scholarly journals Early Chest CT Features of Patients with 2019 Novel Coronavirus (COVID-19) Pneumonia: Relationship to Diagnosis and Prognosis

2020 ◽  
Author(s):  
Hui Juan Chen ◽  
Jie Qiu ◽  
Biao Wu ◽  
Tao Huang ◽  
Yunsuo Gao ◽  
...  
Keyword(s):  
Early Stage ◽  
Clinical Manifestations ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Ground Glass ◽  
Rt Pcr ◽  
Icu Patients ◽  
Clinical Prognosis ◽  
Discharged Patients ◽  
Ct Features

Abstract Objective: To elucidate the consistency between CT findings and real time reverse-transcription–polymerase chain- reaction (RT-PCR) results and investigate the relationship between CT features and clinical prognosis in COVID-19.Methods: The clinical manifestations, laboratory parameters and CT imaging findings were analyzed in thirty-four patients with COVID-19 confirmed by RT-PCR from January 20 to February 4 in Hainan province. CT score was compared between the discharged patients and ICU patients.Results: Fever (85%) and cough (79%) were most commonly seen. 10 (29%) patients demonstrated negative results on their first RT-PCR.22/34(65%) patients showed pure ground glass opacity (GGO). 17/34 (50%) patients had five lobes of lung involvement, while the 23(68%) patients had lower lobes were involved and 24/34 (71%) were subpleural. Lesions of 24 (71%) patients were distributed mainly in the subpleural. During follow-up, the initial CT lesions of ICU patients are distributed in both subpleural and parenchyma (80%) and the lesions are scattered. 60% of ICU patients had five lobes involved, while this was seen in only 25% discharged patients. Lesions of discharged patients are mainly in the subpleural (75%). 62.5% of discharged patients showed pure ground-glass opacity. 80% ICU demonstrated progressive stage on their first CT scan. 75 % discharged patients were at an early stage. CT score of ICU patients were significantly higher than that of the discharged patients.Conclusion: Chest CT plays a crucial role in the early diagnosis of COVID-19, particularly for those patients with negative RT-PCR. The initial features in CT may be associated with prognosis.Authors Hui Juan Chen and Jie Qiu contributed equally to this work.

scholarly journals Clinical manifestations, CT features and outcome of 39 patients with COVID-19: retrospective case analysis

2020 ◽  
Author(s):  
Haohao Lu ◽  
Chuansheng Zheng ◽  
Qiaoxia Tong ◽  
Jin Tian
Keyword(s):  
Early Stage ◽  
Clinical Manifestations ◽  
Ground Glass Opacity ◽  
Ground Glass ◽  
Rt Pcr ◽  
Retrospective Case ◽  
Recovery Stage ◽  
Discharged Patients ◽  
D Dimer ◽  
Pulmonary Ct

Abstract 1. BackgroundTo explore the manifestations and evolution of the pulmonary CT in COVID-19, and to analyze the causes and countermeasures of “Recurrent positive” in discharged patients.2. MethodsData of 39 patients with COVID-19 were collected. RT-PCR was positive at admission.From onset to discharge, pulmonary CT was performed regularly.During the treatment,Blood-RT,CRP and D-dimer were detected.3.ResultFrom the onset to 14 days, the lesions in pulmonary CT increased significantly.After treatment, pulmonary CT before discharge showed that some patients' lesions were completely absorbed, and some residual strip like lesions or ground glass opacity with reduced density.Two weeks after discharge, there were 2 patients with new ground glass opacity.There were 20 patients with D-dimer increased.4.ConclusionIn the early stage of COVID-19, the pulmonary CT has the characteristic manifestations, which is helpful for early diagnosis.In the middle stage, pulmonary lesions changed rapidly.In the recovery stage, some of the patients remained strip like lesions.It is necessary to pay attention to the possibility of pulmonary fibrosis after recovery.The discharge standard of COVID-19 needs to be more strict to avoid “Recurrent positive”,the discharged patients should continue to be observed.D-dimer was increased in some patients, it is safe to use heparin in anticoagulation without contraindications.

scholarly journals Diagnostic performance of chest CT in differentiating COVID-19 from other causes of ground-glass opacities

