scholarly journals One-year follow-up of chest CT findings in patients after SARS-CoV-2 infection

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yanfei Chen ◽  
Cheng Ding ◽  
Ling Yu ◽  
Wanru Guo ◽  
Xuewen Feng ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
Bacterial Infections ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Pulmonary Functions ◽  
Reticular Pattern ◽  
Lung Abnormalities ◽  
Serial Ct ◽  
One Year

Abstract Background Knowledge about the 1-year outcome of COVID-19 is limited. The aim of this study was to follow-up and evaluate lung abnormalities on serial computed tomography (CT) scans in patients with COVID-19 after hospital discharge. Methods A prospective cohort study of patients with COVID-19 from the First Affiliated Hospital, Zhejiang University School of Medicine was conducted, with assessments of chest CT during hospitalization and at 2 weeks, 1 month, 3 months, 6 months, and 1 year after hospital discharge. Risk factors of residual CT opacities and the influence of residual CT abnormalities on pulmonary functions at 1 year were also evaluated. Results A total of 41 patients were followed in this study. Gradual recovery after hospital discharge was confirmed by the serial CT scores. Around 47% of the patients showed residual aberration on pulmonary CT with a median CT score of 0 (interquartile range (IQR) of 0–2) at 1 year after discharge, with ground-glass opacity (GGO) with reticular pattern as the major radiologic pattern. Patients with residual radiological abnormalities were older (p = 0.01), with higher rate in current smokers (p = 0.04), higher rate in hypertensives (p = 0.05), lower SaO2 (p = 0.004), and higher prevalence of secondary bacterial infections during acute phase (p = 0.02). Multiple logistic regression analyses indicated that age was a risk factor associated with residual radiological abnormalities (OR 1.08, 95% CI 1.01–1.15, p = 0.02). Pulmonary functions of total lung capacity (p = 0.008) and residual volume (p < 0.001) were reduced in patients with residual CT abnormalities and were negatively correlated with CT scores. Conclusion During 1-year follow-up after discharge, COVID-19 survivors showed continuous improvement on chest CT. However, residual lesions could still be observed and correlated with lung volume parameters. The risk of developing residual CT opacities increases with age.

scholarly journals Computed tomography manifestations in super early stage 2019 novel coronavirus pneumonia

2020 ◽  
pp. 028418512092480
Author(s):  
Shan Hu ◽  
Zhen Li ◽  
Xu Chen ◽  
Chang-Hong Liang
Keyword(s):  
Computed Tomography ◽  
Early Stage ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Ground Glass ◽  
Reticular Pattern ◽  
Initial Stage ◽  
Pr China ◽  
Novel Coronavirus

Background The recent outbreak of pneumonia cases in Wuhan, PR China, was caused by a novel beta coronavirus, the 2019 novel coronavirus (COVID-19). Purpose To summarize chest computed tomography (CT) manifestations of the early stage of COVID-19 infection and provide a piece of reliable imaging evidence for initial screening and diagnosis. Material and Methods From 10 January 2020 to 10 February 2020, we continuously observed chest CT imaging of 14 patients with clinically suspected new coronavirus infection in the two weeks after onset of symptoms. Ground-glass opacity (GGO), consolidation, reticular pattern, and ground-glass mimic nodules in each patient’s chest CT image were recorded. Results We enrolled 14 patients, of which nine patients had the infection confirmed by reverse transcription polymerase chain reaction (RT-PCR). Five patients were highly suspected of infection. All cases had epidemiological evidence. GGO was a dominant imaging manifestation in the initial days of infection. GGO performance accounts for 40% in 1– 2 days, 90% in 3– 6 days, and 85% in 7– 10 days. With disease progression, consolidation appeared on follow-up CT. Consolidation performance accounts for 0% in 1– 2 days, 40% in 3– 6 days, and 71% in 7– 10 days. The lesions are mostly near the pleura. The number of lesions and the extent of the lesions increased as the disease progressed. Conclusion Patients with novel coronavirus pneumonia have characteristic CT features in the initial stage of infection, which can be used as an essential supplement for nucleic acid examination.

