To report the spectrum of chest computed tomographic (CT) imaging findings in coronavirus disease-19 (COVID-19) infected Indian patients. Methods: This was a prospective descriptive study comprising 147 consecutive reverse transcriptase polymerase chain reaction (RT-PCR) positive patients who underwent CT chest. Prevalence, distribution, extent and type of abnormal lung findings were recorded. Results: Among the total study cohort of 147 patients, 104 (70.7 %) were males and 43 (29.3 %) were females with mean age of 40.9 ± 17.2 years (range 24-71 years). We observed lung parenchymal abnormalities in 51 (34.7 %) cases whereas 96 (65.3 %) RT-PCR positive cases had a normal chest CT. Only 12.2 % of the patients were dyspneic, 6.1 % had desaturation, 7.4 % had increased respiratory rate and 10.9 % had comorbidities. Among the patients with abnormal CT findings bilateral 39/51 (76.5 %), multilobar (88.2 %) lung involvement with a predominant peripheral and posterior distribution was commonly observed. With regards to the type of opacity, ground glass opacity (GGO) was the dominant abnormality found in all 51 (100 %) cases. Pure GGO was observed in 15 (29.4 %), GGO with crazy paving pattern was seen in 15 (29.4 %) and GGO mixed with consolidation was noted in 21(41.2 %). Peri-lesional or intralesional segmental or subsegmental pulmonary vessel enlargement was observed in 36 (70.6 %) cases.
Conclusion:In this study population predominantly with mild symptoms and few comorbidities, two-thirds of RT-PCR positive patients had a normal chest CT; whereas the remaining patients showed typical findings of predominant GGOs with a bilateral distribution and peripheral predominance.
Objective: To study the spectrum of chest CT features in coronavirus disease-19 (COVID-19) pneumonia and to identify the initial CT findings that may have the potential to predict a poor short-term outcome. Methods: This was a retrospective study comprising 211 reverse transcriptase-polymerase chain reaction (RT-PCR) positive patients who had undergone non-contrast chest CT. Prevalence, extent, pattern, distribution and type of abnormal lung findings were recorded. Patients with positive CT findings were divided into two groups; clinically stable (requiring in-ward hospitalization) and clinically unstable [requiring intensive care unit (ICU) admission or demised] based on short-term follow-up. Results: Lung parenchymal abnormalities were present in 42.2% (89/211) whereas 57.8% (122/211) cases had a normal chest CT. The mean age of clinically unstable patients (63.6 ± 8.3 years) was significantly different from the clinically stable group (44.6 ± 13.2 years) (p-value < 0.05). Bilaterality, combined involvement of central–peripheral and anteroposterior lung along with a higher percentage of the total lung involvement, presence of crazy paving, coalescent consolidations with air bronchogram and segmental pulmonary vessel enlargement were found in a significantly higher proportion of clinically unstable group (ICU/demised) compared to the stable group (in-ward hospitalization) with all p values < 0.05. Conclusion: Certain imaging findings on initial CT have the potential to predict short-term outcome in COVID-19 pneumonia. Extensive pulmonary abnormalities, evaluated by combined anteroposterior, central–peripheral and a higher percentage of the total lung involvement, indicate a poor short-term outcome. Similarly, the presence of crazy paving pattern, consolidation with air bronchogram and segmental vascular changes are also indicators of poor short-term outcome. Advances in knowledge: Certain findings on initial CT can predict an adverse short-term prognosis in COVID-19 pneumonia.
The results from the present study suggest promising role of SWI in the discrimination of tuberculomas from metastatic brain lesions and gliomas with the presence of a complete and regular peripheral hypointense ring favoring the diagnosis of tuberculomas.
Background
The data on medium-term follow-up of coronavirus disease-19 (COVID-19) pneumonia survivors is scarce. Medium-term follow-up will generate knowledge and help in devising a structured follow-up plan and to facilitate enrolment in clinical trials assessing the role of antifibrotic drugs in modifying the course of disease in order to avert long-term pulmonary sequelae of disease. The study was aimed to evaluate the lung findings on a medium-term follow-up (3 months or more) chest computed tomography (CT) in COVID-19 pneumonia survivors, assess the rate of resolution or persistence of lung abnormalities and to identify the initial demographic, clinical, and imaging characteristics that could potentially predict the persistence of lung abnormalities on follow-up.
Results
Out of the total study cohort of 81 patients, 46 (56.8%) demonstrated complete resolution of lung findings and the remaining 35 (43.2%) had residual lung opacities on follow-up CT. The most common type of residual abnormality was ground glass opacity (GGO) (16/35; 45.7%), followed by parenchymal bands (9/35; 25.7%), mixed pattern of GGO and parenchymal bands (6/35; 17.2%), bronchiectasis (6/35; 17.2%), and interlobular septal thickening (4/35; 11.4%). Patients with residual abnormalities were older, had higher BMI, more comorbidities, lower SpO2, longer hospital stay, higher rate of intensive care unit (ICU) admission, higher WBC count, a higher CT severity score, and lower rate of steroid administration with all p values < 0.05.
Conclusion
Nearly half of post-COVID-19 survivors had residual lung abnormalities after ≥ 3 months of follow-up. Certain clinico-radiological characteristics have the potential to identify the individuals at risk of having residual lung abnormalities on medium-term follow-up.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.