Article ; Online: CT in coronavirus disease 2019 (COVID-19): a systematic review of chest CT findings in 4410 adult patients.
2020 Volume 30, Issue 11, Page(s) 6129–6138
Abstract: ... WHO databases for studies mentioning the chest CT imaging findings of adult COVID-19 patients.: Results ... prevalent chest CT findings in adult COVID-19 patients. • Follow-up CT shows a progression of GGOs ... of COVID-19 on chest CT in adult patients by providing a comprehensive review of the published literature ...
| Abstract | Objective: The objective of this systematic review was to evaluate the key imaging manifestations of COVID-19 on chest CT in adult patients by providing a comprehensive review of the published literature. Methods: We performed a systematic literature search from the PubMed, Google Scholar, Embase, and WHO databases for studies mentioning the chest CT imaging findings of adult COVID-19 patients. Results: A total of 45 studies comprising 4410 patients were included. Ground glass opacities (GGO), in isolation (50.2%) or coexisting with consolidations (44.2%), were the most common lesions. Distribution of GGOs was most commonly bilateral, peripheral/subpleural, and posterior with predilection for lower lobes. Common ancillary findings included pulmonary vascular enlargement (64%), intralobular septal thickening (60%), adjacent pleural thickening (41.7%), air bronchograms (41.2%), subpleural lines, crazy paving, bronchus distortion, bronchiectasis, and interlobular septal thickening. CT in early follow-up period generally showed an increase in size, number, and density of GGOs, with progression into mixed areas of GGOs plus consolidations and crazy paving, peaking at 10-11 days, before gradually resolving or persisting as patchy fibrosis. While younger adults more commonly had GGOs, extensive/multilobar involvement with consolidations was prevalent in the older population and those with severe disease. Conclusion: This review describes the imaging features for diagnosis, stratification, and follow-up of COVID-19 patients. The most common CT manifestations are bilateral, peripheral/subpleural, posterior GGOs with or without consolidations with a lower lobe predominance. It is pertinent to be familiar with the various imaging findings to positively impact the management of these patients. Key points: • Ground glass opacities (GGOs), whether isolated or coexisting with consolidations, in bilateral and subpleural distribution, are the most prevalent chest CT findings in adult COVID-19 patients. • Follow-up CT shows a progression of GGOs into a mixed pattern, reaching a peak at 10-11 days, before gradually resolving or persisting as patchy fibrosis. • Younger people tend to have more GGOs. Older or sicker people tend to have more extensive involvement with consolidations. |
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| MeSH term(s) | Adult ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/diagnostic imaging ; Coronavirus Infections/pathology ; Coronavirus Infections/physiopathology ; Disease Progression ; Female ; Humans ; Lung/diagnostic imaging ; Lung/pathology ; Lung/physiopathology ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/diagnostic imaging ; Pneumonia, Viral/pathology ; Pneumonia, Viral/physiopathology ; SARS-CoV-2 ; Tomography, X-Ray Computed/methods ; Young Adult |
| Keywords | covid19 |
| Language | English |
| Publishing date | 2020-05-30 |
| Publishing country | Germany |
| Document type | Journal Article ; Systematic Review |
| ZDB-ID | 1085366-2 |
| ISSN | 1432-1084 ; 0938-7994 ; 1613-3749 |
| ISSN (online) | 1432-1084 |
| ISSN | 0938-7994 ; 1613-3749 |
| DOI | 10.1007/s00330-020-06975-7 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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