Emerging 2019 Novel Coronavirus (2019-nCoV) Pneumonia

Radiology. 2020 Apr;295(1):210-217. doi: 10.1148/radiol.2020200274. Epub 2020 Feb 6.

Abstract

BackgroundThe chest CT findings of patients with 2019 Novel Coronavirus (2019-nCoV) pneumonia have not previously been described in detail.PurposeTo investigate the clinical, laboratory, and imaging findings of emerging 2019-nCoV pneumonia in humans.Materials and MethodsFifty-one patients (25 men and 26 women; age range 16-76 years) with laboratory-confirmed 2019-nCoV infection by using real-time reverse transcription polymerase chain reaction underwent thin-section CT. The imaging findings, clinical data, and laboratory data were evaluated.ResultsFifty of 51 patients (98%) had a history of contact with individuals from the endemic center in Wuhan, China. Fever (49 of 51, 96%) and cough (24 of 51, 47%) were the most common symptoms. Most patients had a normal white blood cell count (37 of 51, 73%), neutrophil count (44 of 51, 86%), and either normal (17 of 51, 35%) or reduced (33 of 51, 65%) lymphocyte count. CT images showed pure ground-glass opacity (GGO) in 39 of 51 (77%) patients and GGO with reticular and/or interlobular septal thickening in 38 of 51 (75%) patients. GGO with consolidation was present in 30 of 51 (59%) patients, and pure consolidation was present in 28 of 51 (55%) patients. Forty-four of 51 (86%) patients had bilateral lung involvement, while 41 of 51 (80%) involved the posterior part of the lungs and 44 of 51 (86%) were peripheral. There were more consolidated lung lesions in patients 5 days or more from disease onset to CT scan versus 4 days or fewer (431 of 712 lesions vs 129 of 612 lesions; P < .001). Patients older than 50 years had more consolidated lung lesions than did those aged 50 years or younger (212 of 470 vs 198 of 854; P < .001). Follow-up CT in 13 patients showed improvement in seven (54%) patients and progression in four (31%) patients.ConclusionPatients with fever and/or cough and with conspicuous ground-glass opacity lesions in the peripheral and posterior lungs on CT images, combined with normal or decreased white blood cells and a history of epidemic exposure, are highly suspected of having 2019 Novel Coronavirus (2019-nCoV) pneumonia.© RSNA, 2020.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Betacoronavirus / isolation & purification*
  • COVID-19
  • COVID-19 Testing
  • China / epidemiology
  • Clinical Laboratory Techniques
  • Coronavirus Infections / complications
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / diagnostic imaging*
  • Coronavirus Infections / pathology
  • Cough / etiology
  • Female
  • Fever / etiology
  • Humans
  • Leukocyte Count
  • Lung / diagnostic imaging*
  • Lung / pathology
  • Male
  • Middle Aged
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / diagnostic imaging*
  • Pneumonia, Viral / pathology
  • Real-Time Polymerase Chain Reaction
  • Retrospective Studies
  • SARS-CoV-2
  • Tomography, X-Ray Computed*
  • Young Adult