27 maart 2020

Relation Between Chest CT Findings and Clinical Conditions of Coronavirus Disease (COVID-19) Pneumonia: A Multicenter Study by Zhao et al. - American Journal of Roentgenology

Aim
To investigate the relation between chest CT findings and the clinical conditions of COVID-19 pneumonia

Key

Most COVID-19 patients have ground-glass opacities (GGO) or mixed GGO and consolidation and vascular enlargement in the lesion.
Lesions are more likely to have peripheral multifocal distribution in bilateral lung regions, predominantly lower lung regions.

Summary

Retrospective study in 4 hospitals in Hunan, China
101 patients: COVID-19 positive and CT-scan
55.4% male, age: 44 years (range 17-75)
Epidemiology: direct exposure 83%, indirect exposure 12%, no exposure 5%
Symptoms: fever 78%, cough 62%, myalgia/fatigue 17%, sore throat 12%
Groups: Type according guideline on COVID-19 (trial version 5) issued by the China National Health Commission.
- non-emergency (mild- and common-type): 87 (48 men, 39 women)
- emergency (severe- and fatal-type): 14 (eight men, six women)
CT-scan findings:
- Ground-glass opacities (GGO) 86.1%
- Mixed GGO and consolidation 64.4%
- Vascular enlargement in the lesion 71.3%
- Traction bronchiectasis 52.5%
- Architectural distortion 21.8%
- Pleural effusions 13.9%
- Distribution
  - Peripheral 87.1%
  - Bilateral lung regions 82.2%
  - Lower lung predominant 54.5%
  - Multifocal / Diffuse lesions 54.5% / 31.7%
Emergency group:
- Older (53 vs 43 years, p < 0.05)
- CT: more traction bronchiectasis (85 vs 47%), architectural distortion (43 vs 18%), pleural effusions (35 vs 10%), diffuse lesions (79 vs 24%) (p < 0.05)

Non-emergency case. Left arrow: Traction bronchiectasis. Right arrow: Vascular enlargement

Emergency case. Arrow: bilateral diffuse ground-glass opacities and reticulation