scholarly journals Radiological and functional lung sequelae of COVID-19: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Matsuo So ◽  
Hiroki Kabata ◽  
Koichi Fukunaga ◽  
Hisato Takagi ◽  
Toshiki Kuno
Keyword(s):  
Systematic Review ◽  
Pulmonary Function ◽  
Hospital Discharge ◽  
Pulmonary Function Test ◽  
Wide Spectrum ◽  
Meta Analysis ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Function Test

Abstract Background The coronavirus disease 2019 (COVID-19) causes a wide spectrum of lung manifestations ranging from mild asymptomatic disease to severe respiratory failure. We aimed to clarify the characteristics of radiological and functional lung sequelae of COVID-19 patients described in follow-up period. Method PubMed and EMBASE were searched on January 20th, 2021 to investigate characteristics of lung sequelae in COVID-19 patients. Chest computed tomography (CT) and pulmonary function test (PFT) data were collected and analyzed using one-group meta-analysis. Results Our search identified 15 eligible studies with follow-up period in a range of 1–6 months. A total of 3066 discharged patients were included in these studies. Among them, 1232 and 1359 patients were evaluated by chest CT and PFT, respectively. The approximate follow-up timing on average was 90 days after either symptom onset or hospital discharge. The frequency of residual CT abnormalities after hospital discharge was 55.7% (95% confidential interval (CI) 41.2–70.1, I2 = 96.2%). The most frequent chest CT abnormality was ground glass opacity in 44.1% (95% CI 30.5–57.8, I2 = 96.2%), followed by parenchymal band or fibrous stripe in 33.9% (95% CI 18.4–49.4, I2 = 95.0%). The frequency of abnormal pulmonary function test was 44.3% (95% CI 32.2–56.4, I2 = 82.1%), and impaired diffusion capacity was the most frequently observed finding in 34.8% (95% CI 25.8–43.8, I2 = 91.5%). Restrictive and obstructive patterns were observed in 16.4% (95% CI 8.9–23.9, I2 = 89.8%) and 7.7% (95% CI 4.2–11.2, I2 = 62.0%), respectively. Conclusions This systematic review suggested that about half of the patients with COVID-19 still had residual abnormalities on chest CT and PFT at about 3 months. Further studies with longer follow-up term are warranted.

scholarly journals Follow-up Chest CT findings from discharged patients with severe COVID-19: an 83-day observational study

2020 ◽  
Author(s):  
Tianhe Ye ◽  
Yanqing Fan ◽  
Jiacheng Liu ◽  
Chongtu Yang ◽  
Songjiang Huang ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Virus Disease ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Ct Scans ◽  
Ground Glass ◽  
Ct Findings ◽  
Lung Abnormalities ◽  
Discharged Patients

Abstract Background: Chest computed tomography (CT) has been used to be a monitoring measure to assess the severity of lung abnormalities in corona virus disease 19 (COVID-19). Up to date, there has been no reports about follow-up chest CT findings from discharge patients with severe COVID-19. This study aims to describe the change pattern of radiological abnormalities from admission, to discharge, and to the last chest CT follow-up through an 83-day retrospective observation, and focuses on follow-up chest CT findings in discharged patients with severe COVID-19.Methods: Twenty-nine discharged patients (17 males, 12 females; median age, 56 years, IQR, 47-67) confirmed with severe COVID-19 from 13 January to 15 February were enrolled in this study. A total of 80 chest CT scans was performed from admission to the last follow-up. Images were mainly evaluated for ground-glass opacity, consolidation, parenchymal bands, and crazy-paving pattern. A semi-quantitative CT scoring system was used for estimating lung abnormalities of each lobe.Results: All patients received nasal cannula or/and high-flow mask oxygen therapy. Admission occurred 9 days (IQR, 5-13) after symptom onset. The median in-hospital period was 18 days (IQR, 11-26). The last follow-up chest CT was performed 66 days (IQR, 61-77) after symptom onset. Total CT scores in follow-up decreased significantly compared to that of performed in-hospital ([3, IQR, 0-5] to [13, IQR, 10-16], P < 0.001). Predominant patterns on follow-up chest CT performed 64 days after symptom onset were subpleural parenchymal bands (47%, 9/19) and complete radiological resolution (37%, 7/19). Consolidation absorbed earlier than ground-glass opacity did, and subpleural parenchymal bands were the longest-lasting feature during radiological resolution.Conclusions: Radiological abnormalities in patients of severe COVID-19 could be completely absorbed with no residual lung injury in more than two months’ follow-up. Serial chest CT scans could be used as a monitoring modality to help clinician better understand the disease course.

