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

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.

2021 ◽  
Vol 8 (19) ◽  
pp. 1446-1452
Author(s):  
P.M.T. Mahidhar ◽  
Gayathri Gadiyaram ◽  
Rakhee Kumar Paruchuri

BACKGROUND The computerised tomography (CT) characteristics of COVID-19 are reported and compared with the CT characteristics of other viruses to familiarise radiologists with potential CT trends and to determine the effectiveness of chest CT in the diagnosis and treatment of COVID-19. METHODS This was a hospital based descriptive study which involved the first 324 patients with a finding of severe acute respiratory syndrome (SARS-CoV-2) infection validated by real-time reverse transcription-polymerase chain reaction (RT – PCR). Monitoring patients (198 males, 126 females with a mean age of 46.50 years ± 8.96 [SD] and age range of 21 - 76 years) from April 2020 to July 2020. We correlated the image reports from the initial CT analysis with the findings of the laboratory studies and established possible CT patterns for viral infection. RESULTS The initial chest CT studies of the 324 SARS-CoV-2 patients showed that the disease affected all 'five lobes' in 248 (76.54 percent) patients, both 'lower lobes' in 49 (15.12 percent) patients, the right lower lobe in 23 patients (7.10 percent), and the left lower lobe and right middle lobe in 2 patients (0.62 percent). In 303 (93.52 percent) patients, the lesions were primarily peripheral and subpleural; and there were fewer lesions along the bronchovascular bundles. Two major patterns of SARS-CoV-2 lesions on CT images are GGO (ground - glass opacity) and consolidation. In 303 of the 324 patients (93.52 percent), CT showed single or multiple abnormal GGO or consolidation, or both. In the remaining 21 (6.48 percent) cases, neither GGO nor consolidation was observed on CT. Follow-up CT showed moderate or pronounced disease worsening in 12 out of 58 (20.69 percent) cases and follow-up CT showed improvement with the appearance of fibrosis and GGO resolution. CONCLUSIONS In conclusion, the use of a chest CT system in SARS-CoV-2 patients can accurately evaluate pneumonia. Most notably follow-up CT scans may help assess patients with SARS-CoV-2 pneumonia in their response to treatment. KEYWORDS SARS-CoV-2, Pneumonia, Chest Computed Tomography, Ground-Glass Opacities


2020 ◽  
Author(s):  
Tianhe Ye ◽  
Yanqing Fan ◽  
Jiacheng Liu ◽  
Chongtu Yang ◽  
Songjiang Huang ◽  
...  

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.


2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Lingshan Zhong ◽  
Shuo Zhang ◽  
Jigang Wang ◽  
Xinqian Zhao ◽  
Kai Wang ◽  
...  

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.


2020 ◽  
Vol 24 (2) ◽  
pp. 11-36 ◽  
Author(s):  
G. G. Kаrmаzаnovsky ◽  
K. A. Zamyatina ◽  
V. I. Stashkiv ◽  
M. Yu. Shantarevich ◽  
E. V. Kondratyev ◽  
...  

Purpose. The research goal comprises primary analysis of CT examinations results and their interpretation by comparing with the data already available in the literature.Material and methods. During the period from April 17, 2020 to May 18, 2020, 830 chest CT scans were performed and results of 123 CDs with CT scans made by other institutions were interpreted. Follow-up examinations were carried out every 3–4 days or when clinical presentation changed. At the primary stage, we have analysed in a more detail way a group of 69 patients, who were diagnosed with CT-3 or CT-4 volume of lung damage at least once during hospitalization. The patients underwent PCR analysis three times during hospitalization. Among 69 patients, 34 patients had a positive PCR test at least once, the remaining 35 patients had a clinic, corresponding with this disease.Results. At the initial examination, ground-glass opacity prevailed, as it was observed in 44 cases (64%), and lung tissue consolidation was observed in 25 cases (36%) in a group of 69 patients. When comparing the two groups, the average age of the patients with consolidation changes was statistically significantly lower than one of the group where ground-glass opacity prevailed – 51.7 and 59.4 years, respectively (p = 0.01) In the group of patients with pulmonary tissue consolidation, there were fewer concomitant diseases, fatal outcomes, positive PCR test results, a shorter hospitalization period, and fewer cases of tocilizumab administration were noted. At the initial examination the average percentage of pulmonary parenchyma involvement in the group of patients with lung tissue consolidation was higher (63.3%; p = 0.04), follow-up examinations showed c statistically significantly lower average values of the increase in the percentage of involvement of the parenchyma, which acquired negative values after the third CT scan (8.3 after the 2nd CT and −5.2 after the 3rd CT versus 18.5 and 3 in the GGO glass group; p = 0.02 and 0.03, respectively). No visible differences in CT between the period from the onset of the disease and the predominant symptom in CT were revealed. Meanwhile, on the 5th day (the day of the check-up CT examination) the largest number of patients was determined in both groups.Conclusion. An analysis of our experience during the first month of operation of Covid-19 Hospital is presented. According to our data, the appearance of consolidation at the initial CT examination is probably not related to the period, when the disease has been in progress, and may be associated with a more favorable course of the process.


2021 ◽  
Author(s):  
Ran Guo ◽  
Yang Zhang ◽  
Zelin Ma ◽  
Chaoqiang Deng ◽  
Fangqiu Fu ◽  
...  

Abstract Purpose: Regardless of professional societies agreed that CT screening inconsistent with recommendation leads to radiation-related cancer and unexpected cost, many patients undergo unnecessary chest CT before treatment. The goal of this study was to assess the overuse of Chest CT in different type of patients.Methods: Data on 1853 patients who underwent pulmonary resection from May 2019 to May 2020 were retrospectively analyzed. Data collected include age, sex, follow-up time, density and size of nodules and frequency of undergoing Chest CT. Pearson χ2 test and logistic regression were conducted to compare the receipt of CT screening.Results: Among 1853 patients in the study, 689 (37.2%) had overused Chest CT during follow-up of the lung cancer. This rate was 16.2% among patients with solid nodules, 57.5% among patients with pure ground glass opacity (pGGO), and 41.4% among patients with mixed ground glass opacity (mGGO) (P<.001). 50.7% in the “age ≤40” group, 39.8% in the “41≤age ≤50” group, 38.7% in the “51≤age ≤60” group, 32.3% in the “61≤age ≤70” group, 27.8% in the “>70” group underwent unnecessary CT (P<.001). Female get more unnecessary CT than male (40.6% vs 32.8%, P<.001). Factors associated with a greater likelihood of Chest CT is the density of nodules (odds ratios [ORs] of 0.53 for mGGO; 0.15 for solid nodule, P<.0001, vs patients with pGGO).Conclusion: roughly 37% patients with pulmonary nodules received Chest CT too frequently despite national recommendations against the practice. Closer adherence to clinical guidelines is likely to result in more cost-effective care.


Author(s):  
G Qian ◽  
Y Lin ◽  
AHY Ma ◽  
X Zhang ◽  
G Li ◽  
...  

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.


2020 ◽  
Author(s):  
Wangjia Li ◽  
Liangbo Hu ◽  
Junhao Huang ◽  
Fajin Lv ◽  
Binjie Fu ◽  
...  

Abstract Background: Pulmonary spherical ground-glass opacities (GGOs) are commonly detected on initial chest CT scan in patients with coronavirus disease 2019 (COVID-19).We aimed to investigate the evolution of spherical GGOs to better understand their clinical significance.Materials and Methods:A retrospective study of 33 consecutive patients with confirmed COVID-19 and pulmonary spherical GGOs was performed from January 21, 2020, to March 6, 2020. The initial and follow-up CT images and clinical data were reviewed. The initial CT manifestations of spherical GGOs and their subsequent changes were mainly evaluated. Results:A total of 101 pulmonary spherical GGOs, including 38 with and 63 without consolidation, were found in 33 patients. Of the 101 spherical GGOs, 71 (70.3%) and 30 (29.7%) showed progression and direct absorption on follow-up CT images, respectively. GGOs with consolidation were more likely to progress than those without (84.2% vs. 61.9%, p = 0.017). The 71 progressed lesions mainly showed an increase in size and/or density and most (70.4%) of them extended toward the pleura and developed from spherical to patchy. Internal consolidation appeared and increased in 18 (25.4%) and 22 (31.0%) lesions, respectively. During absorption, all the previous progressed and directly absorbed lesions exhibited a simultaneous decrease in size and density. On each patient’s final CT, more lesions with progression had a residual mixed GGO (40.8% vs. 6.7%, p = 0.002) and fewer had pure GGO (39.4% vs. 60.0%, p = 0.016) than those with direct absorption.Conclusion: In patients with COVID-19, most pulmonary spherical ground-glass opacities would progress, especially those with consolidation, and develop into patchy, subpleural lesions.


2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Chao Xiang ◽  
Ji Lu ◽  
Jun Zhou ◽  
Li Guan ◽  
Cheng Yang ◽  
...  

Background. COVID-19 first broke out in China and spread rapidly over the world. Objectives. To describe the CT features of COVID-19 pneumonia and to share our experience at initial diagnoses. Patients and Methods. Data from 53 patients (31 men, 22 women; mean age, 53 years; age range, 16-83 years) with confirmed COVID-19 pneumonia were collected. Their complete clinical data was reviewed, and their CT features were recorded and analyzed. Results. The average time between onset of illness and the initial CT scan was six days (range, 1-42 days). A total of 399 segments were involved and distributed bilaterally (left lung: 186 segments [46.6%], right lung: 213 segments [53.4%]) and peripherally (38 [71.7%] patients). Multiple lobes (45 [84.9%]) and bilateral lower lobes (left lower lobe: 104 [26.1%], right lower lobe: 107 [26.8%], and total: 211 [52.9%]) were the most commonly involved. Ground-glass opacity with consolidation (24 [45.3%]) and pure ground-glass opacity (28 [52.8%]) were the main findings. The other findings were crazy-paving (14 [26.4%]), bronchiectasis (12 [22.6%]), atelectasis (7 [13.2%]), parenchymal bands (6 [11.3%]), air bronchogram (6 [11.3%]), interlobular thickening (5 [9.4%]), reticular pattern (1 [1.9%]), and pleural effusion (1 [1.9%]). Conclusions. Most COVID-19 pneumonia patients had abnormalities on chest CT images at initial presentation. Imaging features combined with patient’s exposure history and onset symptoms could facilitate the identification of the suspected patient for further examinations.


BJR|Open ◽  
2020 ◽  
Vol 2 (1) ◽  
pp. 20200033 ◽  
Author(s):  
Arshed Hussain Parry ◽  
Abdul Haseeb Wani ◽  
Mudasira Yaseen ◽  
Naveed Nazir Shah ◽  
Khurshid Ahmad Dar

Objective: The study aimed to describe the clinical and imaging course of reverse transcriptase polymerase chain reaction) confirmed coronavirus disease (COVID-19) patients who are asymptomatic at admission. Methods: This was a retrospective observational study. Severe acute respiratory syndrome coronavisrus-2 (SARS-CoV-2) positive cases that were asymptomatic at admission were retrospectively enrolled. Specific clinical information, laboratory test results, chest CT imaging features and outcome data during hospital stay were collected and analyzed. Results: 137 non-consecutive asymptomatic patients with reverse transcriptase polymerase chain reaction confirmed COVID-19 were enrolled in the present study. On admission, patients had no symptoms but chest CT findings were present in 61/137 (44.5%). Ground glass opacity (48, 78.7%) followed by ground glass opacity with crazy-paving pattern (9, 14.7%) were the commonest type of opacities with posterior, peripheral predominance and lower zone predilection. Among the initial CT positive group of 61 patients, follow-up imaging revealed progression of pulmonary opacities in 13/61 (21.4%), complete resorption in 21/61 (34.4%), partial resolution in 22/61 (36%) and no change in 5/61 (8.2%). The patients in progression group (54 ± 19.7 years) were older and had higher frequency of co-morbidities (46.2%) compared to the other three groups (10.4%). The patients in progression group had a significantly higher C-reactive protein, higher lactate dehydrogenase and lower lymphocyte count than the other groups (all p-values < 0.05). The duration of hospital stay was longer in the progression group (27.1 ± 11.4 days) compared to the other three groups (16.12 ± 5.8) (p =< 0.05). Conclusion: Nearly half of the asymptomatic cases with confirmed COVID-19 had abnormal chest CT imaging. Asymptomatic infections can have a variable clinicoradiological course. Clinically, some recover without developing symptoms, some present few mild symptoms whereas some deteriorate. Similarly, imaging follow-up may reveal resolution (partial or complete), progression or no change. Advances in knowledge: Clinicoradiological course of asymptomatic COVID-19 cases is diverse.


Sign in / Sign up

Export Citation Format

Share Document