The progression of computed tomographic (CT) images in patients with coronavirus disease (COVID-19) pneumonia

Lei, Pinggui; Fan, Bing; Mao, Jujiang; Wei, Jiangping; Wang, Pingxian

doi:10.1016/j.jinf.2020.03.020

Cited by 37 publications

(34 citation statements)

References 4 publications

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“…Roughly four stages of COVID-19 at chest CT have been described: (a) early stage (0-5 days after symptom onset), which is characterized by either normal findings or mainly ground-glass opacities; (b) progressive stage (5-8 days after symptom onset), which is characterized by increased groundglass opacities and crazy-paving appearance ( Fig 4); (c) peak stage (9-13 days after symptom onset), which is characterized by progressive consolidation ( Figs 6, 7); and (d) late stage (≥14 days after symptom onset), which is characterized by a gradual decrease of consolidation and ground-glass opacities, while signs of fibrosis (including parenchymal bands, architectural distortion, and traction bronchiectasis) may manifest (Fig 8) (47,(53)(54)(55)(56). It has been reported that unilateral involvement is only present in the early and late phases (47).…”

Section: Temporal Evolution Of Lung Abnormalities At Chest Ctmentioning

confidence: 99%

Chest CT in COVID-19: What the Radiologist Needs to Know

2020

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Chest CT has a potential role in the diagnosis, detection of complications, and prognostication of coronavirus disease 2019 (COVID-19). Implementation of appropriate precautionary safety measures, chest CT protocol optimization, and a standardized reporting system based on the pulmonary findings in this disease will enhance the clinical utility of chest CT. However, chest CT examinations may lead to both false-negative and false-positive results. Furthermore, the added value of chest CT in diagnostic decision making is dependent on several dynamic variables, most notably available resources (real-time reverse transcription-polymerase chain reaction [RT-PCR] tests, personal protective equipment, CT scanners, hospital and radiology personnel availability, and isolation room capacity) and the prevalence of both COVID-19 and other diseases with overlapping manifestations at chest CT. Chest CT is valuable to detect both alternative diagnoses and complications of COVID-19 (acute respiratory distress syndrome, pulmonary embolism, and heart failure), while its role for prognostication requires further investigation. The authors describe imaging and managing care of patients with COVID-19, with topics including (a) chest CT protocol, (b) chest CT findings of COVID-19 and its complications, (c) the diagnostic accuracy of chest CT and its role in diagnostic decision making and prognostication, and (d) reporting and communicating chest CT findings. The authors also review other specific topics, including the pathophysiology and clinical manifestations of COVID-19, the World Health Organization case definition, the value of performing RT-PCR tests, and the radiology department and personnel impact related to performing chest CT in COVID-19. ©

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Section: Temporal Evolution Of Lung Abnormalities At Chest Ctmentioning

confidence: 99%

Chest CT in COVID-19: What the Radiologist Needs to Know

2020

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“…They reported a mean dose-length product of 14.4 mGy.cm. A patient with COVID-19 pneumonia could have 3 to 6 chest CT scans in a short period of time, and a healthy patient could have 1 or 2 chest CT scans to ensure that they did not have COVID-19 [ 16 ]. Irradiation awareness is needed, especially for younger patients [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Low-dose chest CT for diagnosing and assessing the extent of lung involvement of SARS-CoV-2 pneumonia using a semi quantitative score

Leger¹,

Jacquier

Barral³

et al. 2020

PLoS ONE

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Objectives The purpose is to assess the ability of low-dose CT (LDCT) to determine lung involvement in SARS-CoV-2 pneumonia and to describe a COVID19-LDCT severity score. Materials and methods Patients with SARS-CoV-2 infection confirmed by RT-PCR were retrospectively analysed. Clinical data, the National Early Warning Score (NEWS) and imaging features were recorded. Lung features included ground-glass opacities (GGO), areas of consolidation and crazy paving patterns. The COVID19-LDCT score was calculated by summing the score of each segment from 0 (no involvement) to 10 (severe impairment). Univariate analysis was performed to explore predictive factor of high COVID19-LDCT score. The nonparametric Mann-Whitney test was used to compare groups and a Spearman correlation used with p<0.05 for significance. Results Eighty patients with positive RT-PCR were analysed. The mean age was 55 years ± 16, with 42 males (53%). The most frequent symptoms were fever (60/80, 75%) and cough (59/80, 74%), the mean NEWS was 1.7±2.3. All LDCT could be analysed and 23/80 (28%) were normal. The major imaging finding was GGOs in 56 cases (67%). The COVID19-LDCT score (mean value = 19±29) was correlated with NEWS (r = 0.48, p<0.0001). No symptoms were risk factor to have pulmonary involvement. Univariate analysis shown that dyspnea, high respiratory rate, hypertension and diabetes are associated to a COVID19-LDCT score superior to 50. Conclusions COVID19-LDCT score did correlate with NEWS. It was significantly different in the clinical low-risk and high-risk groups. Further work is needed to validate the COVID19-LDCT score against patient prognosis.

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“…Lei et al [16] observed that the patients with COVID-19 pneumonia had a typical transition from early stage to advanced stage and advanced stage to dissipating stage. The manifestations of single or multiple GGOs were observed in the early stage, higher density consolidations were presented in the advanced stage, and ground-glass opacities and consolidations were absorbed in the dissipating stage.…”

Section: Discussionmentioning

confidence: 99%

Chest CT Findings after 4 Months from the Onset of COVID-19 Pneumonia: A Case Series

Urciuoli¹,

Guerriero

2020

Diagnostics

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Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although the reference standard for SARS-CoV-2 diagnosis is real-time reverse transcription polymerase chain reaction (RT-PCR), computed tomography (CT) is recommended for both initial evaluation and follow-up. There is a growing body of published evidence about CT evolution during the course of COVID-19 pneumonia. Here, we report six confirmed cases of COVID-19 patients who underwent unenhanced chest CT on admission and after 4 months from the onset of symptoms. Chest-CT at first admission showed the typical CT features of COVID-19. Interestingly, the follow-up CT revealed the persistence of lung abnormalities in five cases even if all the patients were completely asymptomatic. Further studies are needed for a comprehensive understanding of the disease progression and the resulting late imaging modifications.

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The progression of computed tomographic (CT) images in patients with coronavirus disease (COVID-19) pneumonia

Cited by 37 publications

References 4 publications

Chest CT in COVID-19: What the Radiologist Needs to Know

Chest CT in COVID-19: What the Radiologist Needs to Know

Low-dose chest CT for diagnosing and assessing the extent of lung involvement of SARS-CoV-2 pneumonia using a semi quantitative score

Chest CT Findings after 4 Months from the Onset of COVID-19 Pneumonia: A Case Series

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