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Ali H. Elmokadem ◽  
Dalia Bayoumi ◽  
Sherif A. Abo-Hedibah ◽  
Ahmed El-Morsy
Keyword(s):  
Diagnostic Performance ◽  
Pulmonary Nodules ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Ground Glass ◽  
Rt Pcr ◽  
Laboratory Findings ◽  
Halo Sign ◽  
Traction Bronchiectasis ◽  
Chest Ct Scan

Abstract Background To evaluate the diagnostic performance of chest CT in differentiating coronavirus disease 2019 (COVID-19) and non-COVID-19 causes of ground-glass opacities (GGO). Results A total of 80 patients (49 males and 31 females, 46.48 ± 16.09 years) confirmed with COVID-19 by RT-PCR and who underwent chest CT scan within 2 weeks of symptoms, and 100 patients (55 males and 45 females, 48.94 ± 18.97 years) presented with GGO on chest CT were enrolled in the study. Three radiologists reviewed all CT chest exams after removal of all identifying data from the images. They expressed the result as positive or negative for COVID-19 and recorded the other pulmonary CT features with mention of laterality, lobar affection, and distribution pattern. The clinical data and laboratory findings were recorded. Chest CT offered diagnostic accuracy ranging from 59 to 77.2% in differentiating COVID-19- from non-COVID-19-associated GGO with sensitivity from 76.25 to 90% and specificity from 45 to 67%. The specificity was lower when differentiating COVID-19 from non-COVID-19 viral pneumonias (30.5–61.1%) and higher (53.1–70.3%) after exclusion of viral pneumonia from the non-COVID-19 group. Patients with COVID-19 were more likely to have lesions in lower lobes (p = 0.005), peripheral distribution (p < 0.001), isolated ground-glass opacity (p = 0.043), subpleural bands (p = 0.048), reverse halo sign (p = 0.005), and vascular thickening (p = 0.013) but less likely to have pulmonary nodules (p < 0.001), traction bronchiectasis (p = 0.005), pleural effusion (p < 0.001), and lymphadenopathy (p < 0.001). Conclusions Chest CT offered reasonable sensitivity when differentiating COVID-19- from non-COVID-19-associated GGO with low specificity when differentiating COVID-19 from other viral pneumonias and moderate specificity when differentiating COVID-19 from other causes of GGO.

scholarly journals Early chest computed tomography to diagnose COVID-19 from suspected patients: A multicenter retrospective study

2020 ◽  
Author(s):  
Congliang Miao ◽  
Mengdi Jin ◽  
Li Miao ◽  
Xinying Yang ◽  
Peng Huang ◽  
...  
Keyword(s):  
Ground Glass Opacity ◽  
High Specificity ◽  
Diagnostic Value ◽  
Chest Ct ◽  
Imaging Features ◽  
Rt Pcr ◽  
Polymerase Chain ◽  
Low Sensitivity ◽  
Chest Ct Scan ◽  
Ct Features

AbstractObjectiveThe purpose of this study is to distinguish the imaging features of COVID-19 with other chest infectious diseases and evaluate diagnostic value of chest CT for suspected patients.MethodsAdult suspected patients aged>18 years within 14 days who underwent chest CT scan and reverse-transcription polymerase-chain-reaction (RT-PCR) tests were enrolled. The enrolled patients were confirmed and grouped according to results of RT-PCR tests. The data of basic demographics, single chest CT features, and combined chest CT features were analyzed for confirmed and non-confirmed groups.ResultsA total of 130 patients were enrolled with 54 cases positive and 76 cases negative. The typical CT imaging features of positive group were ground glass opacity (GGO), crazy-paving pattern and air bronchogram. The lesions were mostly distributed bilaterally, close to the lower lungs or the pleura. When features combined, GGO with bilateral pulmonary distribution and GGO with pleural distribution were more common, of which were 31 cases (57.4%) and 30 cases (55.6%) respectively. The combinations were almost presented statistically significant (P<0.05) except for the combination of GGO with consolidation. Most combinations presented relatively low sensitivity but extremely high specificity. The average specificity of these combinations is around 90%.ConclusionsThe combinations of GGO could be useful in the identification and differential diagnosis of COVID-19, which alerts clinicians to isolate patients for treatment promptly and repeat RT-PCR tests until incubation ends.

