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Observational Study
. 2021 Dec;28(6):1055-1061.
doi: 10.1007/s10140-021-01937-y. Epub 2021 Jul 29.

Comparing the first and the second waves of COVID-19 in Italy: differences in epidemiological features and CT findings using a semi-quantitative score

Caterina Balacchi  1 , Nicolò Brandi  2 , Federica Ciccarese  1 , Francesca Coppola  1 , Vincenzo Lucidi  1 , Laura Bartalena  1 , Anna Parmeggiani  1 , Alexandro Paccapelo  1 , Rita Golfieri  1
Affiliations
Observational Study

Comparing the first and the second waves of COVID-19 in Italy: differences in epidemiological features and CT findings using a semi-quantitative score

Caterina Balacchi et al. Emerg Radiol. 2021 Dec.

Abstract

Purpose: CT findings of hospitalized COVID-19 patients were analyzed during both the first and the second waves of the pandemic, in order to detect any significant differences between the two groups.

Methods: In this observational, retrospective, monocentric study, all hospitalized patients who underwent CT for suspected COVID-19 pneumonia from February 27 to March 27, 2020 (first wave) and from October 26 to November 24, 2020 (second wave) were enrolled. Epidemiological data, radiological pattern according to the RSNA consensus statement and visual score extension using a semi-quantitative score were compared.

Results: Two hundred and eleven patients (mean age, 64.52 years ± 15.14, 144 males) were evaluated during the first wave while 455 patients (mean age, 68.26 years ± 16.34, 283 males) were studied during the second wave. The same prevalence of patterns was documented in both the first and the second waves (p = 0.916), with non-typical patterns always more frequently observed in elderly patients, especially the "indeterminate" pattern. Compared to those infected during the first wave, the patients of the second wave were older (64.52 vs.68.26, p = 0.005) and presented a slightly higher mean semi-quantitative score (9.0 ± 2.88 vs. 8.4 ± 3.06, p = 0.042). Age and semi-quantitative score showed a positive correlation (r = 0.15, p = 0.001).

Conclusions: There was no difference regarding CT pattern prevalence between the first and the second waves, confirming both the validity of the RSNA consensus and the most frequent radiological COVID-19 features. Non-typical COVID-19 features were more frequently observed in older patients, thus should not be underestimated in the elderly population.

Keywords: COVID-19; CT; Coronavirus; First wave; SARS-CoV-2; Second wave.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Visual score assessment. Diffuse bilateral ground-glass involving all five lobes (a-d). Multiplanar reconstructions allow a better evaluation of the visual score. Score of the right lung (c): right superior lobe = 4, middle lobe = 4, right inferior lobe = 3. Score of the left lung (d): left superior lobe = 3, left inferior lobe = 3. Total score: 17/25
Fig. 2
Fig. 2
The workflow of patient data collection
Fig. 3
Fig. 3
Radiological features of the “typical” pattern: a multiple, peripheral, subpleural ground-glass opacities associated with crazy-paving (arrows); b rounded ground-glass opacities (arrows); c organizing pneumonia characterized by multiple and patchy consolidations, with band-like pattern, peri-lobular opacities and ground-glass; d reverse halo sign (arrow); e halo sign (circle) and double reverse halo sign (also called target sign) (head arrow)
See this image and copyright information in PMC

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