Cohort study of chest CT and clinical changes in 29 patients with coronavirus disease 2019 (COVID-19)
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CHEST
Cohort study of chest CT and clinical changes in 29 patients with coronavirus disease 2019 (COVID-19) Yongxia Zhou 1 & Yineng Zheng 2 & Quan Yang 1 & Liangbo Hu 1 & Juan Liao 3 & Xiaoyan Li 1 Received: 10 March 2020 / Revised: 22 May 2020 / Accepted: 4 June 2020 # European Society of Radiology 2020
Abstract Objectives To investigate the imaging findings and clinical time course of COVID-19 pneumonia. Methods A total of 113 baseline and follow-up CT scans from 24 January 2020 to 18 February 2020 were longitudinally collected from 29 confirmed COVID-19 patients in a single center. The changes in the clinical and laboratory characteristics, imaging features, lesion-to-muscle ratio (LMR), and pulmonary inflammation index (PII) at baseline, 1–6 days, 7–13 days, and ≥ 14 days were compared. Results Of the 29 COVID-19 patients enrolled, the baseline chest CT scan was obtained 3 ± 2 (0–9) days after the onset of symptoms, and each patient had an average of 4 ± 1 (3–5) CT scans with a mean interval of 5 ± 2 (1–14) days. The percentage of patients with fever, cough, shortness of breath, and myalgia obviously decreased at 7–13 days with regular treatment (p < 0.05). The lymphocyte count, C-reactive protein, interleukin-6, and oxygenation index worsened within 1–6 days but improved sharply at 7–13 days. Compared with those at the other three time points, the LMR, PII, and number of involved lobes at 1–6 days were the highest, and gradually improved after 7–13 days. Conclusions Lung lesion development on chest CT reflects the clinical time course of COVID-19 progression over 1–6 days, followed by clinical improvement and the resorption of lesions. CT imaging may be indicated when patients fail to improve within a week of treatment, but repeated chest CT may be unnecessary when the patients show improvements clinically. Key Points • Chest CT reflects the development of coronavirus disease 2019 pneumonia (COVID-19). • COVID-19 usually shows progressive lesions over up to 9 days with subsequent resorption. • Unusual clinical time course of COVID-19 may indicate repeated chest CT. Keywords COVID-19 . Tomography, X-ray computed · . Pneumonia
Abbreviations COVID-19 CT GGO
Coronavirus disease 2019 Computed tomography Ground-glass opacity
LMR PII SARS-CoV-2
Lesion-to-muscle ratio Pneumonia inflammation index Severe acute respiratory syndrome coronavirus 2
Juan Liao and Xiaoyan Li contributed equally to this work. * Juan Liao [email protected]
2
Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, People’s Republic of China
* Xiaoyan Li [email protected]
3
Department of Central Laboratory, Yongchuan Hospital of Chongqing Medical University, Xuanhua Road, No. 439, Yongchuan, Chongqing 402160, People’s Republic of China
1
Department of Radiology, Yongchuan Hospital of Chongqing Medical University, Xuanhua Road, No. 439, Yongchuan, Chongqing 402160, People’s Republic of China
Eur Radiol
Introduction Since December 8, 2019, several cases of unexplained pneumonia ha
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