Chest CT Features of Coronavirus Disease-19 (COVID-19) Pneumonia: Which Findings on Initial CT can Predict an Adverse Short-term Outcome?

Abstract

Abstract Background COVID-19 is a highly contagious viral disease that caused daunting challenges to the health care system; early diagnosis plays a pivotal role in management and prognosis of the disease. Aim of the Work To study the spectrum of chest CT features in coronavirus disease-19 (COVID- 19) pneumonia and to identify the initial CT findings that may have the potential to predict a poor short-term outcome. Patients and Methods This was a retrospective study that included 60 patients (30 clinically improved and 30 clinically deteriorated patients) with RT-PCR confirmed COVID-19 infection who referred to the Radiodiagnosis Department at Ain Shams University Hospitals for chest HRCT examination. An acceptance from the ethical committee of the Radiology Department and the ethical committee of Faculty of Medicine - Ain Shams University was obtained to use the data stored on PACs system with the patient’s consent waived being a retrospective study. Results Shortness of breath, fatigue and presence of other comorbidities were more common in unstable group, seen in 93%, 86% and 66% respectively. CT severity score was higher in unstable group ranging from 12 to 26 together with anteroposterior distribution, central and peripheral distribution, crazy paving and consolidation with air bronchogram. Conclusion Comparison between clinically stable and unstable COVID-19 patients regarding clinical data at admission and initial CT chest findings revealed that higher percentage of total lung affection, central and peripheral involvement, anteroposterior distribution, crazy paving, consolidation with air bronchogram and vessel enlargement were the harbingers of poor prognosis especially in patients of old age, having other comorbidities and presented with shortness of breath.