Clinical and imaging features of COVID-19

Abstract

Since December 2019, multiple cases of 2019 coronavirus disease (COVID-19) have been reported in Wuhan in China's Hubei Province, a disease which has subsequently spread rapidly across the entire country. Highly infectious, COVID-19 has numerous transmission channels and humans are highly susceptible to infection. The main clinical symptoms of COVID-19 are fever, fatigue, and a dry cough. Laboratory examination in the early stage of the disease shows a normal or decreased white blood cell count, and a decreased lymphocyte count. While CT examination serves as the screening and diagnostic basis for COVID-19, its accuracy is limited. The nucleic acid testing is the gold standard for the diagnosis of COVID-19, but has a low sensitivity is low. There is clearly a divide between the two means of examination. This paper reviews the published literature, guidelines and consensus, and summarizes the clinical and imaging characteristics of COVID-19, in order to provide a reliable basis for early diagnosis and treatment.

Keywords: Clinical features; Coronavirus disease 2019; Image features; Novel coronavirus.

Fig. 1

Female patient, 30 years old, clinical symptoms are not typical, CT examination; image shows ground-glass exudation in both lungs (see the red arrows).

Fig. 2

Male patient, 23 years old; Clinical manifestations of fever, dry cough for 5 days, and fatigue for 2 days; relevant contact history; CT examination; no obvious signs of pneumonia were seen in either lung (see the red arrows).

Fig. 3

Female patient, 38 years old, first examination A, image shows solitary consolidative peripheral opacities with ground-glass density in right lower lobe; after 2 days B, image shows progressive consolidative peripheral opacities in right lower lobe (see the red arrows).

Fig. 4

Male patient, 60 years old, first examination A–C, multiple exudative lesions in both lungs; the nucleic acid test was negative. Five days later D–F, exudative lesions of both lungs, with a few lines of shadow; the nucleic acid test was positive. (With thanks to the First Affiliated Hospital of Xi'an Jiaotong University for providing this case) (see the red arrows).

Fig. 5

Male patient, 44 years old, first examination A, no obvious abnormality was found in both lungs; the nucleic acid test was positive. After 4 days B, ground-glass exudation of left lower lobe. (With thanks to the First Affiliated Hospital of Xi'an Jiaotong University for providing this case; (see the red arrows).

Fig. 6

Male patient, 17 years old, clinical manifestations of fever for 1 day, and dry cough for 3 days; no relevant contact history; CT examination; multiple exudates in both lungs; located in bronchovascular bundle or subpleural (see the red arrows).

Fig. 7

Male patient, 23 years old, fever for 4 day, no relevant contact history; CT examination; multifocal GGO in both lungs with patchy consolidation, present a multisegmental pulmonary distribution trend; pleural effusion (see the red arrows).

Fig. 8

Female patient, 37 years old, no relevant contact history; CT examination; multiple peribronchial nodules, consolidation of GGO, the distribution of lesions is different, mainly for the central nodules (see the red arrows).

Fig. 9

Male patient, 25 years old, fever for 4 days, no relevant contact history; CT examination; central lobular nodule and GGO in both lungs, the distribution of lesions differs from that in COVID-19 (see the red arrows).