M COVID

Initial Chest CT Findings in Patients with COVID-19

Allan S. Brett, MD reviewing Song F et al. Radiology 2020 Apr

This report provides a detailed account of initial computed tomographic abnormalities in 51 hospitalized patients.

Chest computed tomography (CT) will be performed in most hospitalized patients with COVID-19. In this report from a single hospital in Shanghai, China, researchers reviewed the key initial CT findings in 51 consecutive patients who were hospitalized with COVID-19. All patients had thin-section noncontrast scans. Mean age was 49 (range, 16–79), and median time from symptom onset to CT was 4 days.

Nearly all patients presented with extensive multifocal involvement; abnormalities were bilateral in 86% of cases. Lesions were particularly evident in the lower lobes, posterior lung fields, and peripheral lung zones. Three quarters of patients had ≥3 involved lobes. Various combinations of pure ground-glass opacities (GGOs), GGOs plus reticular or interlobular septal thickening, and GGOs plus consolidation were common. GGOs predominated in patients whose symptoms started ≤4 days before CT, and areas of consolidation became increasingly evident in those with >4 days of symptoms. Only four patients had pleural effusions.