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Temporal Changes of CT Findings in 90 Patients with COVID-19 Pneumonia: A Longitudinal Study.
Radiology. 2020 08; 296(2):E55-E64.R

Abstract

Background CT may play a central role in the diagnosis and management of coronavirus disease 2019 (COVID-19) pneumonia. Purpose To perform a longitudinal study to analyze the serial CT findings over time in patients with COVID-19 pneumonia. Materials and Methods During January 16 to February 17, 2020, 90 patients (33 men, 57 women; mean age, 45 years) with COVID-19 pneumonia were prospectively enrolled and followed up until being discharged, death, or the end of the study. A total of 366 CT scans were acquired and reviewed by two groups of radiologists for the patterns and distribution of lung abnormalities, total CT scores, and number of zones involved. Those features were analyzed for temporal change. Results CT scores and number of zones involved progressed rapidly, peaked during illness days 6-11 (median CT score, 5; median number of zones involved, five), and were followed by persistence of high levels. The predominant pattern of abnormalities after symptom onset was ground-glass opacity (35 of 78 scans [45%] to 49 of 79 scans [62%] in different periods). The percentage of mixed pattern peaked on illness days 12-17 (30 of 78 scans [38%]) and became the second most predominant pattern thereafter. Pure ground-glass opacity was the most prevalent subtype of ground-glass opacity after symptom onset (20 of 50 scans [40%] to 20 of 28 scans [71%]). The percentage of ground-glass opacity with irregular linear opacity peaked on illness days 6-11 (14 of 50 scans [28%]) and became the second most prevalent subtype thereafter. The distribution of lesions was predominantly bilateral and subpleural. Sixty-six of the 70 patients discharged (94%) had residual disease on final CT scans (median CT score, 4; median number of zones involved, four), with ground-glass opacity (42 of 70 patients [60%]) and pure ground-glass opacity (31 of 42 patients [74%]) the most common pattern and subtype. Conclusion The extent of lung abnormalities at CT peaked during illness days 6-11. The temporal changes of the diverse CT manifestations followed a specific pattern, which might indicate the progression and recovery of the illness. © RSNA, 2020 Online supplemental material is available for this article.

Authors+Show Affiliations

From the Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Ave, Wuhan, Hubei, China 430022 (Y.W., C.D., C.L., Q.R., X.Z., H.S., M.Z.); Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China (Y.W., C.D., C.L., Q.R., X.Z., H.S., M.Z.); and Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (Y.H.).From the Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Ave, Wuhan, Hubei, China 430022 (Y.W., C.D., C.L., Q.R., X.Z., H.S., M.Z.); Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China (Y.W., C.D., C.L., Q.R., X.Z., H.S., M.Z.); and Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (Y.H.).From the Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Ave, Wuhan, Hubei, China 430022 (Y.W., C.D., C.L., Q.R., X.Z., H.S., M.Z.); Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China (Y.W., C.D., C.L., Q.R., X.Z., H.S., M.Z.); and Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (Y.H.).From the Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Ave, Wuhan, Hubei, China 430022 (Y.W., C.D., C.L., Q.R., X.Z., H.S., M.Z.); Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China (Y.W., C.D., C.L., Q.R., X.Z., H.S., M.Z.); and Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (Y.H.).From the Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Ave, Wuhan, Hubei, China 430022 (Y.W., C.D., C.L., Q.R., X.Z., H.S., M.Z.); Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China (Y.W., C.D., C.L., Q.R., X.Z., H.S., M.Z.); and Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (Y.H.).From the Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Ave, Wuhan, Hubei, China 430022 (Y.W., C.D., C.L., Q.R., X.Z., H.S., M.Z.); Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China (Y.W., C.D., C.L., Q.R., X.Z., H.S., M.Z.); and Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (Y.H.).From the Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Ave, Wuhan, Hubei, China 430022 (Y.W., C.D., C.L., Q.R., X.Z., H.S., M.Z.); Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China (Y.W., C.D., C.L., Q.R., X.Z., H.S., M.Z.); and Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (Y.H.).From the Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Ave, Wuhan, Hubei, China 430022 (Y.W., C.D., C.L., Q.R., X.Z., H.S., M.Z.); Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China (Y.W., C.D., C.L., Q.R., X.Z., H.S., M.Z.); and Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (Y.H.).

