Radiological findings and clinical characteristics of pregnant women with COVID-19 pneumonia

Abstract

Objective: To study chest CT images and clinical characteristics of COVID-19 pneumonia in pregnant patients to examine any correlation.

Methods: Between December 31, 2019 and March 7, 2020, 23 hospitalized pregnant patients with confirmed COVID-19 were enrolled in the study. Clinical presentations were collected retrospectively from records, including laboratory testing, chest CT imaging, and symptoms. Descriptive analysis and correlation of patients' clinical and CT characteristics were performed. Laboratory results from time of first admission and CT absorption (defined as reduction in lesion area, decrease in density, and absorption of some solid components) were compared between symptomatic and asymptomatic patients.

Results: Fifteen (65.2%) patients were asymptomatic with patchy ground-glass opacity in a single lung lobe. Eight (34.8%) patients were symptomatic with multiple patchy ground-glass shadows, consolidation, and fibrous stripes. Differences in lymphocyte percentage and neutrophil granulocyte rate between first admission and CT absorption were significant (P<0.001). Median absorption time was shorter in the asymptomatic group compared with the symptomatic group (5 vs 10 days; P<0.001). Median hospitalization time between asymptomatic and symptomatic patients was 14 vs 25.5 days; P>0.001. Median absorption time and length of hospitalization for all patients was 6 days (IQR 5-8) and 17 days (IQR 13-25), respectively.

Conclusion: Radiological findings and clinical characteristics in pregnant women with COVID-19 were similar to those of non-pregnant women with COVID-19. Median absorption time and length of hospitalization in asymptomatic patients were significantly shorter than in symptomatic patients. Lymphocyte percentage and neutrophil granulocyte rate may be used as laboratory indicators of CT absorption.

Keywords: COVID-19; CT scan; Pneumonia; Pregnancy.

Figure 1

Transverse thin‐section CT scans in pregnant patients with COVID‐19 pneumonia. (a) 32‐y‐old, 38 wk: ground‐glass opacity in the right lower lobe with a diameter of about 8 mm; (b) 28‐y‐old, 39 + 1 wk: bilateral, circular ground‐glass opacity in the lower lobes; (c) 30‐y‐old, 35 + 4 w: single peripheral ground‐glass shadow with air bronchograms in the right upper lobe; (d) 29‐y‐old, 37 + 6 wk: multiple patchy, wedge‐shaped ground‐glass shadows mainly along the bronchovascular area and lung field with subpleural area; (e) 33‐y‐old, 38 + 6 wk, day 5 after onset of symptoms: focal ground‐glass shadow associated with smooth interlobular and intralobular septal thickening in the right lower lobe; (f) 28‐y‐old, 38 + 5 wk, day 6 after onset of symptoms: patchy consolidation and fibrous stripes in the lower lobes.