Classification of High-Resolution Computed Tomography Manifestations for COVID-19 Patients: A Systematic Review

Context: The early detection of COVID-19 is of paramount importance for the disease treatment and control. As real-time reverse-transcription polymerase chain reaction indicates a low sensitivity, the computed tomography of patients’ chest can play an effective role in the diagnosis of COVID-19, particularly for patients with false-negative RT-PCR tests. It is also effective in monitoring the clinical trends and assessing the severity of the disease. Objectives: Accordingly, this study aimed to review the different manifestations of the COVID-19 infections in high-resolution computed tomography images of patients’ chests and analyze the distribution of the disease in the lungs. The results can contribute to providing a comprehensive and concise reference on the appearance of various types of involvement and lung lesions and the extent of these lesions in the COVID-19 patients. Data Sources: We systematically searched four major indexing databases (namely PubMed, Science Direct, Google Scholar, and Cochrane Central) for articles published by May 2021 using the following keywords: High-Resolution Computed Tomography (HRCT), COVID-19, and Manifestations. Results: Overall, 29 studies addressing the role of HRCT in detecting and evaluating the manifestations of the COVID-19 infection in patients’ lungs as ground glass opacification (GGO), consolidation, irregular solid nodules, fibrous stripes, crazy paving pattern, air bronchogram sign, etc. were reviewed. Conclusions: GGO was the most common finding, as reported in 96.6% of the reviewed articles, followed by consolidations (65.5%) and irregular solid nodules (55.2%). Most patients revealed the disease process as a bilateral distribution in the peripheral areas of the lung.