Computed tomography findings in a Brazilian cohort of 48 patients with pneumonia due to coronavirus disease

Abstract

Introduction: This study was conducted to retrospectively review chest computed tomography (CT) findings in a Brazilian cohort of patients with pneumonia caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Methods: Chest CT scans of 78 patients with confirmed coronavirus disease (COVID-19), obtained in March and April 2020, were reviewed. Of 78 cases, the CT scans of 48 (61.5%) showed lung opacities. CT opacity features, their distribution, and the extent of infiltration were evaluated.

Results: The most common CT findings were ground-glass opacities (97.9%), crazy-paving pattern (58.3%), and mixed pattern (18.8%). Rounded lung opacities were observed most frequently (70.8%). Other findings were cystic airspace changes (37.5%), vascular dilatation (35.4%), and the organizing pneumonia pattern (14.6%). The findings were frequently bilateral (87.5%), symmetrical (68.9%), and peripheral (60.2%).

Conclusions: The most common CT findings were ground-glass opacities and the crazy-paving pattern. Involvement was mostly bilateral, symmetrical, and peripheral. Round opacity morphology was frequently observed and might have some degree of specificity to viral COVID-19 pneumonia.

FIGURE 1:. (A) Coronal reformatted CT image of a 59-year-old man with COVID-19 presenting with fever and showing multiple bilateral rounded opacities with crazy-paving aspect. (B) Sagittal reconstructed chest CT image of a 52-year-old woman with COVID-19 pneumonia showing multifocal, patchy, rounded ground-glass and mixed opacities.

FIGURE 2:. CT images obtained from four different patients with COVID-19 pneumonia. (A) Axial CT image of an 86-year-old man showing multiple bilateral patchy areas of ground-glass opacity. Also note peripheral areas of parenchymal consolidation in the right upper lobe. (B) Coronal reconstructed chest CT image of a 59-year-old man showing interlobular lines superimposed on a background of ground-glass opacity (crazy-paving pattern) in the right lung. (C) Axial CT image of a 56 year-old-man depicting tiny cystic air spaces (arrow). (D) Axial CT image of a 64-year-old woman showing vascular dilatation associated with ground-glass opacities in the right lower lobe (arrows).