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CT in coronavirus disease 2019 (COVID-19): a systematic review of chest CT findings in 4410 adult patients.
Eur Radiol. 2020 Nov; 30(11):6129-6138.ER

Abstract

OBJECTIVE

The objective of this systematic review was to evaluate the key imaging manifestations of COVID-19 on chest CT in adult patients by providing a comprehensive review of the published literature.

METHODS

We performed a systematic literature search from the PubMed, Google Scholar, Embase, and WHO databases for studies mentioning the chest CT imaging findings of adult COVID-19 patients.

RESULTS

A total of 45 studies comprising 4410 patients were included. Ground glass opacities (GGO), in isolation (50.2%) or coexisting with consolidations (44.2%), were the most common lesions. Distribution of GGOs was most commonly bilateral, peripheral/subpleural, and posterior with predilection for lower lobes. Common ancillary findings included pulmonary vascular enlargement (64%), intralobular septal thickening (60%), adjacent pleural thickening (41.7%), air bronchograms (41.2%), subpleural lines, crazy paving, bronchus distortion, bronchiectasis, and interlobular septal thickening. CT in early follow-up period generally showed an increase in size, number, and density of GGOs, with progression into mixed areas of GGOs plus consolidations and crazy paving, peaking at 10-11 days, before gradually resolving or persisting as patchy fibrosis. While younger adults more commonly had GGOs, extensive/multilobar involvement with consolidations was prevalent in the older population and those with severe disease.

CONCLUSION

This review describes the imaging features for diagnosis, stratification, and follow-up of COVID-19 patients. The most common CT manifestations are bilateral, peripheral/subpleural, posterior GGOs with or without consolidations with a lower lobe predominance. It is pertinent to be familiar with the various imaging findings to positively impact the management of these patients.

KEY POINTS

• Ground glass opacities (GGOs), whether isolated or coexisting with consolidations, in bilateral and subpleural distribution, are the most prevalent chest CT findings in adult COVID-19 patients. • Follow-up CT shows a progression of GGOs into a mixed pattern, reaching a peak at 10-11 days, before gradually resolving or persisting as patchy fibrosis. • Younger people tend to have more GGOs. Older or sicker people tend to have more extensive involvement with consolidations.

Authors+Show Affiliations

Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, 110029, India.Department of Cardiology, Sri Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, 110029, India.Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, 110029, India.Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, 110029, India. sanjeevradio@gmail.com.

Pub Type(s)

Journal Article
Systematic Review

Language

eng

PubMed ID

32474632

Citation

Ojha, Vineeta, et al. "CT in Coronavirus Disease 2019 (COVID-19): a Systematic Review of Chest CT Findings in 4410 Adult Patients." European Radiology, vol. 30, no. 11, 2020, pp. 6129-6138.
Ojha V, Mani A, Pandey NN, et al. CT in coronavirus disease 2019 (COVID-19): a systematic review of chest CT findings in 4410 adult patients. Eur Radiol. 2020;30(11):6129-6138.
Ojha, V., Mani, A., Pandey, N. N., Sharma, S., & Kumar, S. (2020). CT in coronavirus disease 2019 (COVID-19): a systematic review of chest CT findings in 4410 adult patients. European Radiology, 30(11), 6129-6138. https://doi.org/10.1007/s00330-020-06975-7
Ojha V, et al. CT in Coronavirus Disease 2019 (COVID-19): a Systematic Review of Chest CT Findings in 4410 Adult Patients. Eur Radiol. 2020;30(11):6129-6138. PubMed PMID: 32474632.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - CT in coronavirus disease 2019 (COVID-19): a systematic review of chest CT findings in 4410 adult patients. AU - Ojha,Vineeta, AU - Mani,Avinash, AU - Pandey,Niraj Nirmal, AU - Sharma,Sanjiv, AU - Kumar,Sanjeev, Y1 - 2020/05/30/ PY - 2020/04/17/received PY - 2020/05/20/accepted PY - 2020/05/13/revised PY - 2020/6/1/pubmed PY - 2020/10/29/medline PY - 2020/6/1/entrez KW - COVID-19 KW - Diagnostic imaging KW - Radiology SP - 6129 EP - 6138 JF - European radiology JO - Eur Radiol VL - 30 IS - 11 N2 - OBJECTIVE: The objective of this systematic review was to evaluate the key imaging manifestations of COVID-19 on chest CT in adult patients by providing a comprehensive review of the published literature. METHODS: We performed a systematic literature search from the PubMed, Google Scholar, Embase, and WHO databases for studies mentioning the chest CT imaging findings of adult COVID-19 patients. RESULTS: A total of 45 studies comprising 4410 patients were included. Ground glass opacities (GGO), in isolation (50.2%) or coexisting with consolidations (44.2%), were the most common lesions. Distribution of GGOs was most commonly bilateral, peripheral/subpleural, and posterior with predilection for lower lobes. Common ancillary findings included pulmonary vascular enlargement (64%), intralobular septal thickening (60%), adjacent pleural thickening (41.7%), air bronchograms (41.2%), subpleural lines, crazy paving, bronchus distortion, bronchiectasis, and interlobular septal thickening. CT in early follow-up period generally showed an increase in size, number, and density of GGOs, with progression into mixed areas of GGOs plus consolidations and crazy paving, peaking at 10-11 days, before gradually resolving or persisting as patchy fibrosis. While younger adults more commonly had GGOs, extensive/multilobar involvement with consolidations was prevalent in the older population and those with severe disease. CONCLUSION: This review describes the imaging features for diagnosis, stratification, and follow-up of COVID-19 patients. The most common CT manifestations are bilateral, peripheral/subpleural, posterior GGOs with or without consolidations with a lower lobe predominance. It is pertinent to be familiar with the various imaging findings to positively impact the management of these patients. KEY POINTS: • Ground glass opacities (GGOs), whether isolated or coexisting with consolidations, in bilateral and subpleural distribution, are the most prevalent chest CT findings in adult COVID-19 patients. • Follow-up CT shows a progression of GGOs into a mixed pattern, reaching a peak at 10-11 days, before gradually resolving or persisting as patchy fibrosis. • Younger people tend to have more GGOs. Older or sicker people tend to have more extensive involvement with consolidations. SN - 1432-1084 UR - https://www.unboundmedicine.com/medline/citation/32474632/CT_in_coronavirus_disease_2019__COVID_19_:_a_systematic_review_of_chest_CT_findings_in_4410_adult_patients_ L2 - https://dx.doi.org/10.1007/s00330-020-06975-7 DB - PRIME DP - Unbound Medicine ER -