tetano
Editor, Senior Moderator
J Xray Sci Technol
. 2020 Jul 29.
doi: 10.3233/XST-200711. Online ahead of print.
Dynamic CT assessment of disease change and prognosis of patients with moderate COVID-19 pneumonia
Hua Zhang[SUP] 1 [/SUP], Xiaohong Liu[SUP] 2 [/SUP], Peng Yu[SUP] 3 [/SUP], Mingyuan Cheng[SUP] 1 [/SUP], Weiting Wang[SUP] 4 [/SUP], Yipeng Sun[SUP] 5 [/SUP], Bingliang Zeng[SUP] 6 [/SUP], Bing Fan[SUP] 6 [/SUP]
Affiliations
Abstract
Objectives: To assess prognosis or dynamic change from initial diagnosis until recovery of the patients with moderate coronavirus disease (COVID-19) pneumonia using chest CT images.
Materials and methods: In this retrospective study, 33 patients (18 men, 15 women; median age, 49.0 years) with confirmed with moderate COVID-19 pneumonia in a multicenter hospital were included. The patients underwent at least four chest non-contrast-enhanced computed tomography (CT) scans at approximately 5-day intervals. We analyzed the clinical and CT characteristics of the patients. Moreover, the total CT score and the sum of lung involvement were determined for every CT scan.
Results: The most widespread presenting symptoms were fever (32/33, 97.0%) and cough (17/33, 51.5%), which were often accompanied by decreased lymphocyte count (15/33, 45.5%) and increased C-reactive protein levels (18/33, 54.6%). Bilateral, multifocal ground glass opacities (32/33, 97.0%), consolidation (25/33, 75.8%), vascular thickening (23/33, 69.7%), and bronchial wall thickening (21/33, 63.6%) with peripheral distribution were the most frequent CT findings during moderate COVID-19 pneumonia. In patients recovering from moderate COVID-19 pneumonia, four stages (stages 1-4) of evolution were identified on chest CT with average CT scores of 3.4?2.3, 6.0?4.4, 5.6?3.8, and 4.9?3.2, respectively, from the onset of symptoms. For most patients, the peak of average total CT score increased for approximately 8 days after the onset of symptoms, after which it decreased gradually. The mean CT score of all patients was 4.7 at the time of discharge.
Conclusion: The moderate COVID-19 pneumonia CT score increased rapidly in a short period of time initially, followed by a slow decline over a relatively long time. The peak of the course occurred in stage 2. Complete recovery of patients with moderate COVID-19 pneumonia with high mean CT score at the time of discharge requires longer time.
Keywords: COVID-19; COVID-19 prognosis; Coronavirus disease; Dynamic CT assessment; Moderate COVID-19 Pneumonia.
. 2020 Jul 29.
doi: 10.3233/XST-200711. Online ahead of print.
Dynamic CT assessment of disease change and prognosis of patients with moderate COVID-19 pneumonia
Hua Zhang[SUP] 1 [/SUP], Xiaohong Liu[SUP] 2 [/SUP], Peng Yu[SUP] 3 [/SUP], Mingyuan Cheng[SUP] 1 [/SUP], Weiting Wang[SUP] 4 [/SUP], Yipeng Sun[SUP] 5 [/SUP], Bingliang Zeng[SUP] 6 [/SUP], Bing Fan[SUP] 6 [/SUP]
Affiliations
- PMID: 32741802
- DOI: 10.3233/XST-200711
Abstract
Objectives: To assess prognosis or dynamic change from initial diagnosis until recovery of the patients with moderate coronavirus disease (COVID-19) pneumonia using chest CT images.
Materials and methods: In this retrospective study, 33 patients (18 men, 15 women; median age, 49.0 years) with confirmed with moderate COVID-19 pneumonia in a multicenter hospital were included. The patients underwent at least four chest non-contrast-enhanced computed tomography (CT) scans at approximately 5-day intervals. We analyzed the clinical and CT characteristics of the patients. Moreover, the total CT score and the sum of lung involvement were determined for every CT scan.
Results: The most widespread presenting symptoms were fever (32/33, 97.0%) and cough (17/33, 51.5%), which were often accompanied by decreased lymphocyte count (15/33, 45.5%) and increased C-reactive protein levels (18/33, 54.6%). Bilateral, multifocal ground glass opacities (32/33, 97.0%), consolidation (25/33, 75.8%), vascular thickening (23/33, 69.7%), and bronchial wall thickening (21/33, 63.6%) with peripheral distribution were the most frequent CT findings during moderate COVID-19 pneumonia. In patients recovering from moderate COVID-19 pneumonia, four stages (stages 1-4) of evolution were identified on chest CT with average CT scores of 3.4?2.3, 6.0?4.4, 5.6?3.8, and 4.9?3.2, respectively, from the onset of symptoms. For most patients, the peak of average total CT score increased for approximately 8 days after the onset of symptoms, after which it decreased gradually. The mean CT score of all patients was 4.7 at the time of discharge.
Conclusion: The moderate COVID-19 pneumonia CT score increased rapidly in a short period of time initially, followed by a slow decline over a relatively long time. The peak of the course occurred in stage 2. Complete recovery of patients with moderate COVID-19 pneumonia with high mean CT score at the time of discharge requires longer time.
Keywords: COVID-19; COVID-19 prognosis; Coronavirus disease; Dynamic CT assessment; Moderate COVID-19 Pneumonia.