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Comparison of the computed tomography findings in COVID-19 and other viral pneumonia in immunocompetent adults: a systematic review and meta-analysis.
Eur Radiol. 2020 Dec; 30(12):6485-6496.ER

Abstract

OBJECTIVES

To compare the chest computed tomography (CT) findings of coronavirus disease 2019 (COVID-19) to other non-COVID viral pneumonia.

METHODS

MEDLINE, EMBASE, and Cochrane databases were searched through April 04, 2020, for published English language studies. Studies were eligible if they included immunocompetent patients with up to 14 days of viral pneumonia. Subjects had a respiratory tract sample test positive for COVID-19, adenovirus, influenza A, rhinovirus, parainfluenza, or respiratory syncytial virus. We only included observational studies and case series with more than ten patients. The pooled prevalence of each chest CT pattern or finding was calculated with 95% confidence intervals (95% CI).

RESULTS

From 2263 studies identified, 33 were eligible for inclusion, with a total of 1911 patients (COVID-19, n = 934; non-COVID, n = 977). Frequent CT features for both COVID-19 and non-COVID viral pneumonia were a mixed pattern of ground-glass opacity (GGO) and consolidation (COVID-19, 0.37; 0.17-0.56; non-COVID, 0.46; 0.35-0.58) or predominantly GGO pattern (COVID-19, 0.42; 0.28-0.55; non-COVID 0.25; 0.17-0.32), bilateral distribution (COVID-19, 0.81; 0.77-0.85; non-COVID, 0.69; 0.54-0.84), and involvement of lower lobes (COVID-19, 0.88; 0.80-0.95; non-COVID, 0.61; 0.50-0.82). COVID-19 pneumonia presented a higher prevalence of peripheral distribution (COVID-19 0.77; 0.67-0.87; non-COVID 0.34; 0.18-0.49), and involvement of upper (COVID-19, 0.77; 0.65-0.88; non-COVID 0.18; 0.10-0.27) and middle lobes (COVID-19, 0.61; 0.47-0.76; non-COVID 0.24; 0.11-0.38).

CONCLUSION

Except for a higher prevalence of peripheral distribution, involvement of upper and middle lobes, COVID-19, and non-COVID viral pneumonia had overlapping chest CT findings.

KEY POINTS

• Most common CT findings of coronavirus disease 2019 (COVID-19) were a predominant pattern of ground-glass opacity (GGO), followed by a mixed pattern of GGO and consolidation, bilateral disease, peripheral distribution, and lower lobe involvement. • Most frequent CT findings of non-COVID viral pneumonia were a predominantly mixed pattern of GGO and consolidation, followed by a predominant pattern of GGO, bilateral disease, random or diffuse distribution, and lower lobe involvement. • COVID-19 pneumonia presented a higher prevalence of peripheral distribution, and involvement of upper and middle lobes compared with non-COVID viral pneumonia.

Authors+Show Affiliations

Medical Imaging Research Lab, LABIMED, Department of Radiology, Pavilhão Pereira Filho Hospital, Irmandade Santa Casa de Misericórdia de Porto Alegre, Av. Independência, 75, Porto Alegre, 90020160, Brazil. Postgraduate Program in Medicine and Health Sciences, Pontificia Universidade Catolica do Rio Grande do Sul, Av. Ipiranga, 6690, Porto Alegre, 90619900, Brazil.Medical Imaging Research Lab, LABIMED, Department of Radiology, Pavilhão Pereira Filho Hospital, Irmandade Santa Casa de Misericórdia de Porto Alegre, Av. Independência, 75, Porto Alegre, 90020160, Brazil. Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre, R. Sarmento Leite, 245, Porto Alegre, 90050170, Brazil.Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre, R. Sarmento Leite, 245, Porto Alegre, 90050170, Brazil.Medical Imaging Research Lab, LABIMED, Department of Radiology, Pavilhão Pereira Filho Hospital, Irmandade Santa Casa de Misericórdia de Porto Alegre, Av. Independência, 75, Porto Alegre, 90020160, Brazil. Postgraduate Program in Medicine and Health Sciences, Pontificia Universidade Catolica do Rio Grande do Sul, Av. Ipiranga, 6690, Porto Alegre, 90619900, Brazil. Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre, R. Sarmento Leite, 245, Porto Alegre, 90050170, Brazil.Medical Imaging Research Lab, LABIMED, Department of Radiology, Pavilhão Pereira Filho Hospital, Irmandade Santa Casa de Misericórdia de Porto Alegre, Av. Independência, 75, Porto Alegre, 90020160, Brazil. Postgraduate Program in Medicine and Health Sciences, Pontificia Universidade Catolica do Rio Grande do Sul, Av. Ipiranga, 6690, Porto Alegre, 90619900, Brazil.Department of Radiology, College of Medicine, University of Florida, 1600 SW Archer Rd, Gainesville, FL, 32610, USA.Department of Radiology, College of Medicine, University of Florida, 1600 SW Archer Rd, Gainesville, FL, 32610, USA.Department of Radiology, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho, 373, Rio de Janeiro, 21941902, Brazil.Medical Imaging Research Lab, LABIMED, Department of Radiology, Pavilhão Pereira Filho Hospital, Irmandade Santa Casa de Misericórdia de Porto Alegre, Av. Independência, 75, Porto Alegre, 90020160, Brazil. brunoho@ufcspa.edu.br. Postgraduate Program in Medicine and Health Sciences, Pontificia Universidade Catolica do Rio Grande do Sul, Av. Ipiranga, 6690, Porto Alegre, 90619900, Brazil. brunoho@ufcspa.edu.br. Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre, R. Sarmento Leite, 245, Porto Alegre, 90050170, Brazil. brunoho@ufcspa.edu.br.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