scholarly journals Chest CT changes in COVID-19 patients with hypertension comorbidities

2020 ◽  
Author(s):  
Wei Li ◽  
Wenjun Yu ◽  
Jianwei Liao ◽  
Yijie Fang ◽  
Lin Yao ◽  
...  
Keyword(s):  
Global Health ◽  
Clinical Features ◽  
Clinical Data ◽  
Clinical Characteristics ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Ground Glass ◽  
Rt Pcr ◽  
Relationship Of ◽  
Pcr Test

Abstract AIMTo summarize the chest CT and clinical features of COVID-19 pneumonia patients with hypertension comorbidities.METHODSThe initial chest CT imaging and clinical data of 15 confirmed COVID-19 patients with hypertension comorbidities treated in our hospital were analyzed retrospectively from January 1, 2019 to February 14, 2020. The chest CT images and clinical data were reviewed and their relationship of the disease was analyzed.RESULTSTotally 15 COVID-19 patients diagnosed with hypertension comorbidities were included. In terms of clinical characteristics, 14/15 (93.3%) of patients had characteristics of clustering onset, and the positive rates of the first RT-PCR test and the initial CT were 80% and 93% respectively. The most frequent CT abnormality observed was ground glass opacity (GGO) (13/15, 86.7%), including patchy/ punctate GGO and large/multiple GGO. Most of the lesions were multiple, and 60% of them involved 4-5 lobes. Most patients present with bilateral CT onset (12,80.0%), and most present with subpleural distribution (10,66.7%). The average CT score is 13.7, and 40% of the patients exceeded 20 points.CONCLUSIONThe common chest CT findings in COVID-19 patients with hypertension comorbidities are GGO, most of which at present with bilateral CT onset and subpleural distribution. CT is indispensable in the diagnosis and evaluation of this global health emergency.

scholarly journals A Systematic Meta-Analysis of CT Features of COVID-19: Lessons from Radiology

2020 ◽  
Author(s):  
Vasantha Kumar Venugopal ◽  
Vidur Mahajan ◽  
Sriram Rajan ◽  
Vikash Agarwal ◽  
Ruchika Rajan ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Ground Glass ◽  
Common Finding ◽  
Extensive Literature ◽  
Rt Pcr ◽  
Systematic Analysis ◽  
Clinical Prognosis ◽  
Disease Pattern ◽  
Advanced Stages ◽  
Ct Features

1.AbstractSeveral studies have been published in the past few months describing the CT features of Coronavirus Disease 2019 (COVID-19). There is a great degree of heterogeneity in the study designs, lesion descriptors used and conclusions derived. In our systematic analysis and meta-review, we have attempted to homogenize the reported features and provide a comprehensive view of the disease pattern and progression in different clinical stages. After an extensive literature search, we short-listed and reviewed 49 studies including over 4145 patients with 3615 RT-PCR positive cases of COVID-19 disease. We have found that there is a good agreement among these studies that diffuse bilateral ground-glass opacities (GGOs) is the most common finding at all stages of the disease followed by consolidations and mixed density lesions. 78% of patients with RT-PCR confirmed COVID-19 infections had either ground-glass opacities, consolidation or both. Inter-lobular septal thickening was also found to be a common feature in many patients in advanced stages. The progression of these initial patchy GGO’s and consolidations to diffuse lesions with septal thickening, air bronchograms in the advanced stages, to either diffuse “white-out” lungs needing ICU admissions or finally resolving completely without or with residual fibrotic strips was also found to be congruent among multiple studies. Prominent juxta- lesional pulmonary vessels, pleural effusion and lymphadenopathy in RT-PCR proven cases were found to have poor clinical prognosis. Additionally, we noted wide variation in terminology used to describe lesions across studies and suggest the use of standardized lexicons to describe findings related to diseases of vital importance.

scholarly journals Early clinical and CT features of COVID-19 and community-acquired pneumonia from a fever observation ward in Ningbo, China

2021 ◽  
Author(s):  
G Qian ◽  
Y Lin ◽  
AHY Ma ◽  
X Zhang ◽  
G Li ◽  
...  
Keyword(s):  
Early Stage ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Lower Lobe ◽  
Ground Glass Opacity ◽  
Ct Images ◽  
Community Acquired Pneumonia ◽  
Ground Glass ◽  
Significant Difference ◽  
Eosinophil Counts

Introduction: We aimed to compare the early clinical manifestations, laboratory results and chest computed tomography (CT) images of coronavirus disease 2019 (COVID-19) patients with those of other community-acquired pneumonia (CAP) patients to differentiate COVID-19 before reverse transcription-polymerase chain reaction results are obtained. Methods: The clinical and laboratory data and chest CT images of 51 patients were assessed in a fever observation ward for evidence of COVID-19 between January and February 2020. Results: 24 patients had laboratory-confirmed COVID-19, whereas 27 individuals had negative results. No statistical difference in clinical features was found between COVID-19 and CAP patients except for diarrhoea. There was a significant difference in lymphocyte and eosinophil counts between COVID-19 and CAP patients. 22 (91.67%) COVID-19 patients had bilateral involvement and multiple lesions according to their lung CT images; the left lower lobe (87.50%) and right lower lobe (95.83%) were most often affected, and all lesions were located in peripheral zones of the lung. The most common CT feature of COVID-19 was ground-glass opacity, found in 95.83% of patients, compared to 66.67% of CAP patients. Conclusion: Diarrhoea, lymphocyte counts, eosinophil counts and CT findings (e.g. ground-glass opacity) could help to distinguish COVID-19 from CAP at an early stage of infection, based on findings from our fever observation ward.

scholarly journals CT Features of COVID-19 Pneumonia Differ Depending on the Severity and Duration of Disease

2020 ◽  
Author(s):  
Jan Schaible ◽  
Stefanie Meiler ◽  
Florian Poschenrieder ◽  
Gregor Scharf ◽  
Florian Zeman ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Symptom Onset ◽  
Ground Glass Opacity ◽  
Ground Glass ◽  
Time Interval ◽  
Rt Pcr ◽  
Severity Of Disease ◽  
Duration Of Disease ◽  
Bronchial Dilatation ◽  
Ct Features

Background CT is important in the care of patients with COVID-19 pneumonia. However, CT morphology can change significantly over the course of the disease. To evaluate the CT morphology of RT-PCR-proven COVID-19 pneumonia in a German cohort with special emphasis on identification of potential differences of CT features depending on duration and severity of disease. Method All patients with RT-PCR-proven COVID-19 pneumonia and chest CT performed between March 1 and April 15, 2020 were retrospectively identified. The CT scans were evaluated regarding the presence of different CT features (e. g. ground glass opacity, consolidation, crazy paving, vessel enlargement, shape, and margin of opacifications), distribution of lesions in the lung and extent of parenchymal involvement. For subgroup analyses the patients were divided according to the percentage of parenchymal opacification (0–33 %, 34–66 %, 67–100 %) and according to time interval between symptom onset and CT date (0–5 d, 6–10 d, 11–15 d, > 15 d). Differences in CT features and distribution between subgroups were tested using the Mantel-Haenszel Chi Squared for trend. Results The frequency of CT features (ground glass opacity, consolidation, crazy paving, bronchial dilatation, vessel enlargement, lymphadenopathy, pleural effusion) as well as pattern of parenchymal involvement differed significantly depending on the duration of disease and extent of parenchymal involvement. The early phase of disease was characterized by GGO and to a lesser extent consolidation. The opacifications tended to be round and to some extent with sharp margins and a geographic configuration. The vessels within/around the opacifications were frequently dilated. Later on, the frequency of consolidation and especially crazy paving increased, and the round/geographic shape faded. After day 15, bronchial dilatation occurred, and lymphadenopathy and pleural effusion were seen more frequently than before. Conclusion The prevalence of CT features varied considerably during the course of disease and depending on the severity of parenchymal involvement. Radiologists should take into account the time interval between symptom onset and date of CT and the severity of disease when discussing the likelihood of COVID-19 pneumonia based on CT morphology. Key Points:  Citation Format