scholarly journals Analysis of the role of Chest X-Ray in a large cohort of 1117 patients with SARS-CoV-2 infection: an Italian multicenter study

2020 ◽  
Author(s):  
Valentina Vespro ◽  
Maria Carmela Andrisani ◽  
Stefano Fusco ◽  
Letizia Di Meglio ◽  
Guido Plensich ◽  
...  
Keyword(s):  
Interstitial Pneumonia ◽  
Ground Glass Opacity ◽  
Large Cohort ◽  
Frequent Pattern ◽  
Categorical Variables ◽  
Paired Data ◽  
Chi Square ◽  
Lombardy Region ◽  
Reticular Pattern

Abstract Objective. To describe the radiographic key patterns on CXR in patients with SARS-CoV-2 infection, assessing the prevalence of radiographic signs of interstitial pneumonia. To evaluate pattern variation between a baseline and a follow-up CXR.Materials and methods. 1117 patients tested positive for SARS-CoV-2 infection were retrospectively enrolled from four centers in Lombardy region. All patients underwent a CXR at presentation. Follow-up CXR was performed when clinically indicated.Two radiologists in each center reviewed CXR images and classified them as suggestive or not for interstitial pneumonia, recording the presence of ground-glass opacity (GGO), reticular pattern or consolidation and their distribution.Pearson’s chi-square test for categorical variables and McNemar test (chi-square for paired data) were performed.Results. Patients mean age 63.3 years, 767 were males (65.5%). The main result is the large proportion of positive CXR in COVID-19 patients.Baseline CXR was positive in 940 patients (80.3%), with significant differences in age and sex distribution between patients with positive and negative CXR. 382 patients underwent a follow-up CXR. The most frequent pattern on baseline CXR was the GGO (66.1%), on follow-up was consolidation (53.4%). The most common distributions were peripheral and middle-lower lung zone.Conclusions. We described key-patterns and their distribution on CXR in a large cohort of COVID-19 patients: GGO was the most frequent finding on baseline CXR, while we found an increase in the proportion of lung consolidation on follow-up CXR. CXR proved to be a reliable tool in our cohort obtaining positive results in 80.3% of the baseline cases.

scholarly journals Analysis of Chest CT Results of Coronavirus Disease 2019 (COVID-19) Patients at First Follow-Up

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Lingshan Zhong ◽  
Shuo Zhang ◽  
Jigang Wang ◽  
Xinqian Zhao ◽  
Kai Wang ◽  
...  
Keyword(s):  
Ground Glass Opacity ◽  
Chest Ct ◽  
Ground Glass ◽  
Imaging Data ◽  
Exclusion Criteria ◽  
Pulmonary Lesions ◽  
Normal Chest ◽  
Time Of Admission ◽  
Better Than

Objective. To investigate the dissipation and outcomes of pulmonary lesions at the first follow-up of patients who recovered from moderate and severe cases of COVID-19. Methods. From January 21 to March 3, 2020, a total of 136 patients with COVID-19 were admitted to our hospital. According to inclusion and exclusion criteria, 52 patients who recovered from COVID-19 were included in this study, including 33 moderate cases and 19 severe cases. Three senior radiologists independently and retrospectively analyzed the chest CT imaging data of 52 patients at the last time of admission and the first follow-up after discharge, including primary manifestations, concomitant manifestations, and degree of residual lesion dissipation. Results. At the first follow-up after discharge, 16 patients with COVID-19 recovered to normal chest CT appearance, while 36 patients still had residual pulmonary lesions, mainly including 33 cases of ground-glass opacity, 5 cases of consolidation, and 19 cases of fibrous strip shadow. The proportion of residual pulmonary lesions in severe cases (17/19) was statistically higher than in moderate cases (19/33) ( χ 2   =   5 . 759 , P < 0.05 ). At the first follow-up, residual pulmonary lesions were dissipated to varying degrees in 47 cases, and lesions remained unchanged in 5 cases. There were no cases of increased numbers of lesions, enlargement of lesions, or appearance of new lesions. The dissipation of residual pulmonary lesions in moderate patients was statistically better than in severe patients (Z = −2.538, P < 0.05 ). Conclusion. Clinically cured patients with COVID-19 had faster dissipation of residual pulmonary lesions after discharge, while moderate patients had better dissipation than severe patients. However, at the first follow-up, most patients still had residual pulmonary lesions, which were primarily ground-glass opacity and fibrous strip shadow. The proportion of residual pulmonary lesions was higher in severe cases of COVID-19, which required further follow-up.

scholarly journals Dynamic Changes of Chest CT Follow-up In Coronavirus Disease-19 (COVID-19) Pneumonia: Relationship To Clinical Typing

2020 ◽  
Author(s):  
Nian Liu ◽  
Guanghong He ◽  
Xiongxiong Yang ◽  
Jianxin Chen ◽  
Jie Wu ◽  
...  
Keyword(s):  
Severity Score ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Critical Group ◽  
Occurrence Rate ◽  
Dynamic Changes ◽  
Pleural Thickening ◽  
The Third ◽  
The Right

Abstract Background To investigate the CT changes of different clinical types of COVID-19 pneumonia. Methods This retrospective study included 50 patients with COVID-19 from 16 January 2020 to 25 February 2020. We analyzed the clinical characteristics, CT characteristics and the pneumonia involvement of the patients between the moderate group and the severe and critical group, and the dynamic changes of severity with the CT follow-up time. Results There were differences in the CT severity score of the right lung in the initial CT, and total CT severity score in the initial and follow-up CT between the moderate group and the severe and critical group (all p < 0.05). There was a quadratic relationship between total CT severity score and CT follow-up time in the severe and critical group (r2 = 0.137, p = 0.008), the total CT severity score peaked at the second follow-up CT. There was no correlation between total CT severity score and CT follow-up time in the moderate group (p > 0.05). There were no differences in the occurrence rate of CT characteristics in the initial CT between the two groups (all p > 0.05). There were differences in the occurrence rate of ground-glass opacity and crazy-paving pattern in the second follow-up CT, and pleural thickening or adhesion in the third follow-up CT between the two groups (all p < 0.05). Conclusions The CT changes of COVID-19 pneumonia with different severity were different, and the extent of pneumonia involvement by CT can help to assess the severity of COVID-19 pneumonia rather than the initial CT characteristics.

scholarly journals Dynamic Changes of Chest CT Follow-up In Coronavirus Disease-19 (COVID-19) Pneumonia: Relationship To Clinical Typing

2020 ◽  
Author(s):  
Nian Liu ◽  
Guanghong He ◽  
Xiongxiong Yang ◽  
Jianxin Chen ◽  
Jie Wu ◽  
...  
Keyword(s):  
Severity Score ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Critical Group ◽  
Occurrence Rate ◽  
Dynamic Changes ◽  
Pleural Thickening ◽  
The Third ◽  
The Right

Abstract Background: To investigate the CT changes of different clinical types of COVID-19 pneumonia. Methods: This retrospective study included 50 patients with COVID-19 from 16 January 2020 to 25 February 2020. We analyzed the clinical characteristics, CT characteristics and the pneumonia involvement of the patients between the moderate group and the severe and critical group, and the dynamic changes of severity with the CT follow-up time. Results: There were differences in the CT severity score of the right lung in the initial CT, and total CT severity score in the initial and follow-up CT between the moderate group and the severe and critical group (all p <0.05). There was a quadratic relationship between total CT severity score and CT follow-up time in the severe and critical group (r2=0.137, p=0.008), the total CT severity score peaked at the second follow-up CT. There was no correlation between total CT severity score and CT follow-up time in the moderate group (p >0.05). There were no differences in the occurrence rate of CT characteristics in the initial CT between the two groups (all p >0.05). There were differences in the occurrence rate of ground-glass opacity and crazy-paving pattern in the second follow-up CT, and pleural thickening or adhesion in the third follow-up CT between the two groups (all p <0.05). Conclusions: The CT changes of COVID-19 pneumonia with different severity were different, and the extent of pneumonia involvement by CT can help to assess the severity of COVID-19 pneumonia rather than the initial CT characteristics.