32594211

Citation

Altmayer, Stephan, et al. "Comparison of the Computed Tomography Findings in COVID-19 and Other Viral Pneumonia in Immunocompetent Adults: a Systematic Review and Meta-analysis." European Radiology, vol. 30, no. 12, 2020, pp. 6485-6496.
Altmayer S, Zanon M, Pacini GS, et al. Comparison of the computed tomography findings in COVID-19 and other viral pneumonia in immunocompetent adults: a systematic review and meta-analysis. Eur Radiol. 2020;30(12):6485-6496.
Altmayer, S., Zanon, M., Pacini, G. S., Watte, G., Barros, M. C., Mohammed, T. L., Verma, N., Marchiori, E., & Hochhegger, B. (2020). Comparison of the computed tomography findings in COVID-19 and other viral pneumonia in immunocompetent adults: a systematic review and meta-analysis. European Radiology, 30(12), 6485-6496. https://doi.org/10.1007/s00330-020-07018-x
Altmayer S, et al. Comparison of the Computed Tomography Findings in COVID-19 and Other Viral Pneumonia in Immunocompetent Adults: a Systematic Review and Meta-analysis. Eur Radiol. 2020;30(12):6485-6496. PubMed PMID: 32594211.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of the computed tomography findings in COVID-19 and other viral pneumonia in immunocompetent adults: a systematic review and meta-analysis. AU - Altmayer,Stephan, AU - Zanon,Matheus, AU - Pacini,Gabriel Sartori, AU - Watte,Guilherme, AU - Barros,Marcelo Cardoso, AU - Mohammed,Tan-Lucien, AU - Verma,Nupur, AU - Marchiori,Edson, AU - Hochhegger,Bruno, Y1 - 2020/06/27/ PY - 2020/04/16/received PY - 2020/06/05/accepted PY - 2020/05/25/revised PY - 2020/7/1/pubmed PY - 2020/11/11/medline PY - 2020/6/29/entrez KW - COVID-19 KW - Computed tomography KW - Coronavirus KW - Viral pneumonia KW - X-ray SP - 6485 EP - 6496 JF - European radiology JO - Eur Radiol VL - 30 IS - 12 N2 - OBJECTIVES: To compare the chest computed tomography (CT) findings of coronavirus disease 2019 (COVID-19) to other non-COVID viral pneumonia. METHODS: MEDLINE, EMBASE, and Cochrane databases were searched through April 04, 2020, for published English language studies. Studies were eligible if they included immunocompetent patients with up to 14 days of viral pneumonia. Subjects had a respiratory tract sample test positive for COVID-19, adenovirus, influenza A, rhinovirus, parainfluenza, or respiratory syncytial virus. We only included observational studies and case series with more than ten patients. The pooled prevalence of each chest CT pattern or finding was calculated with 95% confidence intervals (95% CI). RESULTS: From 2263 studies identified, 33 were eligible for inclusion, with a total of 1911 patients (COVID-19, n = 934; non-COVID, n = 977). Frequent CT features for both COVID-19 and non-COVID viral pneumonia were a mixed pattern of ground-glass opacity (GGO) and consolidation (COVID-19, 0.37; 0.17-0.56; non-COVID, 0.46; 0.35-0.58) or predominantly GGO pattern (COVID-19, 0.42; 0.28-0.55; non-COVID 0.25; 0.17-0.32), bilateral distribution (COVID-19, 0.81; 0.77-0.85; non-COVID, 0.69; 0.54-0.84), and involvement of lower lobes (COVID-19, 0.88; 0.80-0.95; non-COVID, 0.61; 0.50-0.82). COVID-19 pneumonia presented a higher prevalence of peripheral distribution (COVID-19 0.77; 0.67-0.87; non-COVID 0.34; 0.18-0.49), and involvement of upper (COVID-19, 0.77; 0.65-0.88; non-COVID 0.18; 0.10-0.27) and middle lobes (COVID-19, 0.61; 0.47-0.76; non-COVID 0.24; 0.11-0.38). CONCLUSION: Except for a higher prevalence of peripheral distribution, involvement of upper and middle lobes, COVID-19, and non-COVID viral pneumonia had overlapping chest CT findings. KEY POINTS: • Most common CT findings of coronavirus disease 2019 (COVID-19) were a predominant pattern of ground-glass opacity (GGO), followed by a mixed pattern of GGO and consolidation, bilateral disease, peripheral distribution, and lower lobe involvement. • Most frequent CT findings of non-COVID viral pneumonia were a predominantly mixed pattern of GGO and consolidation, followed by a predominant pattern of GGO, bilateral disease, random or diffuse distribution, and lower lobe involvement. • COVID-19 pneumonia presented a higher prevalence of peripheral distribution, and involvement of upper and middle lobes compared with non-COVID viral pneumonia. SN - 1432-1084 UR - https://www.unboundmedicine.com/medline/citation/32594211/Comparison_of_the_computed_tomography_findings_in_COVID_19_and_other_viral_pneumonia_in_immunocompetent_adults:_a_systematic_review_and_meta_analysis_ L2 - https://dx.doi.org/10.1007/s00330-020-07018-x DB - PRIME DP - Unbound Medicine ER -