 2020/02/20/ PY - 2020/2/23/pubmed PY - 2020/5/22/medline PY - 2020/2/21/entrez SP - 200463 EP - 200463 JF - Radiology JO - Radiology VL - 295 IS - 3 N2 - In this retrospective study, chest CTs of 121 symptomatic patients infected with coronavirus disease-19 (COVID-19) from four centers in China from January 18, 2020 to February 2, 2020 were reviewed for common CT findings in relationship to the time between symptom onset and the initial CT scan (i.e. early, 0-2 days (36 patients), intermediate 3-5 days (33 patients), late 6-12 days (25 patients)). The hallmarks of COVID-19 infection on imaging were bilateral and peripheral ground-glass and consolidative pulmonary opacities. Notably, 20/36 (56%) of early patients had a normal CT. With a longer time after the onset of symptoms, CT findings were more frequent, including consolidation, bilateral and peripheral disease, greater total lung involvement, linear opacities, "crazy-paving" pattern and the "reverse halo" sign. Bilateral lung involvement was observed in 10/36 early patients (28%), 25/33 intermediate patients (76%), and 22/25 late patients (88%). SN - 1527-1315 UR - https://www.unboundmedicine.com/medline/citation/32077789/full_citation L2 - https://pubs.rsna.org/doi/10.1148/radiol.2020200463?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -