Interpretation of CT signs of 2019 novel coronavirus (COVID-19) pneumonia

Wu, Jing; Pan, Junping; Teng, Da; Xu, Xunhua; Feng, Jianghua; Chen, Yu Chen

doi:10.1007/s00330-020-06915-5

Cited by 79 publications

(150 citation statements)

References 18 publications

(20 reference statements)

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“…The present study showed that the predominant pulmonary parenchymal pattern for this disease is ground-glass haze/opacity followed by consolidation, as seen in 88.5 and 52.8% of patients respectively. This is comparable to the other studies in the Chinese population [15][16][17][18][19]. A study by Chung et al showed that ground-glass opacification was the most frequently encountered imaging feature, as observed in 86% of the study population.…”

Section: Discussionsupporting

confidence: 88%

“…Moreover, according to that study, patients with moderate disease exhibited reversed halo sign more than those with severe disease (31.3 vs 13% respectively) [18]. Another study by Jing et al showed a reversed halo sign in 4.6% of the patients [17]. The findings of our study contrast with these results as they showed no reversed halo sign in any of the patients.…”

Section: Discussioncontrasting

confidence: 84%

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An Analysis of High-Resolution Computed Tomography Chest Manifestations of COVID-19 Patients in Pakistan

Khaliq¹,

Raja²,

Khan³

et al. 2020

Cureus

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The objective of the present study is to describe high-resolution CT (HRCT) chest manifestations of coronavirus disease 2019 (COVID-19) patients presenting to a tertiary healthcare facility in Punjab, Pakistan, and to analyze the distribution of the disease in lung fields. Additionally, we assess the role of chest CT severity scoring (CT-SS) in determining the severity of pneumonia. Methods In this cross-sectional descriptive study conducted from March 30, 2020, to May 30, 2020, 87 confirmed COVID-19 patients undergoing HRCT scan in a tertiary care facility in Punjab, Pakistan were included. The HRCT chest was performed on the patients using a standard protocol. Each study was evaluated for the presence of ground-glass opacities (GGOs), consolidation, mixed pattern, distribution, crazy paving, reverse halo sign, nodules, pleural effusion, and other findings. Additionally, CT-SS was calculated by dividing each lung into 20 zones. Each zone was scored as 0, 1, and 2, representing no involvement, <50% involvement, and >50% involvement of one zone respectively (total score: 0-40 for each patient). The patients were classified into mild, moderate, and severe cases (mild: CT-SS of <20, moderate: CT-SS of 20-30, and severe: CT-SS of >30). Results GGO was the most common finding, as seen in 88.5% of the patients, followed by consolidations (52.8%) and crazy paving (33.3%). The majority of the patients showed the bilateral and peripheral distribution of the disease process. Vascular dilatation and bronchiectasis were seen in 10 patients; pleural effusions were observed in only two study patients, while no patient exhibited reverse halo sign or pulmonary nodules. The superior segment of lower lobes was the most commonly involved segment bilaterally. According to CT-SS, 78 (89.6%), six (6.9%), and three (3.45%) patients had mild, moderate, and severe disease respectively.

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Section: Discussionsupporting

confidence: 88%

Section: Discussioncontrasting

confidence: 84%

An Analysis of High-Resolution Computed Tomography Chest Manifestations of COVID-19 Patients in Pakistan

Khaliq¹,

Raja²,

Khan³

et al. 2020

Cureus

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“…The methodological quality assessment is displayed in Table 2. Risk of bias with respect to method of patient selection was rated "unclear" in 13 studies, 14,[20][21][22][23]27,28,[32][33][34]36,38,41 because these studies did not report whether patients were randomly or consecutively included. Risk of bias with respect to patient spectrum was rated "high" in eight…”

Section: Methodologic Quality Assessmentmentioning

confidence: 99%

Chest CT Imaging Signature of Coronavirus Disease 2019 Infection

Adams

Kwee

Yakar

et al. 2020

Chest

120

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BACKGROUND: Chest CT may be used for the diagnosis of coronavirus disease 2019 (COVID-19), but clear scientific evidence is lacking. Therefore, we systematically reviewed and metaanalyzed the chest CT imaging signature of COVID-19. RESEARCH QUESTION: What is the chest CT imaging signature of COVID-19 infection? STUDY DESIGN AND METHODS: A systematic literature search was performed for original studies on chest CT imaging findings in patients with COVID-19. Methodologic quality of studies was evaluated. Pooled prevalence of chest CT imaging findings were calculated with the use of a random effects model in case of between-study heterogeneity (predefined as I 2 $50); otherwise, a fixed effects model was used. RESULTS: Twenty-eight studies were included. The median number of patients with COVID-19 per study was 124 (range, 50-476), comprising a total of 3,466 patients. Median prevalence of symptomatic patients was 99% (range, >76.3%-100%). Twenty-seven of the studies (96%) had a retrospective design. Methodologic quality concerns were present with either risk of or actual referral bias (13 studies), patient spectrum bias (eight studies), disease progression bias (26 studies), observer variability bias (27 studies), and test review bias (14 studies). Pooled prevalence was 10.6% for normal chest CT imaging findings. Pooled prevalences were 90.0% for posterior predilection, 81.0% for ground-glass opacity, 75.8% for bilateral abnormalities, 73.1% for left lower lobe involvement, 72.9% for vascular thickening, and 72.2% for right lower lobe involvement. Pooled prevalences were 5.2% for pleural effusion, 5.1% for lymphadenopathy, 4.1% for airway secretions/tree-in-bud sign, 3.6% for central lesion distribution, 2.7% for pericardial effusion, and 0.7% for cavitation/ cystic changes. Pooled prevalences of other CT imaging findings ranged between 10.5% and 63.2%.

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“…Indeed, it is not clear if COVID-19 will leave permanent lung and/or physical damage and, if so, to what extent. Alterations of lung tissue such as ground-glass opacities, consolidation, vascular thickening, bronchiectasis, pleural effusion, crazy paving pattern and irregular solid nodules [2], may progress in over 80% of patients [3]. Persisting limitations in respiratory function and gas exchange will likely be more pronounced in the subgroup of ICU survivors.…”

mentioning

confidence: 99%