Correlation between CT findings and outcomes in 46 Patients with Coronavirus Disease-19

Abstract

Purpose: The aim of this study was to retrospectively analyze chest Computed Tomography (CT) findings in COVID-19 pneumonia and identify features associated with poor prognosis.Methods: This retrospective review included 46 patients with RT-PCR confirmed COVID-19 infection. Basic clinical characteristics and detailed CT features were evaluated and compared between patients who recovered (n = 40) from coronavirus and those who expired (n = 6). Chest CT examinations for ground-glass opacity, crazy-paving pattern, consolidation, and fibrosis were scored by two reviewers. The total CT score comprised the sum of lung involvement (5 lobes, scores 1-5 for each lobe, range; 0, none; 25, maximum) was determined.Results: We analyzed clinical data from 46 patients (26 males and 20 females; age 9-82 years) with confirmed COVID-19 pneumonia were evaluated. The chest CTs showed 27 (58.7%) patients had ground-glass opacity, 19 (41.3%) had ground glass and consolidation, and 35 (76.1%) patients had crazy-paving pattern. None of the patients who expired had fibrosis, in contrast to six (15%) patients who recovered from coronavirus. Most patients had subpleural lesions (89.0%), bilateral (87.0%) and lower (93.0%) lung lobe involvement. Diffuse lesions were present in four (67%) patients who succumbed to coronavirus, but only one (2.5%) patient who recovered (p = 0.000). CT identified a greater area of lung lobe involvement in patients who died (p = 0.000). In the group of patients who expired, the total CT score was higher than that of the recovery group (17.2 ± 7.8 vs. 7.1 ± 4.3, p = 0.005). Patients in the death group had lower lymphocyte count and higher C-reactive protein than those in the recovery group (p = 0.011 and p = 0.041, respectively).Conclusion: The CT of patients with COVID-19 mainly showed ground-glass opacity and ground-glass opacity plus consolidation, with a peripheral lower lobe preference. Early fibrosis may correlate with well prognosis. Lymphopenia, elevated C-reactive protein, and high CT score in conjunction with diffuse distribution of lung lesions are indicative of disease severity and short- term mortality.