Sporadic coronavirus and human metapneumovirus lower respiratory tract infection in adults: comparison of chest CT findings and correlation with clinical outcomes

Abstract

Coronavirus(CoV) and human metaneumovirus(hMPV) are worldwide causes of lower respiratory tract infection(LRTI) in adults. Chest CT is increasingly used in the diagnosis and management of LRTI. Our aims were to compare chest CT features for LRTI due to sporadic CoV with hMPV and correlate chest CT findings with clinical outcomes. We retrospectively reviewed records of 61 adults with nucleic acid amplification(NAA) assay positive for CoV and 104 adults positive for hMPV over 33 months at 4 community hospitals in the northeast US. A thoracic radiologist reviewed all chest CT images. Inclusion criteria included:1. symptoms of acute LRTI, 2.chest CT within 7 days of positive NAA assay, 3.no other pulmonary infection/lung disease that might interfere with chest CT interpretation. Ground-glass opacities(GGO) were more frequent (p<.05) with hMPV(47/104,45%) than with sporadic CoV(15/61,25%). Multifocal consolidation was more common (p<.05) with hMPV(31/104,30%) than with sporadic CoV(8/61,13%). LRTI without chest CT findings was more common (p<.05) with sporadic CoV (28/61,46%) than with hMPV (16/104,15%). For hMPV, multifocal consolidation was associated(p<.05) with treatment with assisted ventilation(9/30,30%). For hMPV, no other chest CT finding correlated with any studied outcome(new supplementary oxygen at discharge, discharge to skilled facility, hospital re-admission within 30 days). No chest CT finding correlated with any studied outcome for sporadic CoV. With hMPV, healthcare providers should be aware that multifocal consolidation on chest CT often portends treatment with invasive/non-invasive ventilatory support.