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Early chest CT features of patients with 2019 novel coronavirus (COVID-19) pneumonia: relationship to diagnosis and prognosis.
Eur Radiol. 2020 Nov; 30(11):6178-6185.ER

Abstract

OBJECTIVE

To determine the consistency between CT findings and real-time reverse transcription-polymerase chain reaction (RT-PCR) and to investigate the relationship between CT features and clinical prognosis in COVID-19.

METHODS

The clinical manifestations, laboratory parameters, and CT imaging findings were analyzed in 34 COVID-19 patients, confirmed by RT-PCR from January 20 to February 4 in Hainan Province. CT scores were compared between the discharged patients and the ICU patients.

RESULTS

Fever (85%) and cough (79%) were most commonly seen. Ten (29%) patients demonstrated negative results on their first RT-PCR. Of the 34 (65%) patients, 22 showed pure ground-glass opacity. Of the 34 (50%) patients, 17 had five lobes of lung involvement, while the 23 (68%) patients had lower lobe involvement. The lesions of 24 (71%) patients were distributed mainly in the subpleural area. The initial CT lesions of ICU patients were distributed in both the subpleural area and centro-parenchyma (80%), and the lesions were scattered. Sixty percent of ICU patients had five lobes involved, while this was seen in only 25% of the discharged patients. The lesions of discharged patients were mainly in the subpleural area (75%). Of the discharged patients, 62.5% showed pure ground-glass opacities; 80% of the ICU patients were in the progressive stage, and 75% of the discharged patients were at an early stage. CT scores of the ICU patients were significantly higher than those of the discharged patients.

CONCLUSION

Chest CT plays a crucial role in the early diagnosis of COVID-19, particularly for those patients with a negative RT-PCR. The initial features in CT may be associated with prognosis.

KEY POINTS

• Chest CT is valuable for the early diagnosis of COVID-19, particularly for those patients with a negative RT-PCR. • The early CT findings of COVID-19 in ICU patients differed from those of discharged patients.

Authors+Show Affiliations

Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), No. 19, Xiuhua St, Xiuying Dic, Haikou, 570311, Hainan, People's Republic of China.Department of Ultrasound, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), No. 19, Xiuhua St, Xiuying Dic, Haikou, 570311, Hainan, People's Republic of China.Department of Infectious Disease, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), No. 19, Xiuhua St, Xiuying Dic, Haikou, 570311, Hainan, People's Republic of China.Department of Laboratory Medicine, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), No. 19, Xiuhua St, Xiuying Dic, Haikou, 570311, Hainan, People's Republic of China.Medical Records Room, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), No. 19, Xiuhua St, Xiuying Dic, Haikou, 570311, Hainan, People's Republic of China.Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), No. 19, Xiuhua St, Xiuying Dic, Haikou, 570311, Hainan, People's Republic of China.Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), No. 19, Xiuhua St, Xiuying Dic, Haikou, 570311, Hainan, People's Republic of China.Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), No. 19, Xiuhua St, Xiuying Dic, Haikou, 570311, Hainan, People's Republic of China. fenger0802@163.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32518987

Citation

Chen, Hui Juan, et al. "Early Chest CT Features of Patients With 2019 Novel Coronavirus (COVID-19) Pneumonia: Relationship to Diagnosis and Prognosis." European Radiology, vol. 30, no. 11, 2020, pp. 6178-6185.
Chen HJ, Qiu J, Wu B, et al. Early chest CT features of patients with 2019 novel coronavirus (COVID-19) pneumonia: relationship to diagnosis and prognosis. Eur Radiol. 2020;30(11):6178-6185.
Chen, H. J., Qiu, J., Wu, B., Huang, T., Gao, Y., Wang, Z. P., Chen, Y., & Chen, F. (2020). Early chest CT features of patients with 2019 novel coronavirus (COVID-19) pneumonia: relationship to diagnosis and prognosis. European Radiology, 30(11), 6178-6185. https://doi.org/10.1007/s00330-020-06978-4
Chen HJ, et al. Early Chest CT Features of Patients With 2019 Novel Coronavirus (COVID-19) Pneumonia: Relationship to Diagnosis and Prognosis. Eur Radiol. 2020;30(11):6178-6185. PubMed PMID: 32518987.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early chest CT features of patients with 2019 novel coronavirus (COVID-19) pneumonia: relationship to diagnosis and prognosis. AU - Chen,Hui Juan, AU - Qiu,Jie, AU - Wu,Biao, AU - Huang,Tao, AU - Gao,Yunsuo, AU - Wang,Zhen Ping, AU - Chen,Yang, AU - Chen,Feng, Y1 - 2020/06/09/ PY - 2020/02/20/received PY - 2020/05/22/accepted PY - 2020/05/15/revised PY - 2020/6/11/pubmed PY - 2020/10/28/medline PY - 2020/6/11/entrez KW - COVID-19 KW - Pneumonia KW - Thorax KW - Tomography SP - 6178 EP - 6185 JF - European radiology JO - Eur Radiol VL - 30 IS - 11 N2 - OBJECTIVE: To determine the consistency between CT findings and real-time reverse transcription-polymerase chain reaction (RT-PCR) and to investigate the relationship between CT features and clinical prognosis in COVID-19. METHODS: The clinical manifestations, laboratory parameters, and CT imaging findings were analyzed in 34 COVID-19 patients, confirmed by RT-PCR from January 20 to February 4 in Hainan Province. CT scores were compared between the discharged patients and the ICU patients. RESULTS: Fever (85%) and cough (79%) were most commonly seen. Ten (29%) patients demonstrated negative results on their first RT-PCR. Of the 34 (65%) patients, 22 showed pure ground-glass opacity. Of the 34 (50%) patients, 17 had five lobes of lung involvement, while the 23 (68%) patients had lower lobe involvement. The lesions of 24 (71%) patients were distributed mainly in the subpleural area. The initial CT lesions of ICU patients were distributed in both the subpleural area and centro-parenchyma (80%), and the lesions were scattered. Sixty percent of ICU patients had five lobes involved, while this was seen in only 25% of the discharged patients. The lesions of discharged patients were mainly in the subpleural area (75%). Of the discharged patients, 62.5% showed pure ground-glass opacities; 80% of the ICU patients were in the progressive stage, and 75% of the discharged patients were at an early stage. CT scores of the ICU patients were significantly higher than those of the discharged patients. CONCLUSION: Chest CT plays a crucial role in the early diagnosis of COVID-19, particularly for those patients with a negative RT-PCR. The initial features in CT may be associated with prognosis. KEY POINTS: • Chest CT is valuable for the early diagnosis of COVID-19, particularly for those patients with a negative RT-PCR. • The early CT findings of COVID-19 in ICU patients differed from those of discharged patients. SN - 1432-1084 UR - https://www.unboundmedicine.com/medline/citation/32518987/Early_chest_CT_features_of_patients_with_2019_novel_coronavirus__COVID_19__pneumonia:_relationship_to_diagnosis_and_prognosis_ DB - PRIME DP - Unbound Medicine ER -