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Chest CT findings of COVID-19 pneumonia by duration of symptoms

      Highlights

      • Pulmonary CT features of the 2019 novel coronavirus disease were diverse.
      • This disease changed rapidly at the early stage, and lasted for a long time.
      • CT could provide semi-quantitative analysis of pulmonary damage severity.

      Abstract

      Purpose

      To evaluate lung abnormalities on thin-section computed tomographic (CT) scans in patients with COVID-19 and correlate findings to duration of symptoms.

      Methods

      In total, 348 CT scans in 112 patients were classified according to the time after the onset of the initial symptoms, namely stage-1 (0–4 days); stage-2 (5–9 days); stage-3 (10–14 days); stage-4 (15–21 days); stage-5 (22–28 days); and stage-6 (>28 days). Each lung lobe was evaluated for extent affected by ground-glass opacities (GGO), crazy-paving pattern and consolidation, in five categories of percentual severity. Summation of scores from all five lung lobes provided the total CT score (maximal CT score, 25).

      Results

      The predominant patterns of lung abnormalities were GGOs, crazy-paving pattern, consolidation and linear opacities. The frequency of crazy-paving pattern, consolidation and linear opacities peaked at stage-3 (62.7 %), stage-4 (75.0 %) and stage-5 (83.1 %), respectively, and decreased thereafter. Total CT scores increased from stage-1 to stage-2 (2.8 ± 3.1, vs. 6.5 ± 4.6, respectively, P < 0.01), and thereafter remained high. The lower lobes were more inclined to be involved with higher CT scores except for stage-1. At stage-6 98.1 % of CT scans still showed abnormalities (CT score 7.5 ± 4.1).

      Conclusion

      Thin-section CT could provide semi-quantitative analysis of pulmonary damage severity. This disease changed rapidly at the early stage, then tended to be stable and lasted for a long time.

      Keywords

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      References

        • Huang C.
        • Wang Y.
        • Li X.
        • Ren L.
        • Zhao J.
        • Hu Y.
        • Zhang L.
        • Fan G.
        • Xu J.
        • Gu X.
        • Cheng Z.
        • Yu T.
        • Xia J.
        • Wei Y.
        • Wu W.
        • Xie X.
        • Yin W.
        • Li H.
        • Liu M.
        • Xiao Y.
        • Gao H.
        • Guo L.
        • Xie J.
        • Wang G.
        • Jiang R.
        • Gao Z.
        • Jin Q.
        • Wang J.
        • Cao B.
        Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China.
        Lancet. 2020; 395: 497-506
        • Corman V.M.
        • Landt O.
        • Kaiser M.
        • Molenkamp R.
        • Meijer A.
        • Chu D.K.W.
        • Bleicker T.
        • Brunink S.
        • Schneider J.
        • Schmidt M.L.
        • Mulders D.
        • Haagmans B.L.
        • van der Veer B.
        • van den Brink S.
        • Wijsman L.
        • Goderski G.
        • Romette J.L.
        • Ellis J.
        • Zambon M.
        • Peiris M.
        • Goossens H.
        • Reusken C.
        • Koopmans M.P.G.
        • Drosten C.
        Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR.
        Euro Surveill. 2020; 25
        • Fang Y.
        • Zhang H.
        • Xie J.
        • Lin M.
        • Ying L.
        • Pang P.
        • Ji W.
        Sensitivity of chest CT for COVID-19: comparison to RT-PCR.
        Radiology. 2020; 200432
        • Ye G.
        • Li Y.
        • Lu M.
        • Chen S.
        • Luo Y.
        • Wang S.
        • Wang Y.
        • Wang X.
        Experience of different upper respiratory tract sampling strategies for detection of COVID-19.
        J. Hosp. Infect. 2020;
        • Xie X.
        • Zhong Z.
        • Zhao W.
        • Zheng C.
        • Wang F.
        • Liu J.
        Chest CT for typical 2019-nCoV pneumonia: relationship to negative RT-PCR testing.
        Radiology. 2020; 200343
        • Shigemura J.
        • Ursano R.J.
        • Morganstein J.C.
        • Kurosawa M.
        • Benedek D.M.
        Public responses to the novel 2019 coronavirus (2019-nCoV) in Japan: mental health consequences and target populations.
        Psychiatry Clin. Neurosci. 2020;
        • Pan Y.
        • Guan H.
        • Zhou S.
        • Wang Y.
        • Li Q.
        • Zhu T.
        • Hu Q.
        • Xia L.
        Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China.
        Eur. Radiol. 2020;
        • Pan F.
        • Ye T.
        • Sun P.
        • Gui S.
        • Liang B.
        • Li L.
        • Zheng D.
        • Wang J.
        • Hesketh R.L.
        • Yang L.
        • Zheng C.
        Time course of lung changes on chest CT during recovery from 2019 novel coronavirus (COVID-19) pneumonia.
        Radiology. 2020; 200370
        • Chang Y.C.
        • Yu C.J.
        • Chang S.C.
        • Galvin J.R.
        • Liu H.M.
        • Hsiao C.H.
        • Kuo P.H.
        • Chen K.Y.
        • Franks T.J.
        • Huang K.M.
        • Yang P.C.
        Pulmonary sequelae in convalescent patients after severe acute respiratory syndrome: evaluation with thin-section CT.
        Radiology. 2005; 236: 1067-1075
        • Ling Z.
        • Xu X.
        • Gan Q.
        • Zhang L.
        • Luo L.
        • Tang X.
        • Liu J.
        Asymptomatic SARS-CoV-2 infected patients with persistent negative CT findings.
        Eur. J. Radiol. 2020; 126108956