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Evolution of CT findings in patients with mild COVID-19 pneumonia.
Eur Radiol. 2020 Sep; 30(9):4865-4873.ER

Abstract

OBJECTIVES

To delineate the evolution of CT findings in patients with mild COVID-19 pneumonia.

METHODS

CT images and medical records of 88 patients with confirmed mild COVID-19 pneumonia, a baseline CT, and at least one follow-up CT were retrospectively reviewed. CT features including lobar distribution and presence of ground glass opacities (GGO), consolidation, and linear opacities were analyzed on per-patient basis during each of five time intervals spanning the 3 weeks after disease onset. Total severity scores were calculated.

RESULTS

Of patients, 85.2% had travel history to Wuhan or known contact with infected individuals. The most common symptoms were fever (84.1%) and cough (56.8%). The baseline CT was obtained on average 5 days from symptom onset. Four patients (4.5%) had negative initial CT. Significant differences were found among the time intervals in the proportion of pulmonary lesions that are (1) pure GGO, (2) mixed attenuation, (3) mixed attenuation with linear opacities, (4) consolidation with linear opacities, and (5) pure consolidation. The majority of patients had involvement of ≥ 3 lobes. Bilateral involvement was more prevalent than unilateral involvement. The proportions of patients observed to have pure GGO or GGO and consolidation decreased over time while the proportion of patients with GGO and linear opacities increased. Total severity score showed an increasing trend in the first 2 weeks.

CONCLUSIONS

While bilateral GGO are predominant features, CT findings changed during different time intervals in the 3 weeks after symptom onset in patients with COVID-19.

KEY POINTS

• Four of 88 (4.5%) patients with COVID-19 had negative initial CT. • Majority of COVID-19 patients had abnormal CT findings in ≥ 3 lobes. • A proportion of patients with pure ground glass opacities decreased over the 3 weeks after symptom onset.

Authors+Show Affiliations

Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, People's Republic of China.Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, People's Republic of China.Department of Diagnostic Radiology, University of Texas M.D. Anderson Cancer Center, Houston, TX, 77030, USA. carolcwu@gmail.com.Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, People's Republic of China.Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, People's Republic of China.Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, People's Republic of China.Department of Radiology, the Eighth Hospital of Xi'an, Xi'an, 710061, People's Republic of China.Department of Radiology, the Eighth Hospital of Xi'an, Xi'an, 710061, People's Republic of China.Department of Radiology, Xi'an Chest Hospital, Xi'an, 710100, People's Republic of China.Department of Radiology, Xi'an Chest Hospital, Xi'an, 710100, People's Republic of China.Department of Radiology, Ankang Center Hospital, Ankang, 725000, People's Republic of China.Department of Radiology, Ankang Center Hospital, Ankang, 725000, People's Republic of China.Department of Radiology, Hanzhong Center Hospital, Hanzhong, 723000, People's Republic of China.Department of Radiology, Baoji Center Hospital, Baoji, 721008, People's Republic of China.Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, People's Republic of China. yj1118@mail.xjtu.edu.cn.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32291502

Citation

Liang, Ting, et al. "Evolution of CT Findings in Patients With Mild COVID-19 Pneumonia." European Radiology, vol. 30, no. 9, 2020, pp. 4865-4873.
Liang T, Liu Z, Wu CC, et al. Evolution of CT findings in patients with mild COVID-19 pneumonia. Eur Radiol. 2020;30(9):4865-4873.
Liang, T., Liu, Z., Wu, C. C., Jin, C., Zhao, H., Wang, Y., Wang, Z., Li, F., Zhou, J., Cai, S., Liang, Y., Zhou, H., Wang, X., Ren, Z., & Yang, J. (2020). Evolution of CT findings in patients with mild COVID-19 pneumonia. European Radiology, 30(9), 4865-4873. https://doi.org/10.1007/s00330-020-06823-8
Liang T, et al. Evolution of CT Findings in Patients With Mild COVID-19 Pneumonia. Eur Radiol. 2020;30(9):4865-4873. PubMed PMID: 32291502.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evolution of CT findings in patients with mild COVID-19 pneumonia. AU - Liang,Ting, AU - Liu,Zhe, AU - Wu,Carol C, AU - Jin,Chao, AU - Zhao,Huifang, AU - Wang,Yan, AU - Wang,Zekun, AU - Li,Fen, AU - Zhou,Jie, AU - Cai,Shubo, AU - Liang,Yukun, AU - Zhou,Heping, AU - Wang,Xibin, AU - Ren,Zhuanqin, AU - Yang,Jian, Y1 - 2020/04/15/ PY - 2020/02/19/received PY - 2020/03/19/accepted PY - 2020/03/14/revised PY - 2020/4/16/pubmed PY - 2020/8/21/medline PY - 2020/4/16/entrez KW - Coronavirus KW - Pneumonia KW - Tomography SP - 4865 EP - 4873 JF - European radiology JO - Eur Radiol VL - 30 IS - 9 N2 - OBJECTIVES: To delineate the evolution of CT findings in patients with mild COVID-19 pneumonia. METHODS: CT images and medical records of 88 patients with confirmed mild COVID-19 pneumonia, a baseline CT, and at least one follow-up CT were retrospectively reviewed. CT features including lobar distribution and presence of ground glass opacities (GGO), consolidation, and linear opacities were analyzed on per-patient basis during each of five time intervals spanning the 3 weeks after disease onset. Total severity scores were calculated. RESULTS: Of patients, 85.2% had travel history to Wuhan or known contact with infected individuals. The most common symptoms were fever (84.1%) and cough (56.8%). The baseline CT was obtained on average 5 days from symptom onset. Four patients (4.5%) had negative initial CT. Significant differences were found among the time intervals in the proportion of pulmonary lesions that are (1) pure GGO, (2) mixed attenuation, (3) mixed attenuation with linear opacities, (4) consolidation with linear opacities, and (5) pure consolidation. The majority of patients had involvement of ≥ 3 lobes. Bilateral involvement was more prevalent than unilateral involvement. The proportions of patients observed to have pure GGO or GGO and consolidation decreased over time while the proportion of patients with GGO and linear opacities increased. Total severity score showed an increasing trend in the first 2 weeks. CONCLUSIONS: While bilateral GGO are predominant features, CT findings changed during different time intervals in the 3 weeks after symptom onset in patients with COVID-19. KEY POINTS: • Four of 88 (4.5%) patients with COVID-19 had negative initial CT. • Majority of COVID-19 patients had abnormal CT findings in ≥ 3 lobes. • A proportion of patients with pure ground glass opacities decreased over the 3 weeks after symptom onset. SN - 1432-1084 UR - https://www.unboundmedicine.com/medline/citation/32291502/Evolution_of_CT_findings_in_patients_with_mild_COVID_19_pneumonia_ L2 - https://dx.doi.org/10.1007/s00330-020-06823-8 DB - PRIME DP - Unbound Medicine ER -