Clinical and High-Resolution CT Features of the COVID-19 Infection: Comparison of the Initial and Follow-up Changes

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ABSTRACT

Objectives:
In late December 2019, an outbreak of coronavirus disease (COVID-19) in Wuhan, China, was caused by the newly named severe acute respiratory syndrome coronavirus 2. The goal was to quantify the severity of COVID-19 infection. using high-resolution computed tomography (CT) of the chest and determine its relationship with clinical parameters.

Materials and methods:
From January 11, 2020 to February 5, 2020, clinical, laboratory, and high-resolution CT characteristics of 42 patients (26-75 years, 25 men) with COVID-19 were analyzed. Initial and follow-up CT scans averaged 4,5 days and 11,6 days from disease onset and were evaluated retrospectively to determine the severity and progression of pneumonia. Correlations between clinical parameters, baseline CT characteristics, and progression of opacifications were evaluated with Spearman correlation and linear regression analysis.

Results:

• Thirty-five patients (83%) showed a progressive process according to CT characteristics during the initial stage from baseline.
• Follow-up CT findings showed progressive opacifications, consolidation, interstitial thickening, fibrous strands, and air bronchograms, compared with baseline CT (all P < 0.05).
• Before regular treatments, there was a moderate correlation between days from onset and total opacifications score (R = 0.68, P < 0.01).
• C-reactive protein, erythrocyte sedimentation rate, and lactate dehydrogenase showed a significantly positive correlation with the severity of pneumonia assessed on initial CT (Range, 0,36-0,75; P < 0,05).
• Higher temperature and severity of opacifications assessed on initial CT were significantly related to progression of opacifications on follow-up CT (P = 0.001-0.04).

Conclusions:
Patients with COVID-19 infection generally presented with typical ground-glass opacities and other CT features, which showed significant correlations with some clinical and laboratory measurements. Follow-up CT images often demonstrated progressions during the early stage from disease onset.