Friday, 29 March, 2024
HomeCoronavirus WatchChest CT findings in COVID-19 pneumonia — multicentre study

Chest CT findings in COVID-19 pneumonia — multicentre study

A multi-centre study (n=101) of the relationship between chest CT findings and the clinical conditions of coronavirus disease (COVID-19) pneumonia determined that most patients with COVID-19 pneumonia have ground-glass opacities (GGO) (86.1%) or mixed GGO and consolidation (64.4%) and vascular enlargement in the lesion (71.3%). In addition, lead authors Wei Zhao, Zheng Zhong, and colleagues at The Second Xiangya Hospital, Central South University, First Hospital of Changsha, Changsha Public Health Treatment Centre, revealed that lesions present on CT images were more likely to have peripheral distribution (87.1%) and bilateral involvement (82.2%) and be lower lung predominant (54.5%) and multifocal (54.5%).

Zhao, Zhong and colleagues collected their 101 cases of COVID-19 pneumonia across four institutions in China's Hunan province, comparing clinical characteristics and imaging features between two groups: nonemergency (mild or common disease) and emergency (severe or fatal disease).

Accordingly, most of the cohort (70.2%) were 21-50 years old, and most patients (78.2%) had fever as the onset symptom. Only five patients showed disease associated with a family outbreak.

While the emergency group patients were older than the patients in the nonemergency group, the rate of underlying disease was not significantly different in the two groups — suggesting that viral load could be a better reflection of the severity and extent of COVID-19 pneumonia.

As Zhao and Zhong explained further: "Architectural distortion, traction bronchiectasis, and pleural effusions, which may reflect the viral load and virulence of COVID-19, were statistically different between the two groups and may help us to identify the emergency type disease."

The authors of this article also noted that CT involvement score can help evaluate the severity and extent of COVID-19 pneumonia.

Abstract
Objective: The increasing number of cases of confirmed coronavirus disease (COVID-19) in China is striking. The purpose of this study was to investigate the relation between chest CT findings and the clinical conditions of COVID-19 pneumonia.
Materials and Methods: Data on 101 cases of COVID-19 pneumonia were retrospectively collected from four institutions in Hunan, China. Basic clinical characteristics and detailed imaging features were evaluated and compared between two groups on the basis of clinical status: nonemergency (mild or common disease) and emergency (severe or fatal disease).

Results: Patients 21–50 years old accounted for most (70.2%) of the cohort, and five (5.0%) patients had disease associated with a family outbreak. Most patients (78.2%) had fever as the onset symptom. Most patients with COVID-19 pneumonia had typical imaging features, such as ground-glass opacities (GGO) (87 [86.1%]) or mixed GGO and consolidation (65 [64.4%]), vascular enlargement in the lesion (72 [71.3%]), and traction bronchiectasis (53 [52.5%]). Lesions present on CT images were more likely to have a peripheral distribution (88 [87.1%]) and bilateral involvement (83 [82.2%]) and be lower lung predominant (55 [54.5%]) and multifocal (55 [54.5%]). Patients in the emergency group were older than those in the non-emergency group. Architectural distortion, traction bronchiectasis, and CT involvement score aided in evaluation of the severity and extent of the disease.
Conclusion: Patients with confirmed COVID-19 pneumonia have typical imaging features that can be helpful in early screening of highly suspected cases and in evaluation of the severity and extent of disease. Most patients with COVID-19 pneumonia have GGO or mixed GGO and consolidation and vascular enlargement in the lesion. Lesions are more likely to have peripheral distribution and bilateral involvement and be lower lung predominant and multifocal. CT involvement score can help in evaluation of the severity and extent of the disease.

Authors
Wei Zhao, Zheng Zhong, Xingzhi Xie, Qizhi Yu, Jun Liu

[link url="https://www.sciencedaily.com/releases/2020/03/200303175318.htm"]American Roentgen Ray Society material[/link]

[link url="https://www.ajronline.org/doi/10.2214/AJR.20.22976"]Journal of American Roentgenology abstract[/link]

MedicalBrief — our free weekly e-newsletter

We'd appreciate as much information as possible, however only an email address is required.