High-resolution computed tomography manifestations of COVID-19 infections in patients of different ages

Abstract

Purpose: We aimed to compare chest HRCT lung signs identified in scans of differently aged patients with COVID-19 infections.

Methods: Case data of patients diagnosed with COVID-19 infection in Hangzhou City, Zhejiang Province in China were collected, and chest HRCT signs of infected patients in four age groups (<18 years, 18-44 years, 45-59 years, ≥60 years) were compared.

Results: Small patchy, ground-glass opacity (GGO), and consolidations were the main HRCT signs in 98 patients with confirmed COVID-19 infections. Patients aged 45-59 years and aged ≥60 years had more bilateral lung, lung lobe, and lung field involvement, and greater lesion numbers than patients <18 years. GGO accompanied with the interlobular septa thickening or a crazy-paving pattern, consolidation, and air bronchogram sign were more common in patients aged 45-59 years, and ≥60 years, than in those aged <18 years, and aged 18-44 years.

Conclusions: Chest HRCT manifestations in patients with COVID-19 are related to patient's age, and HRCT signs may be milder in younger patients.

Keywords: COVID-19; Ground-glass opacity; High-resolution computed tomography; Pure ground-glass opacity.

Fig. 1

An 11-year-old child was admitted to hospital with a 4-day history of nasal congestion. HRCT showed small patchy opacity approximately 1 cm in diameter in the left upper lobe and in the right lower lobe abutting the pleura. The left upper lobe lesions were thin GGO (A, yellow arrow), and the right lower lobe lesions were mixed GGO (B, yellow arrow).

Fig. 2

A 34-year-old male had an 8-day history of fever with fatigue and generalized aching. HRCT scans showed multiple GGO accompanied with interlobular septa thickening, and crazy paving pattern in the bilateral lower lobes under the pleura. Air bronchogram signs (yellow arrows) in the GGO were observed in bilateral lower lobes.

Fig. 3

A 48-year-old male presented with a 1-week history of coughing and a 5-day history of fever. HRCT demonstrated multiple patchy or nodular opacity and GGO under the pleura, with poorly defined margins, mostly in the lower lobe of the lung, and a few consolidations in the right lower lobe lesion (yellow arrow).

Fig. 4

A 73-year-old male presented with a 2-week history of dry cough and a 1-week history of fever. HRCT revealed multiple patchy and large patchy GGO (yellow arrow) with crazy paving pattern (red arrow) under the pleura in both lungs, and mixed with consolidation of the right lower lobe lesions (green arrow). Most lesions were located in the peripheral zone of both lungs.

Fig. 5

A 63-year-old female presented with an 8-day history of fever with occasional cough. HRCT showed large consolidating shadows in the lower lobes of both lungs with interlobular septa thickening, and the lower lobe lesions involved the central zone.