Abstract
PurposeCT findings of hospitalized COVID-19 patients were analyzed during both the first and the second waves of the pandemic, in order to detect any significant differences between the two groups.MethodsIn this observational, retrospective, monocentric study, all hospitalized patients who underwent CT for suspected COVID-19 pneumonia from February 27 to March 27, 2020 (first wave) and from October 26 to November 24, 2020 (second wave) were enrolled. Epidemiological data, radiological pattern according to the RSNA consensus statement and visual score extension using a semi-quantitative score were compared.ResultsTwo hundred and eleven patients (mean age, 64.52 years ± 15.14, 144 males) were evaluated during the first wave while 455 patients (mean age, 68.26 years ± 16.34, 283 males) were studied during the second wave. The same prevalence of patterns was documented in both the first and the second waves (p = 0.916), with non-typical patterns always more frequently observed in elderly patients, especially the “indeterminate” pattern. Compared to those infected during the first wave, the patients of the second wave were older (64.52 vs.68.26, p = 0.005) and presented a slightly higher mean semi-quantitative score (9.0 ± 2.88 vs. 8.4 ± 3.06, p = 0.042). Age and semi-quantitative score showed a positive correlation (r = 0.15, p = 0.001).ConclusionsThere was no difference regarding CT pattern prevalence between the first and the second waves, confirming both the validity of the RSNA consensus and the most frequent radiological COVID-19 features. Non-typical COVID-19 features were more frequently observed in older patients, thus should not be underestimated in the elderly population.
Highlights
These hypotheses have been supported by a recent Italian study [4] in which it was demonstrated that the patients who died during this period (June–August 2020) were older, had more comorbidies and had a higher probability of superinfections compared to those infected during the first wave of the pandemic, suggesting that, during the summer, those most affected were the more fragile subject of the population
At the end of March 2020, shortly after the dramatic worldwide spread of COVID-19, the Radiological Society of North America (RSNA) provided a consensus statement on reporting CT findings related to COVID-19 pneumonia, aimed to speed up and standardize its diagnostic suspicion [7]
The present study demonstrated that there was no statistically significant difference regarding CT pattern prevalence between the first and the second waves in Italy
Summary
These hypotheses have been supported by a recent Italian study [4] in which it was demonstrated that the patients who died during this period (June–August 2020) were older, had more comorbidies and had a higher probability of superinfections compared to those infected during the first wave of the pandemic, suggesting that, during the summer, those most affected were the more fragile subject of the population. At the end of March 2020, shortly after the dramatic worldwide spread of COVID-19, the Radiological Society of North America (RSNA) provided a consensus statement on reporting CT findings related to COVID-19 pneumonia, aimed to speed up and standardize its diagnostic suspicion [7] This consensus statement turned out to be accurate in clinical trials, with a positive predictive value of “typical” pattern of up to 87.8% in an epidemic setting [8]
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