COVID-19 patients with progressive and non-progressive CT manifestations

Yiqing Tan; Xiaoyang Wang; Wenjie Yang; Zenghui Cheng; Qiqi Cao; Ashan Pan; Jianyi Dai; Qingfeng Sun; Fengquan Zhao; Fuhua Yan; Le Qin

doi:10.1016/j.jrid.2020.07.001

COVID-19 patients with progressive and non-progressive CT manifestations

Radiol Infect Dis. 2020 Sep;7(3):97-105. doi: 10.1016/j.jrid.2020.07.001. Epub 2020 Jul 15.

Authors

Yiqing Tan¹, Xiaoyang Wang², Wenjie Yang³, Zenghui Cheng³, Qiqi Cao³, Ashan Pan⁴, Jianyi Dai⁴, Qingfeng Sun⁵, Fengquan Zhao⁶, Fuhua Yan³, Le Qin³

Affiliations

¹ Department of Radiology, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, Hubei 430063, China.
² Department of Radiology, Ruian People's Hospital, Ruian, Zhejiang 325200, China.
³ Department of Radiology, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai 200025, China.
⁴ Department of Radiology, Yueqing People's Hospital, Yueqing, Zhejiang 325600, China.
⁵ Department of Infectious Diseases, Ruian People's Hospital, Ruian, Zhejiang 325200, China.
⁶ Department of Infectious Diseases, Wenzhou Central Hospital, Wenzhou, Zhejiang 325000, China.

Abstract

Objective: To explore the clinical and radiological characteristics of COVID-19 patients with progressive and non-progressive CT manifestations.

Methods: 160 patients with COVID-19 were retrospectively included from Wenzhou and Wuhan, China. CT features including lesion position, attenuation, form and total scores (0-4) at the segment level were evaluated. Other images signs were also assessed. 65 patients were classified as progressive (group 1) and 95 as non-progressive CT (group 2) groups according to score changes between the initial and second CT.

Results: Symptoms onset-initial CT interval time in group 1 [5 (2, 7) days] were significantly shorter than that in group 2 [10 (8, 14) days] (P < 0.001). Group 2 had higher radiological scores, with more lobes and segments affected, and other CT signs (P < 0.05). In group 1, radiological scores, the number of lobes and segments affected as well as lesions in both peripheral and central distribution, mixed ground grass opacity and consolidation density, and patchy form increased in the second CT (P < 0.05). More reticular pattern, subpleural linear opacity and bronchial dilatation were also found (P < 0.05).

Conclusion: Typically radiological characteristics of progressive CT patients could potentially help to predict changes and increase understanding of the natural history of COVID-19.

Keywords: COVID-19; CT; Pneumonia; Progression.