Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study

Abstract

Background A cluster of patients with coronavirus disease 2019 (COVID-19) pneumonia caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were successively reported in Wuhan, China. We aimed to describe the CT findings across different timepoints throughout the disease course.Methods Patients with COVID-19 pneumonia (confirmed by next-generation sequencing or RT-PCR) who were admitted to one of two hospitals in Wuhan and who underwent serial chest CT scans were retrospectively enrolled. Patients were grouped on the basis of the interval between symptom onset and the first CT scan: group 1 (subclinical patients; scans done before symptom onset), group 2 (scans done ≤1 week after symptom onset), group 3 (>1 week to 2 weeks), and group 4 (>2 weeks to 3 weeks). Imaging features and their distribution were analysed and compared across the four groups.Findings 81 patients admitted to hospital between Dec 20, 2019, and Jan 23, 2020, were retrospectively enrolled. The cohort included 42 (52%) men and 39 (48%) women, and the mean age was 49·5 years (SD 11·0). The mean number of involved lung segments was 10·5 (SD 6·4) overall, 2·8 (3·3) in group 1, 11·1 (5·4) in group 2, 13·0 (5·7) in group 3, and 12·1 (5·9) in group 4. The predominant pattern of abnormality observed was bilateral (64 [79%] patients), peripheral (44 [54%]), ill-defined (66 [81%]), and ground-glass opacification (53 [65%]), mainly involving the right lower lobes (225 [27%] of 849 affected segments). In group 1 (n=15), the predominant pattern was unilateral (nine [60%]) and multifocal (eight [53%]) ground-glass opacities (14 [93%]). Lesions quickly evolved to bilateral (19 [90%]), diffuse (11 [52%]) ground-glass opacity predominance (17 [81%]) in group 2 (n=21). Thereafter, the prevalence of ground-glass opacities continued to decrease (17 [57%] of 30 patients in group 3, and five [33%] of 15 in group 4), and consolidation and mixed patterns became more frequent (12 [40%] in group 3, eight [53%] in group 4).Interpretation COVID-19 pneumonia manifests with chest CT imaging abnormalities, even in asymptomatic patients, with rapid evolution from focal unilateral to diffuse bilateral ground-glass opacities that progressed to or co-existed with consolidations within 1-3 weeks. Combining assessment of imaging features with clinical and laboratory findings could facilitate early diagnosis of COVID-19 pneumonia. Articles 2www.thelancet.com/infection Published online February 24, 2020 https://doi.

Clinical and CT imaging features of the COVID-19 pneumonia: Focus on pregnant women and children

“…Therefore, CT could be regarded as an efficient tool for the early detection and monitoring the dynamic evolution in the patients with COVID-19. 24 Our study has several limitations. Firstly, the sample size was relatively small.…”

Multiple parameters required for diagnosis of COVID-19 in clinical practice

“…Laboratory results were considered as auxiliary information to diagnose COVID-19 infection. 5,7 In our hospital, there were 14 cases confirmed COVID-19 infection. Of 14 patients, white-cell count was tended to be normal in 12 patients (85.71%), lymphocyte (8/14, 57.14%) and monocyte (9/14, 64.29%) percentage had a tendency to decrease.…”

“…But it doesn't mean that the abnormalities of CT images could be observed in the COVID-19 infection while the initial RT-PCR is positive or negative. [3][4][5][6] Therefore, even though chest CT plays a key role in detection or diagnosis of COVID-19 infection, however, chest CT examination and RT-PCR results should be mutual verification for precise diagnosis in the patient suspected COVID-19 infection.…”

“…were observed in the patients with COVID-19 infection. 5,7 Of these clinical characteristics, fever and cough were the most frequency percentage of initial symptoms, and the other manifestations should be taken consideration.…”

The evolution of CT characteristics in the patients with COVID-19 pneumonia

“…Recently, the studies demonstrated that the CT findings were typical signs for diagnosis at different stages of COVID-19 pneumonia. 3,4 Particularly, ground glass opacities (GGO) and consolidation were the principal manifestation in the CT images (CT scans before onset of symptoms or CT scans done ≤ 1 week after symptom onset), and GGO was decreased with increasing the stages of COVID-19 pneumonia. However, the consolidation or GGO mixed consolidation increased, and reticular was also observed in the later stages (scan > 1 week after symptom onset).…”