CT manifestations of coronavirus disease-2019: A retrospective analysis of 73 cases by disease severity

Abstract

Purpose: To report CT features of coronavirus disease-2019 (COVID-19) in patients with various disease severity.

Methods: The CT manifestations and clinical data of 73 patients with COVID-19 were retrospectively collected in 6 hospitals from Jan 21 to Feb 3, 2020. We analyzed the initial and follow-up CT features of patients with disease severity, according to the Guidelines for the Diagnosis and Treatment of New Coronavirus Pneumonia.

Results: Six patients (8%) were diagnosed as mild type pneumonia; these patients had no obvious abnormal CT findings or manifested mild changes of lung infection. All 43 patients (59 %) with common type presented unique or multiple ground-glass opacities (GGO) in the periphery of the lungs, with or without interlobular septal thickening. In the 21 patients (29 %) with severe type, extensive GGO and pulmonary consolidation were found in 16 cases (16/21, 76 %) and 5 cases (24 %), respectively. An extensive "white lung", with atelectasis and pleural effusion were found in critical type patients (3, 4%). On the resolutive phase of the disease, CT abnormalities showed complete resolution, or demonstrated residual linear opacities.

Conclusions: Different CT features are seen according to disease severity, which can help COVID-19 stratification.

Keywords: Computer tomography; Coronavirus disease-2019; Diagnosis; Pneumonia; X-ray.

Fig. 1

CT features of coronavirus disease-2019 by disease severity. A. An axial CT image in a 33-year-female mild type patient (2 days from symptom onset to CT scan) shows thickening of lung texture. B. An axial CT image in a 37-year-male common type patient (6 days from symptom onset to CT scan) shows multiple ground-glass opacities in both lungs. C. An axial CT image in a 56-year-female severe type patient shows extensive ground-glass opacities and pulmonary consolidation, enlargement of bronchi and vessels. D. An axial CT image in a 47-year-female critical type patient (9 days from symptom onset to CT scan) shows extensive ground-glass opacities in multiple lobes, formatting "white lung".

Fig. 2

CT features of the disease amelioration in patient with coronavirus disease-2019. A 27-year-old female patient has fever for 10 days and pharyngalgia for 3 days, with the medical history of contacting with the infected patient. The detection of new coronavirus nucleic acid was positive. A. On admission day, CT scan shows multiple ground-glass opacities and pulmonary consolidation in both lungs. B. Three days after admission, CT scan shows that the density of the foci is lighter and the size is smaller than that at admission day. C. Seven days after treatment, re-examination of CT shows that the lesions in both lungs are further absorbed.