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Clinical characteristics and longitudinal chest CT features of healthcare workers hospitalized with coronavirus disease 2019 (COVID-19).

ABSTRACT: Rationale: The clinical data and corresponding dynamic CT findings were investigated in detail to describe the clinical and imaging profiles of COVID-19 pneumonia disease progression. Methods: Forty HCWs with COVID-19 were included in this study and 30 enrolled for imaging assessment. Disease was divided into four stages based on time from onset: stage 1 (1-6 days), stage 2 (7-13 days), stage 3 (14-22 days), and stage 4 (> 22 days). Clinical wand imaging data were analyzed retrospectively. Results: The cohort included 33 female and 7 male cases, with a median age of 40 years. Six had underlying comorbidities. More than half of the cases were nurses (22, 55%). Each stage included 39, 37, 34 and 32 CTs, respectively. Bilateral lesions, multifocal lesions and lesions with GGO pattern occurred in both lower lobes at all stages. The crazy-paving pattern (20, 54%), air bronchogram (13, 35%), and pleural effusion (2, 5%) were the most common CT features in stage 2. Consolidation score peaked in stage 2 whereas total lesions score peaked in stage 3. Conclusions: COVID-19 pneumonia in HCWs has a potential predilection for younger female workers. Stage 2 of COVID-19 pneumonia may be the key period for controlling progression of the disease, and consolidation scores may be an objective reflection of the severity of lung involvement.

SUBMITTER: Liu H

PROVIDER: S-EPMC7645347 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Clinical characteristics and longitudinal chest CT features of healthcare workers hospitalized with coronavirus disease 2019 (COVID-19).

Liu Huaping H Luo Shiyong S Li Hailan H Zhang Youming Y Huang Chiyao C Li Xili X Tan Yiqing Y Chen Mingna M

International journal of medical sciences 20200921 17

<b>Rationale:</b> The clinical data and corresponding dynamic CT findings were investigated in detail to describe the clinical and imaging profiles of COVID-19 pneumonia disease progression. <b>Methods:</b> Forty HCWs with COVID-19 were included in this study and 30 enrolled for imaging assessment. Disease was divided into four stages based on time from onset: stage 1 (1-6 days), stage 2 (7-13 days), stage 3 (14-22 days), and stage 4 (> 22 days). Clinical wand imaging data were analyzed retrospe ...[more]

PMID: 33162792

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Project description:INTRODUCTION:The evolution of computed tomography (CT) findings in patients with mild coronavirus disease 2019 (COVID-19) pneumonia has not been described in detail. A large-scale longitudinal study is urgently required. METHODS:We analyzed 606 CT scans of 182 patients. The dynamic evolution of CT scores was evaluated using two staging methods: one was divided into 10 periods based on decile intervals, and the other was one stage per week. Moreover, the latter was used to evaluate the dynamic evolution of imaging performance. A published severity scoring system was used to compare findings of the two methods. RESULTS:In the dynamic evolution of 10 stages, the total lesion CT score peaked during stage 3 (9-11 days) and stage 6 (17-18 days), with scores?=?7.19?±?3.66 and 8.00?±?4.57, respectively. The consolidation score peaked during stage 6 (17-18 days; score?=?2.72?±?3.07). In contrast, when a 1-week interval was used and time was divided into five stages, the total lesion score peaked during week 3 (score?=?7.3?±?4.15). The consolidation score peaked during week 2 (score?=?2.54?±?3.25). The predominant CT patterns differed significantly during each stage (P?<?0.01). Ground-glass opacities (GGO), with an increased trend during week 3 and beyond, was the most common pattern in each stage (33-46%). The second most common patterns during week 1 were GGO and consolidation (24%). The linear opacity pattern with an increased trend was the second most common pattern during week 2 and beyond (21-32%). CONCLUSIONS:The total lesion score of mild COVID-19 pneumonia peaked 17-18 days after disease onset. The consolidation scores objectively reflected the severity of the lung involvement compared with total lesion scores. Each temporal stage of mild COVID-19 pneumonia mainly manifested as GGO pattern. Moreover, good prognosis may be associated with increases in the proportions of the GGO and linear opacity patterns during the later stage of disease.

