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Dynamic CT assessment of disease change and prognosis of patients with moderate COVID-19 pneumonia.
J Xray Sci Technol. 2020; 28(5):851-861.JX

Abstract

OBJECTIVES

To assess prognosis or dynamic change from initial diagnosis until recovery of the patients with moderate coronavirus disease (COVID-19) pneumonia using chest CT images.

MATERIALS AND METHODS

In this retrospective study, 33 patients (18 men, 15 women; median age, 49.0 years) with confirmed with moderate COVID-19 pneumonia in a multicenter hospital were included. The patients underwent at least four chest non-contrast-enhanced computed tomography (CT) scans at approximately 5-day intervals. We analyzed the clinical and CT characteristics of the patients. Moreover, the total CT score and the sum of lung involvement were determined for every CT scan.

RESULTS

The most widespread presenting symptoms were fever (32/33, 97.0%) and cough (17/33, 51.5%), which were often accompanied by decreased lymphocyte count (15/33, 45.5%) and increased C-reactive protein levels (18/33, 54.6%). Bilateral, multifocal ground glass opacities (32/33, 97.0%), consolidation (25/33, 75.8%), vascular thickening (23/33, 69.7%), and bronchial wall thickening (21/33, 63.6%) with peripheral distribution were the most frequent CT findings during moderate COVID-19 pneumonia. In patients recovering from moderate COVID-19 pneumonia, four stages (stages 1-4) of evolution were identified on chest CT with average CT scores of 3.4±2.3, 6.0±4.4, 5.6±3.8, and 4.9±3.2, respectively, from the onset of symptoms. For most patients, the peak of average total CT score increased for approximately 8 days after the onset of symptoms, after which it decreased gradually. The mean CT score of all patients was 4.7 at the time of discharge.

CONCLUSION

The moderate COVID-19 pneumonia CT score increased rapidly in a short period of time initially, followed by a slow decline over a relatively long time. The peak of the course occurred in stage 2. Complete recovery of patients with moderate COVID-19 pneumonia with high mean CT score at the time of discharge requires longer time.

Authors+Show Affiliations

Department of Radiology, the Third Affiliated Hospital of Nanchang University (also known as the First Hospital of Nanchang), Jiangxi, China.Department of Radiology, JiangXi PingXiang people's hospital, Jiangxi, China.Department of Radiology, JiangXi JinXian people's hospital, Jiangxi, China.Department of Radiology, the Third Affiliated Hospital of Nanchang University (also known as the First Hospital of Nanchang), Jiangxi, China.Department of Radiology, Jiangxi provincial chest hospital, Jiangxi, China.InferVision, Beijing, China.Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, Jiangxi, China.Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, Jiangxi, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32741802

Citation

Zhang, Hua, et al. "Dynamic CT Assessment of Disease Change and Prognosis of Patients With Moderate COVID-19 Pneumonia." Journal of X-ray Science and Technology, vol. 28, no. 5, 2020, pp. 851-861.
Zhang H, Liu X, Yu P, et al. Dynamic CT assessment of disease change and prognosis of patients with moderate COVID-19 pneumonia. J Xray Sci Technol. 2020;28(5):851-861.
Zhang, H., Liu, X., Yu, P., Cheng, M., Wang, W., Sun, Y., Zeng, B., & Fan, B. (2020). Dynamic CT assessment of disease change and prognosis of patients with moderate COVID-19 pneumonia. Journal of X-ray Science and Technology, 28(5), 851-861. https://doi.org/10.3233/XST-200711
Zhang H, et al. Dynamic CT Assessment of Disease Change and Prognosis of Patients With Moderate COVID-19 Pneumonia. J Xray Sci Technol. 2020;28(5):851-861. PubMed PMID: 32741802.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dynamic CT assessment of disease change and prognosis of patients with moderate COVID-19 pneumonia. AU - Zhang,Hua, AU - Liu,Xiaohong, AU - Yu,Peng, AU - Cheng,Mingyuan, AU - Wang,Weiting, AU - Sun,Yipeng, AU - Zeng,Bingliang, AU - Fan,Bing, PY - 2020/8/4/pubmed PY - 2020/10/21/medline PY - 2020/8/4/entrez KW - COVID-19 KW - COVID-19 prognosis KW - Coronavirus disease KW - Dynamic CT assessment KW - Moderate COVID-19 Pneumonia SP - 851 EP - 861 JF - Journal of X-ray science and technology JO - J Xray Sci Technol VL - 28 IS - 5 N2 - OBJECTIVES: To assess prognosis or dynamic change from initial diagnosis until recovery of the patients with moderate coronavirus disease (COVID-19) pneumonia using chest CT images. MATERIALS AND METHODS: In this retrospective study, 33 patients (18 men, 15 women; median age, 49.0 years) with confirmed with moderate COVID-19 pneumonia in a multicenter hospital were included. The patients underwent at least four chest non-contrast-enhanced computed tomography (CT) scans at approximately 5-day intervals. We analyzed the clinical and CT characteristics of the patients. Moreover, the total CT score and the sum of lung involvement were determined for every CT scan. RESULTS: The most widespread presenting symptoms were fever (32/33, 97.0%) and cough (17/33, 51.5%), which were often accompanied by decreased lymphocyte count (15/33, 45.5%) and increased C-reactive protein levels (18/33, 54.6%). Bilateral, multifocal ground glass opacities (32/33, 97.0%), consolidation (25/33, 75.8%), vascular thickening (23/33, 69.7%), and bronchial wall thickening (21/33, 63.6%) with peripheral distribution were the most frequent CT findings during moderate COVID-19 pneumonia. In patients recovering from moderate COVID-19 pneumonia, four stages (stages 1-4) of evolution were identified on chest CT with average CT scores of 3.4±2.3, 6.0±4.4, 5.6±3.8, and 4.9±3.2, respectively, from the onset of symptoms. For most patients, the peak of average total CT score increased for approximately 8 days after the onset of symptoms, after which it decreased gradually. The mean CT score of all patients was 4.7 at the time of discharge. CONCLUSION: The moderate COVID-19 pneumonia CT score increased rapidly in a short period of time initially, followed by a slow decline over a relatively long time. The peak of the course occurred in stage 2. Complete recovery of patients with moderate COVID-19 pneumonia with high mean CT score at the time of discharge requires longer time. SN - 1095-9114 UR - https://www.unboundmedicine.com/medline/citation/32741802/Dynamic_CT_assessment_of_disease_change_and_prognosis_of_patients_with_moderate_COVID_19_pneumonia_ L2 - https://content.iospress.com/openurl?genre=article&id=doi:10.3233/XST-200711 DB - PRIME DP - Unbound Medicine ER -