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• Research Paper Volume 12, Issue 9 pp 7652-7659

  Typical radiological progression and clinical features of patients with coronavirus disease 2019

  Relevance score: 17.84191

  Min Wang, Linghong Guo, Qi Chen, Guojin Xia, Bo Wang

  Keywords: COVID-19, 2019 novel coronavirus pneumonia, radiological features, chest CT, ground-glass opacity

  Published in Aging on May 2, 2020

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  We aimed to describe typical radiological features and progression of Coronavirus disease 2019 (COVID-19) patients. We reviewed the chest CT scans, laboratory findings, and clinical records of 66 COVID-19 patients who were admitted to affiliated hospitals of Nanchang university, Nanchang, China, from Jan 21 to Feb 2, 2020. CT was used to evaluate the radiological characteristics of COVID-19 patients. Only 4 patients (4/66, 6%) claimed their exposure to COVID-19 pneumonia patients. The major symptoms were fever (60/66, 91%) and cough (37/66, 56%). The predominant features of lesion were scattered (43/66, 65%), bilateral (50/66, 76%), ground-glass opacity (64/66, 97%), and air bronchogram sign (47/66, 71%). Forty-eight patients (48/66, 73%) had more than two lobes involved. Right lower lobe (58/66, 88%) and left lower lobe (49/66, 74%) were most likely invaded. Twelve patients (12/66, 18%) had at least one comorbid condition. Pleural traction (29/66, 44%), crazy paving (15/66, 23%), interlobular septal thickening (11/66, 17%), and consolidation (7/66, 11%) were also observed. The typical radiology features of COVID-19 patients are scattered ground-glass opacity in the bilateral lobes. Fever and cough are the major symptoms. Evaluating chest CT, clinical symptoms, and laboratory results could facilitate the early diagnosis of COVID-19, and judge disease progression.

  

  Ground-glass opacity and crazy paving in the CT scans of COVID-19 pneumonia patients. (A) Multiple nodular ground-glass opacity scattered in both lungs of a 44-year-old male patient; (B) Mixed ground-glass opacity along the long axis of subpleural in both lungs of a 67-year-old male patient; (C) Crazy paving was observed in the bilateral lower lungs of a 67-year-old male patient at the fourth day since admission. Typical lesions were marked with red arrows.

  
  
  

  

  Consolidation, halo sign, and bronchiectasia in the CT scans of COVID-19 pneumonia patients. (A) Consolidation accompanying air bronchogram sign was found in the right lower lobe of a 46-year-old male patient; (B) Halo sign was observed in the right lower lobe of a 18-year-old male patient; (C) Bronchiectasia was observed in the right lower lobe of a 30-year-old male patient with bilateral ground-glass opacity. Typical lesions were marked with red arrows.

  
  
  

  

  Radiological worsen progression of two COVID-19 pneumonia patients. (A, B): Bilateral, large, and multiple ground-glass opacity was observed in a 47-year-old male patient with type 2 diabetes after 8 days since admission; (C, D) Consolidation accompanying air bronchogram were found in the bilateral lower lungs of a 29-year-old male patient after 5 days since admission. Typical lesions were marked with red arrows.

  
  
  

  

  Radiological improvement of two COVID-19 pneumonia patients. (A, B) Patch lesions were absorbed and changed into reticular spline ones (a 31-year-old female patient); (C–D) Significant improvement of CT sign was achieved in a 22-year-old male patient. Typical lesions were marked with red arrows.

  
  
  

  

  A serial CT images after admission of a 54-year-old male patient. (A) Patch ground-glass opacity was observed in the middle right lobe. (B) 5 days later, significant larger patch ground-glass opacities were observed in bilateral lungs. (C) Follow-up CT scans on day 13 after admission show a remarkable improvement. Typical lesions were marked with red arrows.

  
  
  

  

  A serial CT images after admission of a 54-year-old female patient. (A) Patch ground-glass opacity mainly located in the left lower lobe. (B) Significant larger patch ground-glass opacities were observed in both lower lobes after 8 days. (C) Follow-up CT scans on day 20 after admission show a remarkable improvement. Typical lesions were marked with red arrows.