Subscribe to RSS
DOI: 10.4103/ijri.IJRI_367_20
CT chest analysis of 2019 novel coronavirus pneumonia: An Indian perspective
Financial support and sponsorship Nil.Abstract
Context: Since its outbreak, the COVID-19 pneumonia pandemic is rapidly spreading across India; although computed tomography of chest (CT chest) is not recommended as a screening tool, there is a rapid surge in the CT chest performed in suspected cases. We should be aware of the imaging features among the Indian population. Aim: To analyze the CT chest features in Indian COVID-19 patients. Settings and Design: Retrospective study. Subjects and Methods: CT chest of 31 polymerase chain reaction (PCR) verified patients of COVID-19 was assessed for ground-glass opacities (GGO), consolidations, bronchiectasis, pleural effusions, vascular enlargement, crazy paving, and reverse halo sign. Statistical Analysis Used: The data was analyzed in Microsoft Excel 2019. Results: Only one patient showed a normal scan. Multilobar involvements with parenchymal abnormalities were seen in all the patients with bilateral involvement in 74.1%. 42.5% of the lung parenchymal abnormalities were pure GGOs, while 41.6% had GGOs mixed with consolidation. Peripheral and posterior lung field involvement was seen in 70.5% and 65.5%, respectively; 56.8% had well-defined margins. Pure GGOs were seen in all six patients, who underwent CT in the first 2 days of onset of symptoms. Seventeen patients scanned between 3 and 6 days of the illness showed GGOs mixed with consolidation and pure consolidations 76%. Vascular enlargement, crazy paving, and reverse halo sign were seen in 70%, 53%, and 35% of the patients, respectively. Patients scanned after 1 week of symptoms showed traction bronchiectasis along with GGOs and or consolidations. Conclusions: COVID-19 pneumonia showed multifocal predominantly subpleural basal posteriorly located GGOs and/or consolidations which were predominantly well defined. “Crazy paving” was prevailing in the intermediate stage while early traction bronchiectasis among the patients presented later in the course of illness.
Publication History
Received: 13 May 2020
Accepted: 08 July 2020
Article published online:
13 July 2021
© 2021. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India
-
References
- 1 Zhu N, Zhang D, Wang W, Li X, Yang B, Song J. et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020; 382: 727-33
- 2 Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed 2020; 91: 157-60
- 3 Update on Novel Coronavirus: One positive case reported in Kerala [Internet]. Available from: pib.gov.in/Pressreleaseshare.aspx?PRID=1601095. [Last cited on 2020 Apr 04].
- 4 Dai W, Zhang H, Yu J, Xu H, Chen H, Luo S. et al. CT imaging and differential diagnosis of COVID-19. Can Assoc Radiol J 2020; 71: 195-200
- 5 Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J. et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020; 323: 1061-9
- 6 Zhao W, Zhong Z, Xie X, Yu Q, Liu J. Relation between chest CT findings and clinical conditions of coronavirus disease (COVID-19) pneumonia: A multicenter study. AJR Am J Roentgenol 2020; 214: 1072-77
- 7 Patel A, Jernigan DB. 2019-nCoV CDC Response Team. Initial Public Health Response and Interim Clinical Guidance for the 2019 novel coronavirus outbreak - United States, December 31, 2019-February 4, 2020. MMWR Morb Mortal Wkly Rep 2020; 69: 140-46
- 8 Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W. et al. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: A report of 1014 cases. Radiology 2020:200642. doi: 10.1148/radiol.2020200642.
- 9 Bernheim A, Mei X, Huang M, Yang Y, Fayad ZA, Zhang N. et al. Chest CT findings in coronavirus disease-19 (COVID-19): Relationship to duration of infection. Radiology 2020; 295: 200463 DOI: 10.1148/radiol.2020200463.
- 10 Song F, Shi N, Shan F, Zhang Z, Shen J, Lu H. et al. Emerging 2019 novel coronavirus (2019-nCoV) pneumonia. Radiology 2020; 295: 210-7
- 11 Yoon SH, Lee KH, Kim JY, Lee YK, Ko H, Kim KH. et al. Chest radiographic and CT findings of the 2019 novel coronavirus disease (COVID-19): Analysis of nine patients treated in Korea. Korean J Radiol 2020; 21: 494-500
- 12 Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus disease 2019 (COVID-19): A systematic review of imaging findings in 919 patients. AJR Am J Roentgenol 2020; 215: 87-93
- 13 Kohli A. Can imaging impact the coronavirus pandemic?. Indian J Radiol Imaging 2020; 30: 1-3
- 14 Fang Y, Zhang H, Xie J, Lin M, Ying L, Pang P. et al. Sensitivity of chest CT for COVID-19: Comparison to RT-PCR. Radiology 2020;200432.
- 15 Long C, Xu H, Shen Q, Zhang X, Fan B, Wang C. et al. Diagnosis of the Coronavirus disease (COVID-19): rRT-PCR or CT?. Eur J Radiol 2020; 126: 108961
- 16 Paul NS, Roberts H, Butany J, Chung T, Gold W, Mehta S. et al. Radiologic pattern of disease in patients with severe acute respiratory syndrome: The Toronto experience. Radiographics 2004; 24: 553-63
- 17 Das KM, Lee EY, Langer RD, Larsson SG. Middle East respiratory syndrome coronavirus: What does a radiologist need to know?. AJR Am J Roentgenol 2016; 206: 1193-201
- 18 Chung M, Bernheim A, Mei X, Zhang N, Huang M, Zeng X. et al. CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology 2020; 295: 202-7
- 19 Kong W, Agarwal PP. Chest imaging appearance of COVID-19 infection. Radiol Cardiothorac Imaging 2020; 2: e200028
- 20 Han R, Huang L, Jiang H, Dong J, Peng H, Zhang D. Early clinical and CT manifestations of coronavirus disease 2019 (COVID-19) pneumonia. AJR Am J Roentgenol 2020;1-6. doi: 10.2214/AJR.20.22961.