Abstract
As a pandemic, a most-common pattern resembled organizing pneumonia (OP) has been identified by CT findings in novel coronavirus disease (COVID-19). We aimed to delineate the evolution of CT findings and outcome in OP of COVID-19. 106 COVID-19 patients with OP based on CT findings were retrospectively included and categorized into non-severe (mild/common) and severe (severe/critical) groups. CT features including lobar distribution, presence of ground glass opacities (GGO), consolidation, linear opacities and total severity CT score were evaluated at three time intervals from symptom-onset to CT scan (day 0-7, day 8-14, day > 14). Discharge or adverse outcome (admission to ICU or death), and pulmonary sequelae (complete absorption or lesion residuals) on CT after discharge were analyzed based on the CT features at different time interval. 79 (74.5%) patients were non-severe and 103 (97.2%) were discharged at median day 25 (range, day 8-50) after symptom-onset. Of 67 patients with revisit CT at 2-4 weeks after discharge, 20 (29.9%) had complete absorption of lesions at median day 38 (range, day 30-53) after symptom-onset. Significant differences between complete absorption and residuals groups were found in percentages of consolidation (1.5% vs. 13.8%, P = 0.010), number of involved lobe > 3 (40.0% vs. 72.5%, P = 0.030), CT score > 4 (20.0% vs. 65.0%, P = 0.010) at day 8-14. Most OP cases had good prognosis. Approximately one-third of cases had complete absorption of lesions during 1-2 months after symptom-onset while those with increased frequency of consolidation, number of involved lobe > 3, and CT score > 4 at week 2 after symptom-onset may indicate lesion residuals on CT.
Highlights
Since late December 2019, the ongoing outbreak of Coronavirus Disease 2019 (COVID-19) related pneumonia, caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; previously known as 2019-nCoV), has rapidly expanded throughout worldwide [1,2,3]
It is noting that the most common findings on chest computed tomography (CT), i.e. peripheral ground glass opacity (GGO), consolidation or both predominantly in bilateral and multifocal distributions highly resembled to a CT pattern of organizing pneumonia (OP) [5, 6]
As a common lung injury, most cases of OP were demonstrated to have a good prognosis, while permanent damage and interstitial fibrosis were still observed in scare severe cases [7]
Summary
Since late December 2019, the ongoing outbreak of Coronavirus Disease 2019 (COVID-19) related pneumonia, caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; previously known as 2019-nCoV), has rapidly expanded throughout worldwide [1,2,3]. It is noting that the most common findings on chest computed tomography (CT), i.e. peripheral ground glass opacity (GGO), consolidation or both predominantly in bilateral and multifocal distributions highly resembled to a CT pattern of organizing pneumonia (OP) [5, 6]. Prognosis of OP pattern in COVID-19 including radiological outcome and disease course relating to resolution of pulmonary lesions remains currently unclear. A most-common pattern resembled organizing pneumonia (OP) has been identified by CT findings in novel coronavirus disease (COVID-19). We aimed to delineate the evolution of CT findings and outcome in OP of COVID-19
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