Chest CT Findings on Admission of COVID-19 Pneumonia and Its Association with Disease Severity and Duration of Illness: A Retrospective Study

Abstract

RATIONALE: Coronavirus Disease 2019 (COVID-19) that has caused an ongoing pandemic, is diagnosed by realtime reverse transcriptase polymerase chain reaction (RT-PCR). Computed tomography (CT) scans have shown typical changes of the disease but there is limited data comparing CT scan findings with COVID-19 clinical severity and illness duration. The study aims to determine the common chest CT findings of COVID-19 pneumonia in association with clinical severity and duration of symptoms.METHODS: This is a single-center, retrospective study including all adult patients with COVID-19 pneumonia, admitted from March 2020 to August 2020, with baseline RT-PCR and chest CT scan. Demographic data and CT scan findings were tabulated and analyzed using STATA 13.1.RESULTS: In this study of 304 patients, majority were above 60 years old (49%), male(62%), non-smokers (72.6%) with associated hypertension(56%) and diabetes mellitus(34%). Most common symptoms were cough (82%), dyspnea (76%) and fever (69%). Predominant chest CT patterns of COVID-19 pneumonia were ground glass opacity (GGO) (65%) and consolidation (39%) in bilateral, peripheral, and lower lobe distribution. Moderate group had higher GGO (72%, p0.047), unilateral (10%,p0.001) and peripheral distribution (68%,p0.001). Severe to critical groups had higher consolidation, number of lobes (>4 lobes), and diffuse involvement. Subjects with less than 14 days of symptoms, had more GGO. Those with more than 4 days of symptoms, had CT findings that were bilateral, more than 4 lobes, and extending to middle and upper lobes.CONCLUSION: Chest CT patterns typical of COVID-19 pneumonia and their extent of involvement were associated with clinical severity and illness duration. A simple Chest CT scan would help support physicians' decision making and prognostication.