Early CT features of COVID-19 pneumonia, association with patients' age and duration of presenting complaint

• Published in: Egyptian journal of radiology and nuclear medicine 2021-07, Vol.52 (1), p.164-9
• Main Authors: EL Kady, Reem M, Hassan, Hosam A, Daqqaq, Tareef S, Makboul, Rania, Ibrahim, Hanan Mosleh
• Format: Article
• Language: English
• Subjects: Age; Atypical CT imaging features; Bacterial pneumonia; Coronaviruses; COVID-19; CT imaging; Development and progression; Disease transmission; Fever; Medical imaging; Medical research; Medicine, Experimental; Patients; Pleural effusion; Pneumonia; Polymerase chain reaction; Prognosis; Pulmonary arteries; Respiratory diseases; Thrombosis; Typical CT imaging features
• ISSN: 0378-603X; 2090-4762
• DOI: 10.1186/s43055-021-00539-5

Background Coronavirus disease (COVID-19) is a respiratory syndrome with a variable degree of severity. Imaging is a vital component of disease monitoring and follow-up in coronavirus pulmonary syndromes. The study of temporal changes of CT findings of COVID-19 pneumonia can help in better understanding of disease pathogenesis and prediction of disease prognosis. In this study, we aim to determine the typical and atypical CT imaging features of COVID-19 and discuss the association of typical CT imaging features with the duration of the presenting complaint and patients' age. Results The lesions showed unilateral distribution in 20% of cases and bilateral distribution in 80% of cases. The lesions involved the lower lung lobes in 30% of cases and showed diffuse involvement in 58.2% of cases. The lesions showed peripheral distribution in 74.5% of cases. The most common pattern was multifocal ground glass opacity found in 72.7% of cases. Atypical features like cavitation and pleural effusion can occur early in the disease course. There was significant association between increased number of the lesions, bilaterality, diffuse pattern of lung involvement and older age group ([greater than or equal to] 50 years old) and increased duration of presenting complaint ([greater than or equal to] 4 days). There was significant association between crazy-paving pattern and increased duration of presenting complaint. No significant association could be detected between any CT pattern and increased patient age. Conclusion The most common CT feature of COVID-19 was multifocal ground glass opacity. Atypical features like cavitation and pleural effusion can occur early in the course of the disease. Our cases showed more extensive lesions with bilateral and diffuse patterns of distribution in the older age group and with increased duration of presenting complaint. There was a significant association between crazy-paving pattern and increased duration of presenting complaint. No significant association could be detected between any CT pattern and increased patient age.