CT imaging features of 4121 patients with COVID-19: A meta-analysis

J Med Virol. 2020 Jul;92(7):891-902. doi: 10.1002/jmv.25910. Epub 2020 Apr 29.

Abstract

Objective: We systematically reviewed the computed tomography (CT) imaging features of coronavirus disease 2019 (COVID-19) to provide reference for clinical practice.

Methods: Our article comprehensively searched PubMed, FMRS, EMbase, CNKI, WanFang databases, and VIP databases to collect literatures about the CT imaging features of COVID-19 from 1 January to 16 March 2020. Three reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies, and then, this meta-analysis was performed by using Stata12.0 software.

Results: A total of 34 retrospective studies involving a total of 4121 patients with COVID-19 were included. The results of the meta-analysis showed that most patients presented bilateral lung involvement (73.8%, 95% confidence interval [CI]: 65.9%-81.1%) or multilobar involvement (67.3%, 95% CI: 54.8%-78.7%) and just little patients showed normal CT findings (8.4%). We found that the most common changes in lesion density were ground-glass opacities (68.1%, 95% CI: 56.9%-78.2%). Other changes in density included air bronchogram sign (44.7%), crazy-paving pattern (35.6%), and consolidation (32.0%). Patchy (40.3%), spider web sign (39.5%), cord-like (36.8%), and nodular (20.5%) were common lesion shapes in patients with COVID-19. Pleural thickening (27.1%) was found in some patients. Lymphadenopathy (5.4%) and pleural effusion (5.3%) were rare.

Conclusion: The lung lesions of patients with COVID-19 were mostly bilateral lungs or multilobar involved. The most common chest CT findings were patchy and ground-glass opacities. Some patients had air bronchogram, spider web sign, and cord-like. Lymphadenopathy and pleural effusion were rare.

Keywords: computed tomography; coronavirus disease 2019; imaging features; meta-analysis; pneumonia; systematical review.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Betacoronavirus / genetics
  • Betacoronavirus / pathogenicity*
  • Biomarkers / analysis
  • COVID-19
  • COVID-19 Testing
  • China / epidemiology
  • Clinical Laboratory Techniques / methods*
  • Coronavirus Infections / complications
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / diagnostic imaging*
  • Coronavirus Infections / epidemiology
  • Humans
  • Lung / diagnostic imaging
  • Lung / pathology
  • Lymphadenopathy / complications
  • Lymphadenopathy / diagnostic imaging*
  • Lymphadenopathy / epidemiology
  • Pandemics*
  • Pleural Effusion / complications
  • Pleural Effusion / diagnostic imaging*
  • Pleural Effusion / epidemiology
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / diagnostic imaging*
  • Pneumonia, Viral / epidemiology
  • Retrospective Studies
  • SARS-CoV-2
  • Severity of Illness Index
  • Tomography, X-Ray Computed

Substances

  • Biomarkers