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Coronavirus Disease 2019 (COVID-19) Pneumonia: Early Stage Chest CT Imaging Features and Clinical Relevance

25 Pages Posted: 28 Feb 2020

See all articles by Chenying Lu

Chenying Lu

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Weibin Yang

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Yumin Hu

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Junguo Hui

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Gang Zhou

Huanggang Central Hospital - Department of Radiology

Jiner Shu

Zhejiang University - Department of Radiology

Biao Shi

Bengbu First People’s Hospital - Department of Radiology

Guangmin Li

Hubei University of Arts and Science - Department of Radiology

Qiaoyou Weng

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Zufei Wang

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Rajamanickam Vinothkumar

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Yanping Su

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Enfen Shu

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Chuanqiang Lan

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Yangrui Xiao

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Shaobo Shen

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Tiemin Wei

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Jiansong Ji

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research; Wenzhou Medical University - Department of Radiology

More...

Abstract

Background: Early diagnostic of COVID-19 pneumonia remains a dilemma. We aimed to investigate the importance of early stage chest CT imaging features in the early diagnosis of COVID-19 pneumonia.

Methods: This retrospective investigation included 91 patients (49 males and 42 females, aged 18-87 years) confirmed with COVID-19 infection and presented as early stage CT images between January 21, 2020 to February 10, 2020. The early stage CT imaging features were evaluated.

Findings: 66 of 91 (72.5%) COVID-19 patients had a history of exposure to Wuhan or infected patient. The most common symptoms were fever (69/91, 75.8%) and dry cough (60/91, 65.9%). A total of 996 lesions were found in 91 enrolled patients. The early stage CT features included the following: The lesions were mainly bilateral (955/966, 95.9%) and peripheral distribution (607/996, 60.9%), and distributed along the bronchial and vascular bundles (517/996, 51.9%). The most common lesions were small patchy/strip shaped (678/996, 68.1%) pure ground glass opacities (639/996, 64.2%). Furthermore, early stage CT imaging also presents some characteristic signs, including vascular thickening sign in 35/91 (38.5%) patients, crazy paving sign in 56/91 (61.5%) patients, air bronchogram sign in 42/91 (46.2%) patients, and nodule with halo sign in 15 (16.5%) patients.

Interpretation: Multiple small patchy/strip shaped GGO in bilateral and subpleural lungs are the characteristic features of early stage CT of COVID-19 pneumonia, which combined with clinical and laboratory data can help rapid diagnosis and guide early clinical management for COVID-19 pneumonia patients.

Funding Statement: National Natural Science Foundation of China (81803778).

Declaration of Interests: The authors declare no competing interests.

Ethics Approval Statement: Our institutional review board approved the study and did not require additional informed consent for reviewing the patients’ medical records and images.

Keywords: SARS-CoV-2; COVID-19; Pneumonia; Computed tomography

Suggested Citation

Lu, Chenying and Yang, Weibin and Hu, Yumin and Hui, Junguo and Zhou, Gang and Shu, Jiner and Shi, Biao and Li, Guangmin and Weng, Qiaoyou and Wang, Zufei and Vinothkumar, Rajamanickam and Su, Yanping and Shu, Enfen and Lan, Chuanqiang and Xiao, Yangrui and Shen, Shaobo and Wei, Tiemin and Ji, Jiansong, Coronavirus Disease 2019 (COVID-19) Pneumonia: Early Stage Chest CT Imaging Features and Clinical Relevance (February 20, 2020). Available at SSRN: https://ssrn.com/abstract=3543606 or http://dx.doi.org/10.2139/ssrn.3543606

Chenying Lu

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Lishui, 323000
China

Weibin Yang

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Lishui, 323000
China

Yumin Hu

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Lishui, 323000
China

Junguo Hui

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Lishui, 323000
China

Gang Zhou

Huanggang Central Hospital - Department of Radiology

China

Jiner Shu

Zhejiang University - Department of Radiology

China

Biao Shi

Bengbu First People’s Hospital - Department of Radiology

China

Guangmin Li

Hubei University of Arts and Science - Department of Radiology

China

Qiaoyou Weng

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Lishui, 323000
China

Zufei Wang

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Lishui, 323000
China

Rajamanickam Vinothkumar

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Lishui, 323000
China

Yanping Su

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Lishui, 323000
China

Enfen Shu

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Lishui, 323000
China

Chuanqiang Lan

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Lishui, 323000
China

Yangrui Xiao

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Lishui, 323000
China

Shaobo Shen

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Lishui, 323000
China

Tiemin Wei

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research

Lishui, 323000
China

Jiansong Ji (Contact Author)

Zhejiang University - Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research ( email )

Lishui, 323000
China

Wenzhou Medical University - Department of Radiology ( email )

Lishui
China

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