Abstract
This study aimed to compare the chest computed tomography (CT) findings between survivors and non-survivors with Coronavirus Disease 2019 (COVID-19). Between 12 January 2020 and 20 February 2020, the records of 124 consecutive patients diagnosed with COVID-19 were retrospectively reviewed and divided into survivor (83/124) and non-survivor (41/124) groups. Chest CT findings were qualitatively compared on admission and serial chest CT scans were semi-quantitively evaluated between two groups using curve estimations. On admission, significantly more bilateral (97.6% vs. 73.5%, p = 0.001) and diffuse lesions (39.0% vs. 8.4%, p < 0.001) with higher total CT score (median 10 vs. 4, p < 0.001) were observed in non-survivor group compared with survivor group. Besides, crazy-paving pattern was more predominant in non-survivor group than survivor group (39.0% vs. 12.0%, p < 0.001). From the prediction of curve estimation, in survivor group total CT score increased in the first 20 days reaching a peak of 6 points and then gradually decreased for more than other 40 days (R2 = 0.545, p < 0.001). In non-survivor group, total CT score rapidly increased over 10 points in the first 10 days and gradually increased afterwards until ARDS occurred with following death events (R2 = 0.711, p < 0.001). In conclusion, persistent progression with predominant crazy-paving pattern was the major manifestation of COVID-19 in non-survivors. Understanding this CT feature could help the clinical physician to predict the prognosis of the patients.
Highlights
Previous studies suggested a typical time course of computed tomography (CT) findings in survivors with COVID-19, in which initial progression was followed by recovery, the latter starting after about 2 weeks[15,16,17]
All non-survivors aggravated to acute respiratory distress syndrome (ARDS) after a median of 11 days (8–14 days) from symptom onset, while only one patient aggravated to ARDS in survivor group
This study compared the temporal changes in CT manifestations between survivors and non-survivors with COVID-19
Summary
Recent data suggest a higher transmission capability of this virus than the previously reported coronaviruses[3,6]. The clinical characteristics and laboratory findings of COVID-19 patients have been reported including non-specific fever and cough symptoms and lymphopenia[2,4,7,8,9]. In Hubei province, the centre of the outbreak in China, the clinical diagnostic criteria were only dependent on chest CT scan, instead of the RT-PCR test before 19 February 2 02014. Previous studies suggested a typical time course of CT findings in survivors with COVID-19, in which initial progression was followed by recovery, the latter starting after about 2 weeks[15,16,17].
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