BJR Open . Chest CT features of coronavirus disease-19 (COVID-19) pneumonia: which findings on initial CT can predict an adverse short-term outcome?

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BJR Open


. 2020 Jun 19;2(1):20200016.
doi: 10.1259/bjro.20200016. eCollection 2020.
Chest CT features of coronavirus disease-19 (COVID-19) pneumonia: which findings on initial CT can predict an adverse short-term outcome?


Arshed Hussain Parry ¹ , Abdul Haseeb Wani ² , Naveed Nazir Shah ³ , Mudasira Yaseen ⁴ , Majid Jehangir ²



Affiliations

• PMID: 33178976
• PMCID: PMC7594891
• DOI: 10.1259/bjro.20200016

Abstract

Objective: To study the spectrum of chest CT features in coronavirus disease-19 (COVID-19) pneumonia and to identify the initial CT findings that may have the potential to predict a poor short-term outcome.
Methods: This was a retrospective study comprising 211 reverse transcriptase-polymerase chain reaction (RT-PCR) positive patients who had undergone non-contrast chest CT. Prevalence, extent, pattern, distribution and type of abnormal lung findings were recorded. Patients with positive CT findings were divided into two groups; clinically stable (requiring in-ward hospitalization) and clinically unstable [requiring intensive care unit (ICU) admission or demised] based on short-term follow-up.
Results: Lung parenchymal abnormalities were present in 42.2% (89/211) whereas 57.8% (122/211) cases had a normal chest CT. The mean age of clinically unstable patients (63.6 ? 8.3 years) was significantly different from the clinically stable group (44.6 ? 13.2 years) (p-value < 0.05). Bilaterality, combined involvement of central-peripheral and anteroposterior lung along with a higher percentage of the total lung involvement, presence of crazy paving, coalescent consolidations with air bronchogram and segmental pulmonary vessel enlargement were found in a significantly higher proportion of clinically unstable group (ICU/demised) compared to the stable group (in-ward hospitalization) with all p values < 0.05.
Conclusion: Certain imaging findings on initial CT have the potential to predict short-term outcome in COVID-19 pneumonia. Extensive pulmonary abnormalities, evaluated by combined anteroposterior, central-peripheral and a higher percentage of the total lung involvement, indicate a poor short-term outcome. Similarly, the presence of crazy paving pattern, consolidation with air bronchogram and segmental vascular changes are also indicators of poor short-term outcome.
Advances in knowledge: Certain findings on initial CT can predict an adverse short-term prognosis in COVID-19 pneumonia.