Project description:ObjectivesThe aim of this study was to investigate the chest computed tomography (CT) findings in patients with confirmed coronavirus disease 2019 (COVID-19) and to evaluate its relationship with clinical features.Materials and methodsStudy sample consisted of 80 patients diagnosed as COVID-19 from January to February 2020. The chest CT images and clinical data were reviewed, and the relationship between them was analyzed.ResultsTotally, 80 patients diagnosed with COVID-19 were included. With regards to the clinical manifestations, 58 (73%) of the 80 patients had cough, and 61 (76%) of the 80 patients had high temperature levels. The most frequent CT abnormalities observed were ground glass opacity (73/80 cases, 91%), consolidation (50/80 cases, 63%), and interlobular septal thickening (47/80, 59%). Most of the lesions were multiple, with an average of 12 ± 6 lung segments involved. The most common involved lung segments were the dorsal segment of the right lower lobe (69/80, 86%), the posterior basal segment of the right lower lobe (68/80, 85%), the lateral basal segment of the right lower lobe (64/80, 80%), the dorsal segment of the left lower lobe (61/80, 76%), and the posterior basal segment of the left lower lobe (65/80, 81%). The average pulmonary inflammation index value was (34% ± 20%) for all the patients. Correlation analysis showed that the pulmonary inflammation index value was significantly correlated with the values of lymphocyte count, monocyte count, C-reactive protein, procalcitonin, days from illness onset, and body temperature (P < 0.05).ConclusionsThe common chest CT findings of COVID-19 are multiple ground glass opacity, consolidation, and interlobular septal thickening in both lungs, which are mostly distributed under the pleura. There are significant correlations between the degree of pulmonary inflammation and the main clinical symptoms and laboratory results. Computed tomography plays an important role in the diagnosis and evaluation of this emerging global health emergency.

Project description:PurposeTo study the extent of pulmonary involvement in coronavirus 19 (COVID-19) with quantitative CT and to assess the impact of disease burden on opacity visibility on chest radiographs.Materials and methodsThis retrospective study included 20 pairs of CT scans and same-day chest radiographs from 17 patients with COVID-19, along with 20 chest radiographs of controls. All pulmonary opacities were semiautomatically segmented on CT images, producing an anteroposterior projection image to match the corresponding frontal chest radiograph. The quantitative CT lung opacification mass (QCTmass) was defined as (opacity attenuation value + 1000 HU)/1000 × 1.065 (g/mL) × combined volume (cm3) of the individual opacities. Eight thoracic radiologists reviewed the 40 radiographs, and a receiver operating characteristic curve analysis was performed for the detection of lung opacities. Logistic regression analysis was performed to identify factors affecting opacity visibility on chest radiographs.ResultsThe mean QCTmass per patient was 72.4 g ± 120.8 (range, 0.7-420.7 g), and opacities occupied 3.2% ± 5.8 (range, 0.1%-19.8%) and 13.9% ± 18.0 (range, 0.5%-57.8%) of the lung area on the CT images and projected images, respectively. The radiographs had a median sensitivity of 25% and specificity of 90% among radiologists. Nineteen of 186 opacities were visible on chest radiographs, and a median area of 55.8% of the projected images was identifiable on radiographs. Logistic regression analysis showed that QCTmass (P < .001) and combined opacity volume (P < .001) significantly affected opacity visibility on radiographs.ConclusionQCTmass varied among patients with COVID-19. Chest radiographs had high specificity for detecting lung opacities in COVID-19 but a low sensitivity. QCTmass and combined opacity volume were significant determinants of opacity visibility on radiographs.Earlier incorrect version appeared online. This article was corrected on April 6, 2020 and December 14, 2020.Supplemental material is available for this article.© RSNA, 2020.