Pub Type(s)

Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32191587

Citation

Wang, Yuhui, et al. "Temporal Changes of CT Findings in 90 Patients With COVID-19 Pneumonia: a Longitudinal Study." Radiology, vol. 296, no. 2, 2020, pp. E55-E64.
Wang Y, Dong C, Hu Y, et al. Temporal Changes of CT Findings in 90 Patients with COVID-19 Pneumonia: A Longitudinal Study. Radiology. 2020;296(2):E55-E64.
Wang, Y., Dong, C., Hu, Y., Li, C., Ren, Q., Zhang, X., Shi, H., & Zhou, M. (2020). Temporal Changes of CT Findings in 90 Patients with COVID-19 Pneumonia: A Longitudinal Study. Radiology, 296(2), E55-E64. https://doi.org/10.1148/radiol.2020200843
Wang Y, et al. Temporal Changes of CT Findings in 90 Patients With COVID-19 Pneumonia: a Longitudinal Study. Radiology. 2020;296(2):E55-E64. PubMed PMID: 32191587.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Temporal Changes of CT Findings in 90 Patients with COVID-19 Pneumonia: A Longitudinal Study. AU - Wang,Yuhui, AU - Dong,Chengjun, AU - Hu,Yue, AU - Li,Chungao, AU - Ren,Qianqian, AU - Zhang,Xin, AU - Shi,Heshui, AU - Zhou,Min, Y1 - 2020/03/19/ PY - 2020/3/20/pubmed PY - 2020/8/1/medline PY - 2020/3/20/entrez SP - E55 EP - E64 JF - Radiology JO - Radiology VL - 296 IS - 2 N2 - Background CT may play a central role in the diagnosis and management of coronavirus disease 2019 (COVID-19) pneumonia. Purpose To perform a longitudinal study to analyze the serial CT findings over time in patients with COVID-19 pneumonia. Materials and Methods During January 16 to February 17, 2020, 90 patients (33 men, 57 women; mean age, 45 years) with COVID-19 pneumonia were prospectively enrolled and followed up until being discharged, death, or the end of the study. A total of 366 CT scans were acquired and reviewed by two groups of radiologists for the patterns and distribution of lung abnormalities, total CT scores, and number of zones involved. Those features were analyzed for temporal change. Results CT scores and number of zones involved progressed rapidly, peaked during illness days 6-11 (median CT score, 5; median number of zones involved, five), and were followed by persistence of high levels. The predominant pattern of abnormalities after symptom onset was ground-glass opacity (35 of 78 scans [45%] to 49 of 79 scans [62%] in different periods). The percentage of mixed pattern peaked on illness days 12-17 (30 of 78 scans [38%]) and became the second most predominant pattern thereafter. Pure ground-glass opacity was the most prevalent subtype of ground-glass opacity after symptom onset (20 of 50 scans [40%] to 20 of 28 scans [71%]). The percentage of ground-glass opacity with irregular linear opacity peaked on illness days 6-11 (14 of 50 scans [28%]) and became the second most prevalent subtype thereafter. The distribution of lesions was predominantly bilateral and subpleural. Sixty-six of the 70 patients discharged (94%) had residual disease on final CT scans (median CT score, 4; median number of zones involved, four), with ground-glass opacity (42 of 70 patients [60%]) and pure ground-glass opacity (31 of 42 patients [74%]) the most common pattern and subtype. Conclusion The extent of lung abnormalities at CT peaked during illness days 6-11. The temporal changes of the diverse CT manifestations followed a specific pattern, which might indicate the progression and recovery of the illness. © RSNA, 2020 Online supplemental material is available for this article. SN - 1527-1315 UR - https://www.unboundmedicine.com/medline/citation/32191587/full_citation L2 - https://pubs.rsna.org/doi/10.1148/radiol.2020200843?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -