High-resolution computed tomography finding in 552 patients with symptomatic COVID-19: first report from north of Iran

Abstract

Purpose Due to the emergence of the new coronavirus 2019 and the lack of sufficient information about infected patients, this study was conducted to investigate the chest high-resolution computed tomography (HRCT) findings of patients infected with the new coronavirus 2019. Methods This cross-sectional study was performed on COVID-19 patients referred to Medical Imaging Centers of Sari, Mazandaran, Iran, on March 2020 for computed tomography (CT) scan. Symptomatic patients were referred to the Medical Imaging Center for diagnosis confirmation through CT scan. In addition to age and sex, HRCT findings were collected from the picture archiving and communication system (PACS) for further evaluations. Results Out of 552 patients with mean age of 51.2 ± 14.8 years, the male/female ratio was 1.38 to 1. The most common expressive findings in patients were ground-glass opacity (GGO) (87.3%), peripheral distribution (82.4%), and posterior distribution (81.5%). The most conflicting findings in patients were pleural effusion (7.6%), peribronchovascular distribution (7.6%), and lymphadenopathy (5.1%). The peripheral distribution (p = 0.034), round opacities (p = 0.02), single lobe (p = 0.003), and pleural effusion (p = 0.037) were significant in people under and over 50 years of age. Conclusion In summary, the present study indicated that in addition to GGO, peripheral distribution findings could be a vital diagnostic choice in COVID-19 patients.

The incidence of pleural effusion in COVID-19 pneumonia: State-of-the-art review

“…The frequency of pleural effusions varies with age, according to a large observational study by Majidi et al involving 552 COVID-19 patients. 21 In this study, although the overall rate of pleural effusions detected was 7.3%, a higher amount of COVID-19 patients age 50 years and older (10% versus 5.2%; p = 0.037) developed pleural effusions than those 50 years and under. However, this result was not replicated in other smaller observational studies.…”

“… 13 , 14 , 15 , 16 , 17 , 18 , 19 In the two largest observational studies included in our review by Majidi et al and Feng et al, the incidence of pleural effusions were 7.6% and 5.7% among 552 and 442 COVID-19 patients, respectively. 20 , 21 A high incidence of pleural effusions ranging from 13.3% to 62.5% was reported in 14 observational studies reviewed ( Table 1 ). The possible explanation for the high incidence of pleural effusions were: a) Seven observational studies had a small sample size ranging between 16 to 55 COVID-19 patients, 22 , 23 , 24 , 25 , 26 , 27 , 28 b) eight observational studies were single-center studies that focused on describing the radiological characteristics of COVID-19 patients, 24 , 25 , 27 , 29 , 30 , 31 , 32 , 33 and c) five observational studies involved COVID-19-related pleural effusions among children.…”

COVID-19 pneumonia in the emergency department: correlation of initial chest CT findings with short-term outcome

“…One-third of the patients treated in ICU (4/12) required mechanical ventilation. The median hospitalization time was 10 days (4-12), and median length of ICU stay was 5.5 days (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Two patients stayed in ICU for more than 50 days.…”

“…It might be helpful as a supplemental or alternative modality in specific clinical contexts, involving pregnant women and children for example. Chest CT is the modality with higher sensitivity, as typical features are described to occur in the majority of cases [12,13], although it presents relatively low specificity (0.56) and is especially useful in patients with a pre-existing lung disease. Radiation dose and availability represent limitations for performing CT [11].…”

COVID-19 pneumonia—ultrasound, radiographic, and computed tomography findings: a comprehensive pictorial essay

“…GGO are defined as hazy areas of slightly increased density without cancelation of bronchial and vascular contours that may be caused by the partial displacement of air due to partial filling of airspaces or interstitial thickening [ 26 ]; in COVID-19 patients, they may be unilateral or bilateral, mainly with a subpleural distribution, and have been reported with an incidence up to 91% [ 25 , 27 ] (Fig. 6 ).…”