Author/Authors :
Besharat ، Sara Department of Radiology - Clinical Research and Development Center, Shahid Modarres Hospital - Shahid Beheshti University of Medical Sciences , Rahimi ، Fatemehsadat Department of Surgery - Clinical Research and Development Center, Shahid Modarres Hospital - Shahid Beheshti University of Medical Sciences , Afaghi ، Siamak Research Institute of Internal Medicine - Shahid Beheshti University of Medical Sciences , Esmaeili Tarki ، Farzad Research Institute of Internal Medicine - Shahid Beheshti University of Medical Sciences , Pourmotahari ، Fatemeh Clinical Research and Development Center, Shahid Modarres Hospital - Shahid Beheshti University of Medical Sciences , Fathi ، Mohammad Critical Care Quality Improvement Research Center, Shahid Modarres Hospital - Shahid Beheshti University of Medical Sciences , Zali ، Alireza Functional Neurosurgery Research Center - Shahid Beheshti University of Medical Sciences , Sanei Taheri ، Morteza Shahid Beheshti University of Medical Sciences , Ghanaati ، Hossein Advanced Diagnostic and Interventional Radiology Research Center - Tehran University of Medical Sciences , Malekpour Alamdari ، Nasser Critical Care Quality Improvement Research Center, Shahid Modarres Hospital - Shahid Beheshti University of Medical Sciences
Abstract :
Background: Coronavirus disease 2019 (COVID-19) has several chest computed tomography (CT) characteristics, which are important for the early management of this disease, because viral detection via RT-PCR can be time-consuming, resulting in a delayed pneumonia diagnosis. The Radiological Society of North America (RSNA) proposed a reporting language for CT findings related to COVID-19 and defined four CT categories: typical, indeterminate, atypical, and negative. Objectives: To retrospectively evaluate the chest CT characteristics of patients with COVID-19 pneumonia. Patients and Methods: A total of 115 hospitalized laboratory-verified COVID-19 cases, underdoing chest CT scan, were included in this study from April 30 to May 15, 2020. Of 115 cases, 53 were discharged from the hospital, and 62 expired. The initial clinical features and chest CT scans were assessed for the type, pattern, distribution, and frequency of lesions. Moreover, the findings were compared between ward-hospitalized, intensive care unit (ICU)-admitted, and non-surviving (expired) patients. Results: Of four CT categories, typical CT findings for COVID-19 were more frequent in the expired group (77.4%), compared to the ward-admitted (44.8%) and ICU-admitted (70.8%) groups (P = 0.017). However, no significant difference was observed in the prevalence of intermediate or atypical CT findings between the groups. Negative CT scans for the diagnosis of COVID-19 were significantly fewer in the expired group (0%) as compared to the ward-admitted (10.3%) and ICU-admitted (8.3%) groups (P = 0.0180). Also, the mean number of involved lung lobes and segments was significantly higher in the expired group compared to the other two groups (P = 0.032 and 0.010, respectively). The right upper lobe involvement, right middle lobe involvement, bilateral involvement, central lesion, air bronchogram, and pleural effusion were among CT scan findings with a significantly higher prevalence in non-surviving cases (P 0.0001, 0.047, 0.01, 0.036, 0.038, and 0.047, respectively). Conclusion: The increased number of involved lung lobes and segments, bilateral and central distribution patterns, air bronchogram, and severe pleural effusion in the initial chest CT scan can be related to the increased severity and poor prognosis of COVID-19.
Keywords :
Pneumonia , Pandemic , COVID , 19
