Time Course of Lung Changes at Chest CT during Recovery from Coronavirus Disease 2019 (COVID-19)
Top Cited Papers
- 1 June 2020
- journal article
- research article
- Published by Radiological Society of North America (RSNA) in Radiology
- Vol. 295 (3), 715-721
- https://doi.org/10.1148/radiol.2020200370
Abstract
Background Chest CT is used to assess the severity of lung involvement in COVID-19 pneumonia. Purpose To determine the change in chest CT findings associated with COVID-19 pneumonia from initial diagnosis until patient recovery. Materials and Methods This retrospective review included patients with RT-PCR confirmed COVID-19 infection presenting between 12 January 2020 to 6 February 2020. Patients with severe respiratory distress and/ or oxygen requirement at any time during the disease course were excluded. Repeat Chest CT was obtained at approximately 4 day intervals. The total CT score was the sum of lung involvement (5 lobes, score 1-5 for each lobe, range, 0 none, 25 maximum) was determined. Results Twenty one patients (6 males and 15 females, age 25-63 years) with confirmed COVID-19 pneumonia were evaluated. These patients under went a total of 82 pulmonary CT scans with a mean interval of 4±1 days (range: 1-8 days). All patients were discharged after a mean hospitalized period of 17±4 days (range: 11-26 days). Maximum lung involved peaked at approximately 10 days (with the calculated total CT score of 6) from the onset of initial symptoms (R2=0.25), p<0.001). Based on quartiles of patients from day 0 to day 26 involvement, 4 stages of lung CT were defined: Stage 1 (0-4 days): ground glass opacities (GGO) in 18/24 (75%) patients with the total CT score of 2±2; (2)Stage-2 (5-8d days): increased crazy-paving pattern 9/17 patients (53%) with a increase in total CT score (6±4, p=0.002); (3) Stage-3 (9-13days): consolidation 19/21 (91%) patients with the peak of total CT score (7±4); (4) Stage-4 (≥14 days): gradual resolution of consolidation 15/20 (75%) patients with a decreased total CT score (6±4) without crazy-paving pattern. Conclusion In patients recovering from COVID-19 pneumonia (without severe respiratory distress during the disease course), lung abnormalities on chest CT showed greatest severity approximately 10 days after initial onset of symptoms.Keywords
This publication has 16 references indexed in Scilit:
- Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected PneumoniaThe New England Journal of Medicine, 2020
- Treatment patterns and direct medical costs of metastatic colorectal cancer patients: a retrospective study of electronic medical records from urban ChinaJournal of Medical Economics, 2020
- Clinical features of patients infected with 2019 novel coronavirus in Wuhan, ChinaThe Lancet, 2020
- Wave-CAIPI susceptibility-weighted imaging achieves diagnostic performance comparable to conventional susceptibility-weighted imaging in half the scan timeEuropean Radiology, 2020
- Radiographic and CT Features of Viral PneumoniaRadioGraphics, 2018
- A decade after SARS: strategies for controlling emerging coronavirusesNature Reviews Microbiology, 2013
- Imaging of Pulmonary Viral PneumoniaRadiology, 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
- Severe Acute Respiratory Syndrome: Temporal Lung Changes at Thin-Section CT in 30 PatientsRadiology, 2004