Leo Sher, M.D.

A research report, “Chest CT findings in Coronavirus Disease -19 (COVID-19): Relationship to duration of infection” has been published in Radiology online ahead of print (1).

Researchers led by Dr. Adam Bernheim from the Icahn School of Medicine at Mount Sinai in New York examined chest CTs of 121 symptomatic patients infected with COVID-19 from four centers in China in relationship to the time between symptom onset and the initial CT scan. COVID-19 is the seventh known coronavirus which can infect humans. Other examples include severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) which originated in China and Saudi Arabia, respectively.

Data on 61 men and 60 women were included in the study. The mean age was 45.3 years and the age range was 18 – 80 years.

The hallmarks of COVID-19 infection on imaging were bilateral and peripheral ground-glass and consolidative pulmonary opacities. Of the 121 patients, 27 (22%) had no ground-glass opacities and no consolidation on chest CT. Of the 94 patients with ground-glass opacities, consolidation, or both, 41 (34%) had only ground-glass opacities (with no consolidation), and two patients (2%) had consolidation in the absence of ground-glass opacities. Seventy-three of 121 patients (60%) had bilateral lung disease. Thoracic lymphadenopathy, lung cavitation, and pulmonary nodules were absent in all 121 patients, and only one patient had a pleural effusion.

The time between initial onset of symptoms and subsequent chest CT was known for 94 patients and assigned as early (0-2 days), intermediate (3-5 days), or late (6-12 days). With a longer time after the onset of symptoms, CT findings were more frequent, including consolidation, bilateral and peripheral disease, greater total lung involvement, linear opacities, “crazy-paving” pattern and the “reverse halo” sign. Bilateral lung involvement was observed in 10 of 36 early patients (28%), 25 of 33 intermediate patients (76%), and 22 of 25 late patients (88%).

The authors suggest that their findings are important for not only understanding the pathophysiology and natural history of COVID-19, but also for helping to predict patient progression and possible complication development.

Reference

1. Bernheim A, Mei X, Huang M, Yang Y, Fayad ZA, Zhang N, Diao K, Lin B, Zhu X, Li K, Li S, Shan H, Jacobi A, Chung M. Chest CT findings in Coronavirus Disease -19 (COVID-19): Relationship to duration of infection. Radiology. 2020 Feb 20:200463. doi: 10.1148/radiol.2020200463. [Epub ahead of print]