Project description:ObjectiveAimed to summarize the characteristics of chest CT imaging in Chinese hospitalized patients with Coronavirus Disease 2019 (COVID-19) to provide reliable evidence for further guiding clinical routine.MethodsPubMed, Embase and Web of Science databases were searched to identify relevant articles involving the features of chest CT imaging in Chinese patients with COVID-19. All data were analyzed utilizing R i386 4.0.0 software. Random-effects models were employed to calculate pooled mean differences.Results19 retrospective studies (1332 cases) were included. The results demonstrated that the combined proportion of ground-glass opacities (GGO) was 0.79 (95% CI 0.68, 0.89), consolidation was 0.34 (95% CI 0.23, 0.47); mixed GGO and consolidation was 0.46 (95% CI 0.37; 0.56); air bronchogram sign was 0.41 (95% CI 0.26; 0.55); crazy paving pattern was 0.32 (95% CI 0.17, 0.47); interlobular septal thickening was 0.55 (95% CI 0.42, 0.67); reticulation was 0.30 (95% CI 0.12, 0.48); bronchial wall thickening was 0.24 (95% CI 0.11, 0.40); vascular enlargement was 0.74 (95% CI 0.64, 0.86); subpleural linear opacity was 0.28 (95% CI 0.12, 0.48); intrathoracic lymph node enlargement was 0.03 (95% CI 0.00, 0.07); pleural effusions was 0.03 (95% CI 0.02, 0.06). The distribution in lung: the combined proportion of central was 0.05 (95% CI 0.01, 0.11); peripheral was 0.74 (95% CI 0.62, 0.84); peripheral involving central was 0.38 (95% CI 0.19, 0.75); diffuse was 0.19 (95% CI 0.06, 0.32); unifocal involvement was 0.09 (95% CI 0.05, 0.14); multifocal involvement was 0.57 (95% CI 0.48, 0.68); unilateral was 0.16 (95% CI 0.10, 0.23); bilateral was 0.83 (95% CI 0.78, 0.89); The combined proportion of lobes involved (> 2) was 0.70 (95% CI 0.61, 0.78); lobes involved (≦ 2) was 0.35 (95% CI 0.26, 0.44).ConclusionGGO, vascular enlargement, interlobular septal thickening more frequently occurred in patients with COVID-19, which distribution features were peripheral, bilateral, involved lobes > 2. Therefore, based on chest CT features of COVID-19 mentioned, it might be a promising means for identifying COVID-19.

Project description:BackgroundThe current outbreak of coronavirus disease 2019 (COVID-19), epi-centered in Wuhan, Hubei Province of the China, has become a global health emergency. Several studies from China have recently provided the evidence of epidemiological, clinical, laboratory, and outcomes of COVID-19 patients. Investigation on the role of chest CT in patient screening and management course in a large cohort remains paucity.MethodsThis was a retrospective observational study based on the data collected between January 19 and 2020 to February 15, 2020. A clinic workflow using chest CT and RT-PCR assay to screen suspected patient was reviewed. Clinical data were evaluated and patients were classified to mild, common, severe and critical group. Chest CT characteristics of each patient were evaluated and a CT scoring system was applied to grade the lung involvement.ResultsOf 98 enrolled patients, 1, 29, 51 and 17 were clinically classified into mild, common, severe and critical group, respectively. Eighty-three patients (84.7%) demonstrated ground-glass opacity (GGO), 76 patients (77.5%) demonstrated consolidation and 18 patients (18.4%) demonstrated crazy-paving pattern on chest CT. Based on the CT scoring, 2, 35, 55 and 6 patients were categorized to grade 0, grade 1, grade 2 and grade 3, respectively, which significantly consistent with clinical classification (kappa =0.638, P﹤0.05). Twenty-nine patients admitted from fever clinic, with an average interval of 1.2 days (range, 0-4 days) between CT examination and onset of symptom. Three of these patients had negative initial RT-PCR result while abnormalities displayed on the initial chest CT.ConclusionsPeripheral lung distributed GGO and consolidation, without subpleural sparing, are the most common manifestations on chest CT of COVID-19. Abnormalities on chest CT can occur in an early stage of COVID-19, even when RT-PCR assay negative, which may help to early recognition and rapid diagnosis of this disease.

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Clinical characteristics and longitudinal chest CT features of healthcare workers hospitalized with coronavirus disease 2019 (COVID-19).

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Clinical characteristics and longitudinal chest CT features of healthcare workers hospitalized with coronavirus disease 2019 (COVID-19).

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