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 Clinical Characteristics of Coronavirus Disease 2019 in Hainan, China

2020 ◽  
Author(s):  
Shijiao Yan ◽  
Xingyue Song ◽  
Feng Lin ◽  
Haiyan Zhu ◽  
Xiaozhi Wang ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Early Stage ◽  
Laboratory Data ◽  
Ground Glass Opacity ◽  
The Elderly ◽  
Rt Pcr ◽  
Rapid Spread ◽  
The World ◽  
Imported Cases ◽  
Discharged Patients

AbstractBackgroundSince January 2020, coronavirus disease 2019 (Covid-19) has spread rapidly and developing the pandemic model around the world. Data have been needed on the clinical characteristics of the affected patients in an imported cases as model in island outside Wuhan.MethodsWe conducted a retrospective study included all 168 confirmed cases of Covid-19 in Hainan province from 22 January 2020 to 13 March 2020. Cases were confirmed by real-time RT-PCR and were analysed for demographic, clinical, radiological and laboratory data.ResultsOf 168 patients, 160 have been discharged, 6 have died and 2 remain hospitalized. The median age was 51.0 years and 51.8% were females. 129 (76.8%) patients were imported cases, and 118 (70.2%), 51 (30.4%) and 52 (31%) of patients lived in Wuhan or traveled to Wuhan, had contact with Covid-19 patients, or had contact with Wuhan residents, respectively. The most common symptoms at onset of illness were fever (65.5%), dry cough (48.8%) and expectoration (32.1%). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (60.2%). The elderly people with diabetes, hypertension and CVD are more likely to develop severe cases. Follow-up of 160 discharged patients found that 20 patients (12.5%) had a positive RT-PCR test results of pharyngeal swabs or anal swabs or fecal.ConclusionsIn light of the rapid spread of Covid-19 around the world, early diagnosis and quarantine is important to curb the spread of Covid-19 and intensive treatments in early stage is to prevent patients away from critical condition.

scholarly journals Spectrum of Chest Computerised Tomography (CT) findings of Covid 19 in Indian Population

2021 ◽  
Vol 9 (1) ◽  
pp. 43-49
Author(s):  
Shravya Boini ◽  
Vikas Chennamaneni ◽  
Vamshi Kiran Diddy ◽  
Momin Sayed Kashif
Keyword(s):  
Lower Lobe ◽  
Ground Glass Opacity ◽  
Ct Images ◽  
Chest Ct ◽  
Ct Scans ◽  
Ground Glass ◽  
Study Cohort ◽  
Study Population ◽  
Ct Features

Background: To analyze the chest computed tomography (CT) features in patients with coronavirus disease 2019 (COVID-19) pneumonia. Methods: This was a prospective descriptive study comprising 202 consecutive reverse transcriptase polymerase chain reaction (RT-PCR) positive patients who underwent CT chest. For 25 patients, follow-up CT scans were obtained. The CT images were evaluated for the number, type and distribution of the opacity, and CT severity scoring was done Results: Among the total study cohort of 202 patients, 152 were males and 50 were females .From July 07, 2020, to september07, 2020, totally 202 laboratory-confirmed patients with COVID-19 underwent chest CT. For 25 patients, follow-up CT scans were obtained. The CT images were evaluated for the number, type and distribution of the opacity, and the affected lung lobes. Furthermore, the initial CT scan and the follow-up CT scans were compared. Results were patients (98.5%) had two or more opacities in the lung and 3 (1.5%) patients has negative chest CT. 183 (90.6%) patients had only ground-glass opacities; 13 patients (6.4%) had ground-glass and consolidative opacities; and 3 patients (1.5%) had only consolidation. A total 192 of patients (96.5%) showed two or more lobes involved. The opacities tended to be both in peripheral and central 7 (3.5%) or purely peripheral distribution 192 (96.5%). 177 patients (88.9%) had the lower lobe involved.8 patients showed complete resolution of lung findings. Conclusion: In this study population, the typical CT features of COVID 19 pneumonia are ground glass opacity with or without consolidation, which is patchy and peripheral, predominantly in lower lobes.

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