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Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients.
AJR Am J Roentgenol. 2020 07; 215(1):87-93.AA

Abstract

OBJECTIVE.

Available information on CT features of the 2019 novel coronavirus disease (COVID-19) is scattered in different publications, and a cohesive literature review has yet to be compiled. MATERIALS AND

METHODS.

This article includes a systematic literature search of PubMed, Embase (Elsevier), Google Scholar, and the World Health Organization database.

RESULTS.

Known features of COVID-19 on initial CT include bilateral multilobar ground-glass opacification (GGO) with a peripheral or posterior distribution, mainly in the lower lobes and less frequently within the right middle lobe. Atypical initial imaging presentation of consolidative opacities superimposed on GGO may be found in a smaller number of cases, mainly in the elderly population. Septal thickening, bronchiectasis, pleural thickening, and subpleural involvement are some of the less common findings, mainly in the later stages of the disease. Pleural effusion, pericardial effusion, lymphadenopathy, cavitation, CT halo sign, and pneumothorax are uncommon but may be seen with disease progression. Follow-up CT in the intermediate stage of disease shows an increase in the number and size of GGOs and progressive transformation of GGO into multifocal consolidative opacities, septal thickening, and development of a crazy paving pattern, with the greatest severity of CT findings visible around day 10 after the symptom onset. Acute respiratory distress syndrome is the most common indication for transferring patients with COVID-19 to the ICU and the major cause of death in this patient population. Imaging patterns corresponding to clinical improvement usually occur after week 2 of the disease and include gradual resolution of consolidative opacities and decrease in the number of lesions and involved lobes.

CONCLUSION.

This systematic review of current literature on COVID-19 provides insight into the initial and follow-up CT characteristics of the disease.

Authors+Show Affiliations

Department of Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo St, Los Angeles, CA 90033.Department of Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo St, Los Angeles, CA 90033.Department of Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo St, Los Angeles, CA 90033.Department of Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo St, Los Angeles, CA 90033.

Pub Type(s)

Journal Article
Systematic Review

Language

eng

PubMed ID

32174129

Citation

Salehi, Sana, et al. "Coronavirus Disease 2019 (COVID-19): a Systematic Review of Imaging Findings in 919 Patients." AJR. American Journal of Roentgenology, vol. 215, no. 1, 2020, pp. 87-93.
Salehi S, Abedi A, Balakrishnan S, et al. Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients. AJR Am J Roentgenol. 2020;215(1):87-93.
Salehi, S., Abedi, A., Balakrishnan, S., & Gholamrezanezhad, A. (2020). Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients. AJR. American Journal of Roentgenology, 215(1), 87-93. https://doi.org/10.2214/AJR.20.23034
Salehi S, et al. Coronavirus Disease 2019 (COVID-19): a Systematic Review of Imaging Findings in 919 Patients. AJR Am J Roentgenol. 2020;215(1):87-93. PubMed PMID: 32174129.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients. AU - Salehi,Sana, AU - Abedi,Aidin, AU - Balakrishnan,Sudheer, AU - Gholamrezanezhad,Ali, Y1 - 2020/03/14/ PY - 2020/3/17/pubmed PY - 2020/7/3/medline PY - 2020/3/17/entrez KW - 2019-nCoV KW - COVID-19 KW - CT scan KW - coronavirus KW - influenza KW - outbreak KW - pneumonia KW - radiology KW - systematic review KW - viral SP - 87 EP - 93 JF - AJR. American journal of roentgenology JO - AJR Am J Roentgenol VL - 215 IS - 1 N2 - OBJECTIVE. Available information on CT features of the 2019 novel coronavirus disease (COVID-19) is scattered in different publications, and a cohesive literature review has yet to be compiled. MATERIALS AND METHODS. This article includes a systematic literature search of PubMed, Embase (Elsevier), Google Scholar, and the World Health Organization database. RESULTS. Known features of COVID-19 on initial CT include bilateral multilobar ground-glass opacification (GGO) with a peripheral or posterior distribution, mainly in the lower lobes and less frequently within the right middle lobe. Atypical initial imaging presentation of consolidative opacities superimposed on GGO may be found in a smaller number of cases, mainly in the elderly population. Septal thickening, bronchiectasis, pleural thickening, and subpleural involvement are some of the less common findings, mainly in the later stages of the disease. Pleural effusion, pericardial effusion, lymphadenopathy, cavitation, CT halo sign, and pneumothorax are uncommon but may be seen with disease progression. Follow-up CT in the intermediate stage of disease shows an increase in the number and size of GGOs and progressive transformation of GGO into multifocal consolidative opacities, septal thickening, and development of a crazy paving pattern, with the greatest severity of CT findings visible around day 10 after the symptom onset. Acute respiratory distress syndrome is the most common indication for transferring patients with COVID-19 to the ICU and the major cause of death in this patient population. Imaging patterns corresponding to clinical improvement usually occur after week 2 of the disease and include gradual resolution of consolidative opacities and decrease in the number of lesions and involved lobes. CONCLUSION. This systematic review of current literature on COVID-19 provides insight into the initial and follow-up CT characteristics of the disease. SN - 1546-3141 UR - https://www.unboundmedicine.com/medline/citation/32174129/Coronavirus_Disease_2019__COVID_19_:_A_Systematic_Review_of_Imaging_Findings_in_919_Patients_ L2 - https://www.ajronline.org/doi/10.2214/AJR.20.23034 DB - PRIME DP - Unbound Medicine ER -