Objective: Chest CT is useful in assessing the disease course of coronavirus disease-19 (COVID-19). This study aims to identify the characteristics of patients in whom imaging progression occurred while clinical symptoms were relieved and to guide radiological reexamination.
Methods: This retrospective study included 73 patients with reverse transcription-polymerase chain reaction (RT-PCR) confirmed severe acute respiratory syndrome-2 (SARS-CoV-2) infection. All patients received CT reexaminations within 24 h after symptomatic remission. We divided patients into two groups according to the matching degree between clinical and imaging outcomes.
Results: 21 patients displayed imaging progression while symptoms relieved. Patients with imaging progression were prone to be advanced in age [years: 60 (46-65) v 47 (37-60.75), P = 0.030]; lymphopenia (66.7% v 40.4%, P = 0.042) and low level of C-reactive protein [mg/L: 5.7 (1.9-20.2) v 18.9 (6.7-38.9), P = 0.038]. An age over 50 was an independent risk factor for imaging progression (OR = 3.41, 95%CI 1.14-10.20, P = 0.028). In CT images, they were inclined to present lesions with clear border (94.7% v 64.7%, P = 0.012), pure peripheral distribution (89.5% v 39.2%, P < 0.001), without bilateral lungs involved (57.9% v 29.4%, P = 0.028) especially with left lung involved only (42.1% v 17.6%, P = 0.034).
Conclusion: In order to improve the therapeutic effect, the interval before radiological follow-up should be shortened appropriately especially in patients over the age of 50. It is essential to proceed to CT reexamination before symptomatic remission.
Keywords: Computed tomography; Coronavirus disease-19; Prognosis.
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