Chest CT abnormalities in COVID-19: a systematic review

Int J Med Sci. 2021 Aug 1;18(15):3395-3402. doi: 10.7150/ijms.50568. eCollection 2021.

Abstract

Computed tomography (CT) of the chest is one of the main diagnositic tools for coronavirus disease 2019 (COVID-19) infection. To document the chest CT findings in patients with confirmed COVID-19 and their association with the clinical severity, we searched related literatures through PubMed, MEDLINE, Embase, Web of Science (inception to May 4, 2020) and reviewed reference lists of previous systematic reviews. A total of 31 case reports (3768 patients) on CT findings of COVID-19 were included. The most common comorbid conditions were hypertension (18.4%) and diabetes mellitus (8.3%). The most common symptom was fever (78.7%), followed by cough (60.2%). It took an average of 5.6 days from symptom onset to admission. The most common chest CT finding was vascular enlargement (84.8%), followed by ground-glass opacity (GGO) (60.1%), air-bronchogram (47.8%), and consolidation (41.4%). Most lung lesions were located in the lung periphery (72.2%) and involved bilateral lung (76%). Most patients showed normal range of laboratory findings such as white blood cell count (96.4%) and lymphocyte (87.2%). Compared to previous published meta-analyses, our study is the first to summarize the different radiologic characteristics of chest CT in a total of 3768 COVID-19 patients by compiling case series studies. A comprehensive diagnostic approach should be adopted for patients with known COVID-19, suspected cases, and for exposed individuals.

Keywords: Computed tomography (CT); Coronavirus disease 2019 (COVID-19); Systematic review.

Publication types

  • Systematic Review

MeSH terms

  • COVID-19 / blood
  • COVID-19 / diagnostic imaging*
  • Humans
  • Lung / diagnostic imaging
  • Lung Diseases / diagnostic imaging
  • Lymphocyte Count
  • Oxygen / therapeutic use
  • Prognosis
  • Radiography, Thoracic / methods*
  • Tomography, X-Ray Computed / methods*

Substances

  • Oxygen