Arch Acad Emerg Med Lobar Distribution of COVID-19 Pneumonia Based on Chest Computed Tomography Findings; A Retrospective Study

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Arch Acad Emerg Med


. 2020 Apr 18;8(1):e55.
eCollection 2020.
Lobar Distribution of COVID-19 Pneumonia Based on Chest Computed Tomography Findings; A Retrospective Study


Sara Haseli ¹ , Nastaran Khalili ² , Mehrdad Bakhshayeshkaram ¹ , Morteza Sanei Taheri ^{3 4} , Yashar Moharramzad ⁴



Affiliations

• PMID: 32440666

Abstract

Introduction: Computed tomography (CT) imaging has quickly found its place as a beneficial tool in the detection of coronavirus disease 2019 (COVID-19). To date, only a few studies have reported the distribution of lung lesions by segment. This study aimed to evaluate the lobar and segmental distribution of COVID-19 pneumonia based on patients' chest CT scan.
Methods: This was a retrospective study performed on 63 Iranian adult patients with a final diagnosis of COVID-19. All patients had undergone chest CT scan on admission. Demographic data and imaging profile, including segmental distribution, were evaluated. Moreover, a scoring scale was designed to assess the severity of ground-glass opacification (GGO). The relationship of GGO score with age, sex, and symptoms at presentation was investigated.
Results: Among included patients, mean age of patients was 54.2 ?14.9 (range: 26 - 81) years old and 60.3% were male. Overall, the right lower lobe (87.3%) and the left lower lobe (85.7%) were more frequently involved. Specifically, predominant involvement was seen in the posterior segment of the left lower lobe (82.5%). The most common findings were peripheral GGO and consolidation, which were observed in 92.1% and 42.9% of patients, respectively. According to the self-designed GGO scoring scale, about half of the patients presented with mild GGO on admission. GGO score was found to be equally distributed among different sex and age categories; however, the presence of dyspnea on admission was significantly associated with a higher GGO score (p= 0.022). Cavitation, reticulation, calcification, bronchiectasis, tree-in-bud appearance and nodules were not identified in any of the cases.
Conclusion: COVID-19 mainly affects the lower lobes of the lungs. GGO and consolidation in the lung periphery is the imaging hallmark in patients with COVID-19 infection. Absence of bronchiectasis, solitary nodules, cavitation, calcifications, tree-in-bud appearance, and reversed halo-sign indicates that these features are not common findings, at least in the earlier stages.

Keywords: COVID-19; X-ray computed; lung injury; pneumonia; tomography; viral.