Clinical and High-Resolution CT Features of the COVID-19 Infection: Comparison of the Initial and Follow-up Changes
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- 7 March 2020
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Investigative Radiology
- Vol. 55 (6), 332-339
- https://doi.org/10.1097/rli.0000000000000674
Abstract
Objectives In late December 2019, an outbreak of coronavirus disease (COVID-19) in Wuhan, China was caused by a novel coronavirus, newly named severe acute respiratory syndrome coronavirus 2. We aimed to quantify the severity of COVID-19 infection on high-resolution chest computed tomography (CT) and to determine its relationship with clinical parameters. Materials and Methods From January 11, 2020, to February 5, 2020, the clinical, laboratory, and high-resolution CT features of 42 patients (26–75 years, 25 males) with COVID-19 were analyzed. The initial and follow-up CT, obtained a mean of 4.5 days and 11.6 days from the illness onset were retrospectively assessed for the severity and progression of pneumonia. Correlations among clinical parameters, initial CT features, and progression of opacifications were evaluated with Spearman correlation and linear regression analysis. Results Thirty-five patients (83%) exhibited a progressive process according to CT features during the early stage from onset. Follow-up CT findings showed progressive opacifications, consolidation, interstitial thickening, fibrous strips, and air bronchograms, compared with initial CT (all P < 0.05). Before regular treatments, there was a moderate correlation between the days from onset and sum score of opacifications (R = 0.68, P < 0.01). The C-reactive protein, erythrocyte sedimentation rate, and lactate dehydrogenase showed significantly positive correlation with the severity of pneumonia assessed on initial CT (Rrange, 0.36–0.75; P < 0.05). The highest temperature and the severity of opacifications assessed on initial CT were significantly related to the progression of opacifications on follow-up CT (P = 0.001–0.04). Conclusions Patients with the COVID-19 infection usually presented with typical ground glass opacities and other CT features, which showed significant correlations with some clinical and laboratory measurements. Follow-up CT images often demonstrated progressions during the early stage from illness onset.Keywords
This publication has 24 references indexed in Scilit:
- A Novel Coronavirus from Patients with Pneumonia in China, 2019The New England Journal of Medicine, 2020
- Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Infection: Chest CT FindingsAmerican Journal of Roentgenology, 2014
- T cell-mediated immune response to respiratory coronavirusesImmunologic Research, 2014
- Emerging H7N9 Influenza A (Novel Reassortant Avian-Origin) Pneumonia: Radiologic FindingsRadiology, 2013
- Role of procalcitonin and C-reactive protein in differentiation of mixed bacterial infection from 2009 H1N1 viral pneumoniaInfluenza and Other Respiratory Viruses, 2011
- Fleischner Society: Glossary of Terms for Thoracic ImagingRadiology, 2008
- Pulmonary Sequelae in Convalescent Patients after Severe Acute Respiratory Syndrome: Evaluation with Thin-Section CTRadiology, 2005
- An interferon‐γ‐related cytokine storm in SARS patientsJournal of Medical Virology, 2004
- Coronavirus-positive Nasopharyngeal Aspirate as Predictor for Severe Acute Respiratory Syndrome MortalityEmerging Infectious Diseases, 2003
- Thin-Section CT of Severe Acute Respiratory Syndrome: Evaluation of 73 Patients Exposed to or with the DiseaseRadiology, 2003