Clinical and High-Resolution CT Features of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Pneumonia: Comparison of the Initial and Follow-Up Changes

Abstract

Background : To quantify severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia on High-Resolution CT and to determine its relationship with clinical parameters. Methods: From Jan 11, 2020, to Feb 5, 2020, the clinical, laboratory and HRCT features of 42 patients (26-75 years, 25 males) with SARS-CoV-2 pneumonia were analyzed. The initial and follow-up CT obtained a mean of 4.45 days and 11.64 days from the illness onset were retrospectively assessed for the severity and progression of pneumonia. Correlations among clinical parameters, initial CT features and progression of opacifications were evaluated with Spearman correlation and linear regression analysis. Findings: Thirty-five (83%) patients exhibited a progressive process according to CT features during the early stage from onset. Follow-up CT findings showed increasement in the severity of opacifications, consolidation, interstitial thickening, fibrous strips and air bronchogram, compared to initial CT (all p<0.05). Before regular treatments, there was a moderate correlation between the days from onset and sum score of opacifications (R=0.68, p<0.01). The C-reactive protein, erythrocyte sedimentation rate and lactate dehydrogenase showed significantly positive correlation with the severity of pneumonia assessed on initial CT (R range 0.36-0.75, p<0.05). The highest temperature and the severity of opacifications assessed on initial CT were significantly related to the progression of opacifications on follow-up CT (p=0.001-0.04). Interpretation: Patients with the SARS-CoV-2 pneumonia usually presented with typical ground-grass 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 illness onset. Funding Statement: This work was supported, in part, by the National Natural Science Foundation of China (grant numbers: 81730049, 81930045, 31630025 and 81601480) Declaration of Interests: All authors declare no competing interests. Ethics Approval Statement: Our institutional review board approved this retrospective study. Informed consent was not required as the study involved no potential risk to patients.