CT findings of COVID-19 pneumonia in ICU-patients

Background: In December 2019, a cluster of unknown etiology pneumonia cases occurred in Wuhan, China leading to identification of the responsible pathogen as SARS-coV-2. Since then, the coronavirus disease 2019 (COVID-19) has spread to the entire world. Computed Tomography (CT) is frequently used to assess severity and complications of COVID-19 pneumonia. The purpose of this study is to compare the CT patterns and clinical characteristics in intensive care unit (ICU) and non-ICU patients with COVID-19 pneumonia.Design and Methods: This retrospective study included 218 consecutive patients (136 males; 82 females; mean age 63±15 years) with laboratory-confirmed SARS-coV-2. Patients were categorized in two different groups: (a) ICU patients and (b) non-ICU inpatients. We assessed the type and extent of pulmonary opacities on chest CT exams and recorded the information on comorbidities and laboratory values for all patients.Results: Of the 218 patients, 23 (20 males: 3 females; mean age 60 years) required ICU admission, 195 (118 males: 77 females, mean age 64 years) were admitted to a clinical ward. Compared with non-ICU patients, ICU patients were predominantly males (60% versus 83% p=0.03), had more comorbidities, a positive CRP (p=0.04) and higher LDH values (p=0.008). ICU patients’ chest CT demonstrated higher incidence of consolidation (p=0.03), mixed lesions (p=0.01), bilateral opacities (p<0.01) and overall greater lung involvement by consolidation (p=0.02) and GGO (p=0.001).Conclusions: CT imaging features of ICU patients affected by COVID-19 are significantly different compared with non-ICU patients. Identification of CT features could assist in a stratification of the disease severity and supportive treatment.

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Clinical and radiological imaging as prognostic predictors in COVID-19 patients

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-021-00470-9 ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Maha Ibrahim Metwally ◽

Mohammad Abd Alkhalik Basha ◽

Mohamed M. A. Zaitoun ◽

Housseini Mohamed Abdalla ◽

Hanaa Abu Elazayem Nofal ◽

...

Keyword(s):

Oxygen Saturation ◽

Old Age ◽

Fatal Outcome ◽

Age Groups ◽

Lower Lobe ◽

Chest Ct ◽

Imaging Features ◽

Age Group ◽

Significant Relation ◽

Ct Features

Abstract Background Since the announcement of COVID-19 as a pandemic infection, several studies have been performed to discuss the clinical picture, laboratory finding, and imaging features of this disease. The aim of this study is to demarcate the imaging features of novel coronavirus infected pneumonia (NCIP) in different age groups and outline the relation between radiological aspect, including CT severity, and clinical aspect, including age, oxygen saturation, and fatal outcome. We implemented a prospective observational study enrolled 299 laboratory-confirmed COVID-19 patients (169 males and 130 females; age range = 2–91 years; mean age = 38.4 ± 17.2). All patients were submitted to chest CT with multi-planar reconstruction. The imaging features of NCIP in different age groups were described. The relations between CT severity and age, oxygen saturation, and fatal outcome were evaluated. Results The most predominant CT features were bilateral (75.4%), posterior (66.3%), pleural-based (93.5%), lower lobe involvement (89.8%), and ground-glass opacity (94.7%). ROC curve analysis revealed that the optimal cutoff age that was highly exposed to moderate and severe stages of NCIP was 38 years old (AUC = 0.77, p < 0.001). NCIP was noted in 42.6% below 40-year-old age group compared to 84% above 40-year-old age group. The CT severity was significantly related to age and fatal outcome (p < 0.001). Anterior, centrilobular, hilar, apical, and middle lobe involvements had a significant relation to below 90% oxygen saturation. A significant negative correlation was found between CT severity and oxygen saturation (r = − 0.49, p < 0.001). Crazy-paving pattern, anterior aspect, hilar, centrilobular involvement, and moderate and severe stages had a statistically significant relation to higher mortality. Conclusion The current study confirmed the value of CT as a prognostic predictor in NCIP through demonstration of the strong relation between CT severity and age, oxygen saturation, and the fatal outcome. In the era of COVID-19 pandemic, this study is considered to be an extension to other studies discussing chest CT features of COVID-19 in different age groups with demarcation of the relation of chest CT severity to different pattern and distribution of NCIP, age, oxygen saturation, and mortality rate.

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

10.1101/2020.03.24.20042432 ◽

2020 ◽

Cited By ~ 3

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.

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Clinical characteristics and chest CT imaging features of critically ill COVID-19 patients

European Radiology ◽

10.1007/s00330-020-06955-x ◽

2020 ◽

Vol 30 (11) ◽

pp. 6151-6160 ◽

Cited By ~ 5

Author(s):

Nan Zhang ◽

Xunhua Xu ◽

Ling-Yan Zhou ◽

Gang Chen ◽

Yu Li ◽

...

Keyword(s):

Critically Ill ◽

Clinical Characteristics ◽

Ct Imaging ◽

Chest Ct ◽

Imaging Features

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Clinical characteristics and longitudinal chest CT features of healthcare workers hospitalized with coronavirus disease 2019 (COVID-19)

International Journal of Medical Sciences ◽

10.7150/ijms.48696 ◽

2020 ◽

Vol 17 (17) ◽

pp. 2644-2652

Author(s):

Huaping Liu ◽

Shiyong Luo ◽

Hailan Li ◽

Youming Zhang ◽

Chiyao Huang ◽

...

Keyword(s):

Healthcare Workers ◽

Clinical Characteristics ◽

Chest Ct ◽

Ct Features

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High-resolution Chest CT Features and Clinical Characteristics of Patients Infected with COVID-19 in Jiangsu, China

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2020.04.003 ◽

2020 ◽

Vol 95 ◽

pp. 106-112 ◽

Cited By ~ 37

Author(s):

Hui Dai ◽

Xin Zhang ◽

Jianguo Xia ◽

Tao Zhang ◽

Yalei Shang ◽

...

Keyword(s):

High Resolution ◽

Clinical Characteristics ◽

Chest Ct ◽

Ct Features

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Chest CT features associated with the clinical characteristics of patients with COVID-19 pneumonia

Annals of Medicine ◽

10.1080/07853890.2020.1851044 ◽

2021 ◽

Vol 53 (1) ◽

pp. 169-180

Author(s):

Ruichao Niu ◽

Shuming Ye ◽

Yongfeng Li ◽

Hua Ma ◽

Xiaoting Xie ◽

...

Keyword(s):

Clinical Characteristics ◽

Chest Ct ◽

Ct Features

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Correlation Study of Chest CT Features of Severe/Critical type COVID-19 with Early Renal Damage and Clinical Prognosis

10.21203/rs.3.rs-75596/v1 ◽

2020 ◽

Author(s):

Guan Li ◽

Yongchun Ge ◽

Zhiyuan Sun ◽

Song Luo ◽

Wen Wang ◽

...

Keyword(s):

Clinical Characteristics ◽

Renal Damage ◽

Cox Regression ◽

Laboratory Data ◽

Correlation Study ◽

Chest Ct ◽

Clinical Prognosis ◽

Group B ◽

Critical Type ◽

Ct Features

Abstract Background: Among patients with confirmed severe/critical type COVID-19, we found that although the seurm creatinine (Cr) value is in normal range, patients might have occured early renal damage. For severe/critical type COVID-19 patients, whether some chest CT features can be used to predict the early renal damage or clinical prognosis.Methods: 162 patients with severe/critical type COVID-19 were reviewed retrospectively in 13 medical centers from China. According to the level of eGFR, 162 patients were divided into three groups, group A (eGFR < 60 ml/min/1.73m2), group B (60 ml/min/1.73m2 ≤ eGFR < 90 ml/min/1.73m2 group) and group C (eGFR ≥ 90 ml/min/1.73m2). All patients’ baseline clinical characteristics, laboratory data, CT features and clinical outcomes were collected and compared. The eGFR and CT features was assessed using univariate and multivariate Cox regression.Results: Baseline clinical characteristics showed that there were significant differences in age, hypertension, cough and fatigue among groups A, B and C. Laboratory data analysis revealed significant differences between the three groups of leukocyte count, platelet count, C-reactive protein, aspartate aminotransferase, creatine kinase. Chest CT features analysis indicated that crazy-paving pattern has significant statistical difference in groups A and B compared with group C. The eGFR of patients with crazy-paving pattern was significant lower than those without crazy-paving pattern (76.73 ± 30.50 vs. 101.69 ± 18.24 ml/min/1.73m2, p < 0.001), and eGFR (OR = 0.962, 95% CI = 0.940-0.985) was the independent risk factor of crazy-paving pattern. The eGFR (HR = 0.549, 95% CI = 0.331-0.909, p = 0.020) and crazy-paving pattern (HR = 2.996, 95% CI = 1.010-8.714, p = 0.048) were independent risk factors of mortality.Conclusions: In patients with severe/critical type COVID-19, the presence of crazy-paving pattern on chest CT are more likely occured the decline of eGFR and poor clinical prognosis. The crazy-paving pattern appeared could be used as an early warning indicator of renal damage and to guide clinicians to use drugs reasonably.

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Key Points of Clinical and CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV) Imported Pneumonia Based On 21 Cases Analysis

10.1101/2020.03.03.20030775 ◽

2020 ◽

Author(s):

Z.F. Xu ◽

W.X. Wu ◽

Y.B. Jin ◽

A.Z. Pan

Keyword(s):

Clinical Manifestations ◽

Ct Imaging ◽

Chest Ct ◽

Imaging Features ◽

Shortness Of Breath ◽

Multiple Lesions ◽

Reticular Pattern ◽

Severe Group ◽

Novel Coronavirus ◽

Ct Features

AbstractBackground and ObjectiveWHO Director-General declared that the 2019-nCoV outbreak constitutes a Public Health Emergency of International Concern,and the outbreak is still on-going.Chest CT had been a key component of the diagnostic workup for patients with suspected infection. In this retrospective study, we attempt to summarize and analyze the chest CT features of 2019-nCov infections, and to identify the typical features to improved the diagnostic accuracy of new coronavirus pneumonia (NCP).MethodsChest CT scans and Clinical data of 21 patients confirmed NCP in our hospital were enrolled.These patients were divided into mild and sever group according to clinical manifestations described by the 6th clinical practice guideline of NCP in China. Main clinical and chest CT features were analyzed and identify.ResultsFever (85.7%) and cough (80.9%) were the two main symptoms of NCP patients.More significantly higher incidence (85.7%) of shortness of breath in the severe cases. Multiple lesions in both lungs and with incidence of GGO(100%),vascular enlargement (76.5%) and cobblestone/reticular pattern(70.6%) were the major feature.The incidence of consolidation, mixed pattern and vascular enlargement features were up to 100% in the severe group, significantly higher than that of patients in mild group. In addition, the incidence of air-bronchogram, dilated bronchi with thickened wall and fibrosis in the severe group was significantly higher than that in the mild group.ConclusionsFever and cough are the typical clinical features of NCP patients, and chest CT mainly manifested as multiple lesions in both lungs, often accompanied by GGO, vascular enlargement and cobblestone/reticular pattern.Changes in these main CT features can indicate development of the diseaseSummary2019 novel Coronavirus (2019-nCov) had typical clinical manifestations (fever and cough), and presented with characteristic chest CT imaging features (multiple lesions in both lungs, often accompanied by GGO, vascular enlargement and cobblestone/reticular pattern), which are helpful to the radiologist in the early detection and diagnosis of this emerging global health emergency. In addition, changes in these main CT features can indicate development of the disease.HighlightsFever (85.7%) and cough (80.9%) were the two main symptoms of NCP patients.The incidence of shortness of breath was 85.7% in the severe cases, significantly higher than 21.4% in the mild cases.Multiple lesions in both lungs and with incidence of GGO (100%), vascular enlargement (76.5%) and cobblestone/reticular pattern (70.6%) were the major features of NCP patients. 85.7% of cases in serve group displayed 4-5 lobes were involved simultaneously.Changes in these main CT imaging features can indicate development of the disease. About 19.1% of patients (4 of 21) presented with a normal CT.

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Correlation between chest CT features and clinical characteristics of patients with bronchiectasis

10.1183/13993003.congress-2020.3369 ◽

2020 ◽

Author(s):

Houda Rouis ◽

Chirine Moussa ◽

amal chennoufi ◽

Alia Ezzaouia ◽

Wajih Gheribi ◽

...

Keyword(s):

Clinical Characteristics ◽

Chest Ct ◽

Ct Features

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Chest CT features of coronavirus disease-19 (COVID-19) pneumonia: which findings on initial CT can predict an adverse short-term outcome?

BJR|Open ◽

10.1259/bjro.20200016 ◽

2020 ◽

Vol 2 (1) ◽

pp. 20200016 ◽

Cited By ~ 1

Author(s):

Arshed Hussain Parry ◽

Abdul Haseeb Wani ◽

Naveed Nazir Shah ◽

Mudasira Yaseen ◽

Majid Jehangir

Keyword(s):

Chest Ct ◽

P Value ◽

Lung Involvement ◽

Stable Group ◽

Short Term ◽

Term Outcome ◽

Pulmonary Vessel ◽

Short Term Outcome ◽

Ct Findings ◽

Ct Features

Objective: To study the spectrum of chest CT features in coronavirus disease-19 (COVID-19) pneumonia and to identify the initial CT findings that may have the potential to predict a poor short-term outcome. Methods: This was a retrospective study comprising 211 reverse transcriptase-polymerase chain reaction (RT-PCR) positive patients who had undergone non-contrast chest CT. Prevalence, extent, pattern, distribution and type of abnormal lung findings were recorded. Patients with positive CT findings were divided into two groups; clinically stable (requiring in-ward hospitalization) and clinically unstable [requiring intensive care unit (ICU) admission or demised] based on short-term follow-up. Results: Lung parenchymal abnormalities were present in 42.2% (89/211) whereas 57.8% (122/211) cases had a normal chest CT. The mean age of clinically unstable patients (63.6 ± 8.3 years) was significantly different from the clinically stable group (44.6 ± 13.2 years) (p-value < 0.05). Bilaterality, combined involvement of central–peripheral and anteroposterior lung along with a higher percentage of the total lung involvement, presence of crazy paving, coalescent consolidations with air bronchogram and segmental pulmonary vessel enlargement were found in a significantly higher proportion of clinically unstable group (ICU/demised) compared to the stable group (in-ward hospitalization) with all p values < 0.05. Conclusion: Certain imaging findings on initial CT have the potential to predict short-term outcome in COVID-19 pneumonia. Extensive pulmonary abnormalities, evaluated by combined anteroposterior, central–peripheral and a higher percentage of the total lung involvement, indicate a poor short-term outcome. Similarly, the presence of crazy paving pattern, consolidation with air bronchogram and segmental vascular changes are also indicators of poor short-term outcome. Advances in knowledge: Certain findings on initial CT can predict an adverse short-term prognosis in COVID-19 pneumonia.

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