Early chest CT features of patients with 2019 novel coronavirus (COVID-19) pneumonia: relationship to diagnosis and prog
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Early chest CT features of patients with 2019 novel coronavirus (COVID-19) pneumonia: relationship to diagnosis and prognosis Hui Juan Chen 1 & Jie Qiu 2 & Biao Wu 3 & Tao Huang 4 & Yunsuo Gao 5 & Zhen Ping Wang 1 & Yang Chen 1 & Feng Chen 1 Received: 20 February 2020 / Revised: 15 May 2020 / Accepted: 22 May 2020 # European Society of Radiology 2020
Abstract Objective To determine the consistency between CT findings and real-time reverse transcription–polymerase chain reaction (RTPCR) and to investigate the relationship between CT features and clinical prognosis in COVID-19. Methods The clinical manifestations, laboratory parameters, and CT imaging findings were analyzed in 34 COVID-19 patients, confirmed by RT-PCR from January 20 to February 4 in Hainan Province. CT scores were compared between the discharged patients and the ICU patients. Results Fever (85%) and cough (79%) were most commonly seen. Ten (29%) patients demonstrated negative results on their first RT-PCR. Of the 34 (65%) patients, 22 showed pure ground-glass opacity. Of the 34 (50%) patients, 17 had five lobes of lung involvement, while the 23 (68%) patients had lower lobe involvement. The lesions of 24 (71%) patients were distributed mainly in the subpleural area. The initial CT lesions of ICU patients were distributed in both the subpleural area and centro-parenchyma (80%), and the lesions were scattered. Sixty percent of ICU patients had five lobes involved, while this was seen in only 25% of the discharged patients. The lesions of discharged patients were mainly in the subpleural area (75%). Of the discharged patients, 62.5% showed pure ground-glass opacities; 80% of the ICU patients were in the progressive stage, and 75% of the discharged patients were at an early stage. CT scores of the ICU patients were significantly higher than those of the discharged patients. Conclusion Chest CT plays a crucial role in the early diagnosis of COVID-19, particularly for those patients with a negative RTPCR. The initial features in CT may be associated with prognosis. Key Points • Chest CT is valuable for the early diagnosis of COVID-19, particularly for those patients with a negative RT-PCR. • The early CT findings of COVID-19 in ICU patients differed from those of discharged patients. Keywords COVID-19 . Tomography . Pneumonia . Thorax
Abbreviations COVID-19 2019 novel coronavirus CT Computed tomography GGO Ground-glass opacity ICU Intensive care unit
MERS RT-PCR SARS
Middle East respiratory syndrome Real-time reverse transcription–polymerase chain reaction Severe acute respiratory syndrome
Hui Juan Chen and Jie Qiu contributed equally to this work. * Feng Chen [email protected]
3
Department of Infectious Disease, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), No. 19, Xiuhua St, Xiuying Dic, Haikou 570311, Hainan, People’s Republic of China
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Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), No. 19, Xiuhua St, Xiuying Dic, Haikou 570311, Hainan, P
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