Dataset Information

The evolution of chest CT findings from admission to follow-up in 30 moderate to severe adult patients with COVID-19 pneumonia.

ABSTRACT:

Objective

To analyze the evolution of chest computed tomography (CT) findings from admission to follow-up in moderate to severe patients with coronavirus disease-19 (COVID-19) pneumonia.

Methods

During December 2019-April 2020, the sequential CT images of 30 patients with COVID-19 pneumonia were retrospectively analyzed from admission to follow-up. The qualitative evolution tendency of lung abnormalities and semi-quantitative CT scores were analyzed for temporal change.

Results

The mean hospitalized period was 24.5?±?9.6 days (range 6-49 days). The average time from the first, second, third, fourth and follow-up CT examination to the initial symptom onset were 4.2?±?3.1 days, 10.7?±?4.4 days, 17.1?±?3.9 days, 24.6?±?7.5 days, and 42.4?±?15.6 days, respectively. During illness day 0-5, groundglass opacity (GGO) was the main pattern. The following illness day 6-11, the main CT pattern was consolidation and reticular pattern. The consolidation and reticular pattern gradually dissipate during illness day 12-23, and the reticular pattern and light GGO increased. When illness day was???24 days, the reticular pattern and light GGO gradually decrease until complete dissipation. The highest CT score was at illness day 6-11. Pearson correlation analysis showed that the mean and maximum CT score were not correlated with the length of fever (r?=?0.018, p?=?0.923 and r?=?0.086, p?=?0.652) and hospitalization (r?=?0.192, p?=?0.31 and r?=?0.273, p?=?0.144).

Conclusions

The dynamic evolution of CT manifestation in moderate to severe COVID-19 pneumonia patients followed a specific pattern over time. During illness day 6-11, the extent of lung abnormalities on chest CT was the most severe.

Supplementary information

The online version contains supplementary material available at 10.1007/s42058-021-00058-2.

SUBMITTER: Zhou Y

PROVIDER: S-EPMC7937430 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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The evolution of chest CT findings from admission to follow-up in 30 moderate to severe adult patients with COVID-19 pneumonia.

Zhou Yunfeng Y Ren Hao H Wang Shuo S You Feng F Feng Lei L Wang Minhong M Wang Jiangtao J

Chinese journal of academic radiology 20210307 1

<h4>Objective</h4>To analyze the evolution of chest computed tomography (CT) findings from admission to follow-up in moderate to severe patients with coronavirus disease-19 (COVID-19) pneumonia.<h4>Methods</h4>During December 2019-April 2020, the sequential CT images of 30 patients with COVID-19 pneumonia were retrospectively analyzed from admission to follow-up. The qualitative evolution tendency of lung abnormalities and semi-quantitative CT scores were analyzed for temporal change.<h4>Results ...[more]

PMID: 33718774

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Project description:ObjectivesGround-glass opacity and consolidation are recognized typical features of Coronavirus disease-19 (COVID-19) pneumonia on Chest CT, yet ancillary findings have not been fully described. We aimed to describe ancillary findings of COVID-19 pneumonia on CT, to define their prevalence, and investigate their association with clinical data.MethodsWe retrospectively reviewed our CT chest cases with coupled reverse transcriptase polymerase chain reaction (rt-PCR). Patients with negative rt-PCR or without admission chest CT were excluded. Ancillary findings included: vessel enlargement, subpleural curvilinear lines, dependent subpleural atelectasis, centrilobular solid nodules, pleural and/or pericardial effusions, enlarged mediastinal lymph nodes. Continuous data were expressed as median and 95% confidence interval (95% CI) and tested by Mann-Whitney U test.ResultsAncillary findings were represented by 106/252 (42.1%, 36.1 to 48.2) vessel enlargement, 50/252 (19.8%, 15.4 to 25.2) subpleural curvilinear lines, 26/252 (10.1%, 7.1 to 14.7) dependent subpleural atelectasis, 15/252 (5.9%, 3.6 to 9.6) pleural effusion, 15/252 (5.9%, 3.6 to 9.6) mediastinal lymph nodes enlargement, 13/252 (5.2%, 3 to 8.6) centrilobular solid nodules, and 6/252 (2.4%, 1.1 to 5.1) pericardial effusion. Air space disease was more extensive in patients with vessel enlargement or centrilobular solid nodules (p < 0.001). Vessel enlargement was associated with longer history of fever (p = 0.035) and lower admission oxygen saturation (p = 0.014); dependent subpleural atelectasis with lower oxygen saturation (p < 0.001) and higher respiratory rate (p < 0.001); mediastinal lymph nodes with shorter history of cough (p = 0.046); centrilobular solid nodules with lower prevalence of cough (p = 0.023), lower oxygen saturation (p < 0.001), and higher respiratory rate (p = 0.032), and pericardial effusion with shorter history of cough (p = 0.015). Ancillary findings associated with longer hospital stay were subpleural curvilinear lines (p = 0.02), whereas centrilobular solid nodules were associated with higher rate of intensive care unit admission (p = 0.01).ConclusionTypical high-resolution CT findings of COVID-19 pneumonia are frequently associated with ancillary findings that variably associate with disease extent, clinical parameters, and disease severity.Advances in knowledgeAncillary findings might reflect the broad range of heterogeneous mechanisms in severe acute respiratory syndrome from viral pneumonia, and potentially help disease phenotyping.

Project description:OBJECTIVE:The aim of this study was to investigate the clinical and computed tomography (CT) features associated with severe and critical coronavirus disease 2019 (COVID-19) pneumonia. MATERIALS AND METHODS:Eighty-three patients with COVID-19 pneumonia including 25 severe/critical cases and 58 ordinary cases were enrolled. The chest CT images and clinical data of them were reviewed and compared. The risk factors associated with disease severity were analyzed. RESULTS:Compared with the ordinary patients, the severe/critical patients had older ages, higher incidence of comorbidities, cough, expectoration, chest pain, and dyspnea. The incidences of consolidation, linear opacities, crazy-paving pattern, and bronchial wall thickening in severe/critical patients were significantly higher than those of the ordinary patients. Besides, severe/critical patients showed higher incidences of lymph node enlargement, pericardial effusion, and pleural effusion than the ordinary patients. The CT scores of severe/critical patients were significantly higher than those of the ordinary patients (P < 0.001). Receiver operating characteristic curve showed that the sensitivity and specificity of CT score were 80.0% and 82.8%, respectively, for the discrimination of the 2 types. The clinical factors of age older than 50 years, comorbidities, dyspnea, chest pain, cough, expectoration, decreased lymphocytes, and increased inflammation indicators were risk factors for severe/critical COVID-19 pneumonia. Computed tomography findings of consolidation, linear opacities, crazy-paving pattern, bronchial wall thickening, high CT scores, and extrapulmonary lesions were features of severe/critical COVID-19 pneumonia. CONCLUSIONS:There are significant differences in clinical symptoms, laboratory examinations, and CT manifestations between the ordinary patients and the severe/critical patients. Many factors are related to the severity of the disease, which can help clinicians to judge the severity of the patient and evaluate the prognosis.

Dataset Information

The evolution of chest CT findings from admission to follow-up in 30 moderate to severe adult patients with COVID-19 pneumonia.

Objective

Methods

Results

Conclusions

Supplementary information

Publications

The evolution of chest CT findings from admission to follow-up in 30 moderate to severe adult patients with COVID-19 pneumonia.

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