Radiographic findings in 240 patients with COVID-19 pneumonia: time-dependence after the onset of symptoms
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Radiographic findings in 240 patients with COVID-19 pneumonia: time-dependence after the onset of symptoms Sergio Giuseppe Vancheri 1,2 & Giovanni Savietto 1,2 & Francesco Ballati 1,2 & Alessia Maggi 1,2 & Costanza Canino 3 & Chandra Bortolotto 1 & Adele Valentini 1 & Roberto Dore 4 & Giulia Maria Stella 5 & Angelo Guido Corsico 6 & Giorgio Antonio Iotti 7,8 & Francesco Mojoli 7,8 & Stefano Perlini 9,10 & Raffaele Bruno 11 & Lorenzo Preda 1,2 Received: 1 April 2020 / Revised: 30 April 2020 / Accepted: 14 May 2020 # European Society of Radiology 2020
Abstract Objective To analyze the most frequent radiographic features of COVID-19 pneumonia and assess the effectiveness of chest Xray (CXR) in detecting pulmonary alterations. Materials and methods CXR of 240 symptomatic patients (70% male, mean age 65 ± 16 years), with SARS-CoV-2 infection confirmed by RT-PCR, was retrospectively evaluated. Patients were clustered in four groups based on the number of days between symptom onset and CXR: group A (0–2 days), 49 patients; group B (3–5), 75 patients; group C (6–9), 85 patients; and group D (> 9), 31 patients. Alteration’s type (reticular/ground-glass opacity (GGO)/consolidation) and distribution (bilateral/ unilateral, upper/middle/lower fields, peripheral/central) were noted. Statistical significance was tested using chi-square test. Results Among 240 patients who underwent CXR, 180 (75%) showed alterations (group A, 63.3%; group B, 72%; group C, 81.2%; group D, 83.9%). GGO was observed in 124/180 patients (68.8%), reticular alteration in 113/180 (62.7%), and consolidation in 71/180 (39.4%). Consolidation was significantly less frequent (p < 0.01). Distribution among groups was as follows: reticular alteration (group A, 70.9%; group B, 72.2%; group C, 57.9%; group D, 46.1%), GGO (group A, 67.7%; group B, 62.9%; group C, 71%; group D, 76.9%), and consolidation (group A, 35.5%; group B, 31.4%; group C, 47.8%; group D, 38.5%). Alterations were bilateral in 73.3%. Upper, middle, and lower fields were involved in 36.7%, 79.4%, and 87.8%, respectively. Lesions were peripheral in 49.4%, central in 11.1%, or both in 39.4%. Upper fields and central zones were significantly less involved (p < 0.01). Conclusions The most frequent lesions in COVID-19 patients were GGO (intermediate/late phase) and reticular alteration (early phase) while consolidation gradually increased over time. The most frequent distribution was bilateral, peripheral, and with middle/lower predominance. Overall rate of negative CXR was 25%, which progressively decreased over time.
* Giovanni Savietto [email protected] 1
Department of Radiology, I.R.C.C.S. Policlinico San Matteo Foundation, Viale Camillo Golgi, 19, Pavia 27100, Italy
2
Unit of Radiology, Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Viale Camillo Golgi, 19, 27100 Pavia, Italy
3
Medical Oncology Unit, Fondazione I.R.C.C.S. Policlinico San Matteo, Pavia, Italy
4
Radiology Unit, Isituti Clinici Città di Pavia, Pavia, Italy
5
Uni
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