Chest CT Imaging Features of the Pulmonary Sequelae in Four Patients with COVID-19

Objectives: To systematically analyze the chest CT imaging features of children with COVID-19 and provide references for clinical practice. Methods: We searched PubMed, Web of Science, and Embase; data published by Johns Hopkins University; and Chinese databases CNKI, Wanfang, and Chongqing Weipu. Reports on chest CT imaging features of children with COVID-19 from January 1, 2020, to August 10, 2020, were analyzed retrospectively and a meta-analysis carried out using Stata12.0 software. Results: Thirty-seven articles (1747 children) were included in this study. The overall rate of abnormal lung CT findings was 63.2% (95% confidence interval [CI]: 55.8-70.6%), with a rate of 61.0% (95% CI: 50.8-71.2%) in China and 67.8% (95% CI: 57.1-78.4%) in the rest of the world in the subgroup analysis. The incidence of ground-glass opacities was 39.5% (95% CI: 30.7-48.3%), multiple lung lobe lesions 65.1% (95% CI: 55.1-67.9%), and bilateral lung lesions 61.5% (95% CI: 58.8-72.2%). Other imaging features included nodules (25.7%), patchy shadows (36.8%), halo sign (24.8%), consolidation (24.1%), air bronchogram signs (11.2%), cord-like shadows (9.7%), crazy-paving pattern (6.1%), and pleural effusion (9.1%). Two articles reported three cases of white lung, another reported two cases of pneumothorax, and another one case of bullae. CONCLUSION: The lung CT results of children with COVID-19 are usually normal or slightly atypica, with a low sensitivity and specificity compared with that in adults. The lung lesions of COVID-19 pediatric patients mostly involve both lungs or multiple lobes, and the common manifestations are patchy shadows, ground-glass opacities, consolidation, partial air bronchogram signs, nodules, and halo signs; white lung, pleural effusion, and paving stone signs are rare. CLINICAL IMPACT: Therefore, chest CT has limited value as a screening tool for children with COVID-19 and can only be used as an auxiliary assessment tool.

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Human metapneumovirus lower respiratory tract infections in adults: chest CT imaging features and their evolution

10.1183/13993003.congress-2018.pa2028 ◽

2018 ◽

Author(s):

Lawrence A. Marinari ◽

Wallace T. Miller, Jr. ◽

Madeline A. Danny

Keyword(s):

Respiratory Tract ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Ct Imaging ◽

Chest Ct ◽

Human Metapneumovirus ◽

Imaging Features ◽

Lower Respiratory Tract Infections ◽

Tract Infections

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Lower Respiratory Tract Infection with Human Metapneumovirus: Chest CT Imaging Features and Comparison with Other Viruses

European Journal of Radiology ◽

10.1016/j.ejrad.2020.108988 ◽

2020 ◽

Vol 128 ◽

pp. 108988

Author(s):

Lawrence A. Marinari ◽

Madeline A. Danny ◽

Scott A. Simpson ◽

James E. Schmitt ◽

Wallace T. Miller

Keyword(s):

Tract Infection ◽

Respiratory Tract ◽

Respiratory Tract Infection ◽

Lower Respiratory Tract Infection ◽

Lower Respiratory Tract ◽

Ct Imaging ◽

Chest Ct ◽

Human Metapneumovirus ◽

Imaging Features

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Chest CT imaging features of COVID-19 and its correlation with the PaO2/FiO2 ratio: a multicenter study in Upper Egypt

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-020-00373-1 ◽

2020 ◽

Vol 51 (1) ◽

Author(s):

Noha M. Attia ◽

Moustafa H. M. Othman

Keyword(s):

Disease Severity ◽

Negative Correlation ◽

Severity Score ◽

Ct Imaging ◽

Chest Ct ◽

Ground Glass ◽

Arterial Oxygen ◽

Imaging Features ◽

Preliminary Assessment ◽

Moderate Negative Correlation

Abstract Background The main challenge in managing COVID-19 pandemic is containment of the infection by early detection of the disease and wide dissemination of diagnostic tests with high sensitivity and specificity. Various imaging features were identified by chest CT with different patterns from early disease to diffuse disease with complications. However, CT cannot be performed for all patients. The arterial oxygen partial pressure/fraction of inspired oxygen (PaO2/FiO2) ratio is evaluated as a rapid and widely available test for the preliminary assessment of disease severity. This study aimed to evaluate the clinical and chest CT imaging features of COVID-19 in Egyptian patients as well as assess the correlation between the chest CT total severity score and the PaO2/FiO2 ratio to determine its value for preliminary assessment of disease severity. Results The most common symptoms were fever (83.2%), dry cough (77%), malaise (68.8%), prolonged headaches (48.5%), and dyspnea (37.6%). CT was positive in 79.2% of the patients. The CT features at presentation were ground-glass opacities only (40%), ground-glass opacities with consolidation (34.4%), and consolidation only (25.6%). Associated findings included crazy paving (17.5%), interlobular septal thickening (47.5%), air bronchogram (15%), bronchiectasis (12.8%), fibrous bands (8.1%), vascular enlargement within the lesion (45.6%), nodules (6.8%), pericardial thickening (5%), and pleural thickening (24.7%). The lesions were typically multilobar (50.5%), posterior (58.1%) with peripheral and central distribution (41.9%). Moderate negative correlation was observed between the CT total lung severity score and PaO2/FiO2 ratio with r = − 0.42 and P < 0.001. Conclusion The most common pattern of COVID-19 pneumonia in multiple quarantine hospitals was peripheral and central ground-glass opacities with bilateral multilobe posterior involvement and fever was the most common symptom. PaO2/FiO2 ratio has a moderate negative correlation with the CT total severity score and thus can be used in the preliminary assessment of disease severity.

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Chest CT imaging features and clinical outcome of coronavirus disease 2019 (COVID-19): A single-center case study in Ningbo, China

Clinical Imaging ◽

10.1016/j.clinimag.2020.05.028 ◽

2021 ◽

Vol 69 ◽

pp. 27-32

Author(s):

Maoqing Jiang ◽

Ping Chen ◽

Tianfu Li ◽

Yifan Tang ◽

Xueqin Chen ◽

...

Keyword(s):

Clinical Outcome ◽

Ct Imaging ◽

Chest Ct ◽

Imaging Features ◽

Single Center

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Chest CT imaging features of critically ill COVID-19 patients

10.21203/rs.3.rs-18094/v1 ◽

2020 ◽

Author(s):

Nan Zhang ◽

Xunhua Xu ◽

Ling-Yan Zhou ◽

Gang Chen ◽

Yu Li ◽

...

Keyword(s):

Critically Ill ◽

Critically Ill Patients ◽

Ct Imaging ◽

Chest Ct ◽

Imaging Features ◽

Reactive Protein ◽

Disease Outcomes ◽

Recovery Group ◽

Death Group ◽

Lung Lobes

Abstract Objectives To analyze the findings of computed tomography (CT) imaging in critically ill patients diagnosed with coronavirus disease 2019 (COVID-19).Methods This retrospective study reviewed 60 critically ill patients (43 males and 17 females, mean age 64.4±11.0 years) with COVID-19 pneumonia who were admitted to two different clinical centers. Their clinical and medical records were analyzed, and the chest CT images were assessed to determine the involvement of lobes and the distribution of lesions in the lungs between the patients who recovered from the illness and those who died.Results Patients were significantly older in the death group (10/60, 16.67%) than in the recovery group (50/60, 83.33%) (p=0.044). C-reactive protein (CRP) (67.9±50.5 mg/L) was significantly elevated in the death group as opposed to the recovery group (p<0.001). The neutrophil-to-lymphocyte ratio (NLR) was higher in the death group when compared with the recovery group (p=0.030). Involvement of five lung lobes was found in 98% of the patients, with medial or parahilar area involvement observed in all the death patients. Ground-glass opacities (97%), crazy-paving pattern (92%) and air bronchogram (93%) were the most common radiological findings. Presence of emphysema was more prevalent in the death group than in the recovery group (30% vs 2%, p=0.011).Conclusions The degree of lung involvement and lesion distribution with dominance in the medial and parahilar pulmonary areas were more severe in the death patients than in those who recovered. Patient’s age, emphysema, CRP and NLR could be combined with CT to predict the disease outcomes.

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