Chest computed tomography in COVID-19 pneumonia: a retrospective study of 155 patients at a university hospital in Rio de Janeiro, Brazil

Abstract

Objective: To define diagnostic criteria for coronavirus disease 2019 (COVID-19) on computed tomography (CT); to study the correlation between CT and polymerase chain reaction (PCR) testing for infection with severe acute respiratory syndrome coronavirus 2; and to determine whether the extent of parenchymal involvement and the need for mechanical ventilation are associated with the CT findings and clinical characteristics of patients with COVID-19. Materials and Methods: This was a retrospective study of 155 patients with COVID-19 treated between March and May 2020. We attempted to determine whether the CT findings correlated with age and clinical variables, as well as whether the need for mechanical ventilation correlated with the extent of the pulmonary involvement. Results: On average, the patients with COVID-19 were older than were those without (mean age, 54.8 years vs. 45.5 years; p = 0.031). The most common CT finding (seen in 88.6%) was ground-glass opacity, which correlated significantly with a diagnosis of COVID-19 (p = 0.0001). The CT findings that correlated most strongly with the need for mechanical ventilation were parenchymal bands (p = 0.013), bronchial ectasia (p = 0.046), and peribronchovascular consolidations (p = 0.012). The presence of one or more comorbidities correlated significantly with more extensive parenchymal involvement (p = 0.023). For the diagnosis of COVID-19, CT had a sensitivity of 84.3%, a specificity of 36.7%, and an accuracy of 73.5% (p = 0.012 vs. PCR). Conclusion: The patterns of CT findings are useful for the diagnosis of COVID-19 and the evaluation of disease severity criteria. The presence of any comorbidity is associated with greater severity of COVID-19.

The Importance of Radiological Patterns and Small Airway Disease in Long-Term Follow-Up of Postacute COVID-19: A Preliminary Study

“…The epidemiological profile of patients is similar to that found in other studies on COVID-19 [ 25 , 26 ]. However, our sample's median follow-up time (8.8 months) denotes quite prolonged clinical pictures of the disease, which shows two things: postacute COVID-19 manifestations can remain relevant for a long time and the ease of access to the health system in Brazil may not be ideal.…”

Does COVID-19 pneumonia signify secondary organizing pneumonia?: A narrative review comparing the similarities between these two distinct entities

“… 4 , 27 In a similar fashion to COVID-19, the opacities in OP will evolve into a more consolidative appearance with reverse halo signs. 28 , 29 , 30 , 31 Peripheral and lower-lobe predominant GGOs concerning for OP have been described on chest CT during influenza A pandemic. 12 , 32 With the wide variety of radiological manifestations described, it is not surprising why COVID-19 pneumonia can be an excellent mimicker of a variety of different infectious and inflammatory respiratory diseases including OP.…”

Concomitant COVID-19 and pulmonary tuberculosis: computed tomography aspects

“…The COVID-19 pandemic has overburdened health care facilities throughout the world( 1 , 3 , 4 ). During the pandemic, chest CT has proven to be an extremely useful tool in patients with COVID-19 pneumonia( 7 , 8 , 11 , 12 , 13 , 14 , 15 , 16 ), especially for the assessment of disease progression and complications, thus alleviating some of the burden.…”