scholarly journals Outcomes of Recovered COVID-19 Patients: 6 Months of Sequential Observations at a Designated Tertiary Center

2021 ◽  
Author(s):  
Jie Cao ◽  
Wei Wei ◽  
Xianmeng Chen ◽  
Jay H. Ryu ◽  
Xiaowen Hu
Keyword(s):  
Pulmonary Function ◽  
Hospital Discharge ◽  
Chest Ct ◽  
Long Term Outcomes ◽  
Global Pandemic ◽  
Tertiary Center ◽  
Pulmonary Impairment ◽  
Discharged Patients

Abstract Objectives: An ongoing global pandemic of coronavirus disease 2019 (COVID-19) has affecting almost 100,000,000 cases with 2,100,000 deaths worldwide. However, the long-term outcomes of recovered patients remain to be defined.Methods: This is a prospective observational study of patients with COVID-19 using sequential assessments after hospital discharge from a designated tertiary center in Hefei, China. We examined clinical symptom, chest CT imaging, pulmonary function, and 6-min walk distance (6-MWD).Results: There were 62, 61 and 51 discharged patients enrolled the 1-month, 3-month and 6-month observations, respectively. Symptoms persisted in 24 (39%), 25 (41%) and 5 (10%) patients, mainly cough in 31%, 15% and 8% of them, respectively. Mild restrictive pulmonary impairment was detected in 11%, 10%, 12% of patients at 1, 3, 6-month follow-up. Although chest CT scores were overall gradually improved at 1 month (5.0±5.1), 3 months (3.0±4.5) and 6 months (2.0±3.3) compared with that during hospitalization (11.0±6.8), residual CT abnormalities were seen in 73%, 54% and 43% of them at 1, 3, 6 months. At 6-month follow-up, the 6MWD was 541±59 m in these recovered patients, which was significantly lower compared to healthy controls (589±75 m，p<0.01). Only the steroid treatment during hospitalization (p=0.009, OR 12.091, 95% CI 1.882 to 77.678) was associated with abnormal CT score at 6 months.Conclusions: At 6 months after hospital discharge, respiratory symptoms and pulmonary function were improved in most COVID-19 patients while residual impairments were still present in both chest CT images and exercise capacity.

scholarly journals CT changes of severe coronavirus disease 2019 based on prognosis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Bin Liang ◽  
Lingli Xie ◽  
Fan Yang ◽  
Joyman Makamure ◽  
Lijie Zhang ◽  
...  
Keyword(s):  
Clinical Significance ◽  
Ground Glass Opacity ◽  
Ct Scans ◽  
Rapid Rise ◽  
Slow Decline ◽  
Lung Abnormalities ◽  
Discharged Patients ◽  
Serial Ct ◽  
Diffuse Distribution ◽  
Death Group

AbstractThis study aimed to determine the characteristics of CT changes in patients with severe coronavirus disease 2019 (COVID-19) based on prognosis. Serial CT scans in 47 patients with severe COVID-19 were reviewed. The patterns, distribution and CT score of lung abnormalities were assessed. Scans were classified according to duration in weeks after onset of symptoms. These CT abnormalities were compared between discharged and dead patients. Twenty-six patients were discharged, whereas 21 passed away. Discharged patients were characterized by a rapid rise in CT score in the first 2 weeks followed by a slow decline, presence of reticular and mixed patterns from the second week, and prevalence of subpleural distribution of opacities in all weeks. In contrast, dead patients were characterized by a progressive rise in CT score, persistence of ground-glass opacity and consolidation patterns in all weeks, and prevalence of diffuse distribution from the second week. CT scores of death group were significantly higher than those of discharge group (P < 0.05). The CT changes differed between the discharged and dead patients. An understanding of these differences can be of clinical significance in the assessment of the prognosis of severe COVID-19 patients.

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