Meta‐analysis of chest CT features of patients with COVID‐19 pneumonia

Abstract

The objective of this paper is to perform a meta‐analysis regarding the chest computed tomography (CT) manifestations of coronavirus disease‐2019 (COVID‐19) pneumonia patients. PubMed, Embase, and Cochrane Library databases were searched from 1 December 2019 to 1 May 2020 using the keywords of “COVID‐19 virus,” “the 2019 novel coronavirus,” “novel coronavirus,” and “COVID‐19.” Studies that evaluated the CT manifestations of common and severe COVID‐19 pneumonia were included. Among the 9736 searched results, 15 articles describing 1453 common patients and 697 severe patients met the inclusion criteria. Based on the CT images, the common patients were less frequent to exhibit consolidation (odds ratio [OR] = 0.31), pleural effusion (OR = 0.19), lymphadenopathy (OR = 0.17), crazy‐paving pattern (OR = 0.22), interlobular septal thickening (OR = 0.27), reticulation (OR = 0.20), traction bronchiectasis (OR = 0.40) with over two lobes involved (OR = 0.07) and central distribution (OR = 0.18) while more frequent to bear unilateral pneumonia (OR = 4.65) involving one lobe (OR = 13.84) or two lobes (OR = 6.95) when compared with severe patients. Other CT features including ground‐glass opacities ( P = .404), air bronchogram ( P = .070), nodule ( P = .093), bronchial wall thickening ( P = .15), subpleural band ( P = .983), vascular enlargement ( P = .207), and peripheral distribution ( P = .668) did not have a significant association with the severity of the disease. No publication bias among the selected studies was suggested (Harbord's tests, P > .05 for all.) We obtained reliable estimates of the chest CT manifestations of COVID‐19 pneumonia patients, which might provide an important clue for the diagnosis and classification of COVID‐19 pneumonia.

Role of upfront CT pulmonary angiography at admission in COVID-19 patients

“…Since the outbreak of the COVID-19 epidemic, the impact of unenhanced chest CT has been widely reported and is no longer discussed [ 11 , 12 ]. Given the high risk of pulmonary embolism in the COVID-19 pneumonia, first-line CTPA is an option that deserves to be considered.…”

Predictive values of blood urea nitrogen/creatinine ratio and other routine blood parameters on disease severity and survival of COVID‐19 patients

“…4 According to the WHO data, as of early May 2020, over 3 million global cases had been confirmed, more than 20 000 deaths. 5 While this virus affects many systems in animals, it usually occurs in the form of pneumonia in humans. 6,7 However, mildly-and moderately-affected patients have a better prognosis, and milder symptoms.…”

“…The neutrophil-lymphocyte ratio (NLR) and C-reactive protein (CRP) make up some of these parameters. 5,14 In our study, we aimed to evaluate the role of applicable and cost-effective BUN/Cr ratios, as well as other routine blood parameters, to predict both the severity and survival of those with COVID-19 disease. Nonsevere patients met all of the features such as the history of contact, respiratory symptoms or fever, typical viral pneumonia involvement in computed tomography, and positive test result of RT-PCR for SARS-CoV-2 RNA.…”

Pulmonary cavitation – an under-recognized late complication of severe COVID-19 lung disease

“…None had received prior immunosuppression. All 12 were males, required invasive mechanical ventilation, and the median (range) time from symptom onset to invasive mechanical ventilation was 8 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) days. Three were admitted directly via our institution's Emergency Department and intubated within 24 hours, and nine patients were transferred from other hospitals within 72 hours of intubation.…”