Radiological manifestations from 101 patients with 2019 Novel Coronavirus Disease (COVID-19) in Hamadan, West of Iran: Typical and atypical findings

Abstract

Background Coronavirus disease 2019 (COVID-19) has spread widely throughout the world and become a pandemic disease. In this study we decided to investigate the chest computed tomography (CT) findings in COVID-19 patients in Hamadan, west of Iran. Methods This cross-sectional study was conducted on 101 patients with confirmed COVID-19 infection from February to March 2020. Demographic, clinical, laboratory and chest CT information of identified COVID-19 patients were assessed. Results Totally, 101 patients diagnosed with COVID-19 were included. The mean age of the patients was 55.21 ± 14.08 years and 54% (53.47%) of them were male. With regards to clinical manifestations, 82.18%, 72.28% and 54.46% of COVID-19 patients had dry cough, dyspnea and fever, respectively and 44.5% had lymphopenia. The right lower lobe was the most common (69%) and severe involved lobe followed by left lower lobe, right middle lobe, and lingual; however, anterior segment of upper lobes showed least involvement with abnormality in the late course of disease. The most common pattern is ground glass opacity, but atypical patterns such as round pneumonia, moderate to severe plural effusion and segmental lobar collapse consolidation was seen without evidence of mediastinal adenopathy, cavitation or nodule. Chest X ray (CXR) was not sensitive method as a first line imaging because 34.65% of them were normal. Conclusion CXR is not sensitive method as first line imaging too (34.65% normal first CXR), but Chest CT is very sensitive and nonspecific modality for diagnosis of COVID – 19. Lower lobe and posterior basal predominance involvements were seen in most cases. About 12% showed atypical chest CT features.

Target-shaped combined halo and reversed-halo sign, an atypical chest CT finding in COVID-19

“…Lymphadenopathy, pleural effusion, and lung cavitation were less common imaging features [3]. Previous studies have reported the halo and reversed halo signs as less frequent findings in patients with COVID-19 [3][4][5][6][7]. The halo sign describes a nodule or mass surrounded by ground glass opacity.…”