Chest CT findings of COVID-19 pneumonia by duration of symptoms

Eur J Radiol. 2020 Jun;127:109009. doi: 10.1016/j.ejrad.2020.109009. Epub 2020 Apr 18.


Purpose: To evaluate lung abnormalities on thin-section computed tomographic (CT) scans in patients with COVID-19 and correlate findings to duration of symptoms.

Methods: In total, 348 CT scans in 112 patients were classified according to the time after the onset of the initial symptoms, namely stage-1 (0-4 days); stage-2 (5-9 days); stage-3 (10-14 days); stage-4 (15-21 days); stage-5 (22-28 days); and stage-6 (>28 days). Each lung lobe was evaluated for extent affected by ground-glass opacities (GGO), crazy-paving pattern and consolidation, in five categories of percentual severity. Summation of scores from all five lung lobes provided the total CT score (maximal CT score, 25).

Results: The predominant patterns of lung abnormalities were GGOs, crazy-paving pattern, consolidation and linear opacities. The frequency of crazy-paving pattern, consolidation and linear opacities peaked at stage-3 (62.7 %), stage-4 (75.0 %) and stage-5 (83.1 %), respectively, and decreased thereafter. Total CT scores increased from stage-1 to stage-2 (2.8 ± 3.1, vs. 6.5 ± 4.6, respectively, P < 0.01), and thereafter remained high. The lower lobes were more inclined to be involved with higher CT scores except for stage-1. At stage-6 98.1 % of CT scans still showed abnormalities (CT score 7.5 ± 4.1).

Conclusion: Thin-section CT could provide semi-quantitative analysis of pulmonary damage severity. This disease changed rapidly at the early stage, then tended to be stable and lasted for a long time.

Keywords: COVID-19; Computed tomographic; Crazy-paving pattern; Ground-glass opacities.

MeSH terms

  • Adult
  • Aged
  • Betacoronavirus
  • COVID-19
  • Coronavirus Infections / diagnostic imaging*
  • Female
  • Humans
  • Lung / diagnostic imaging
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / diagnostic imaging*
  • SARS-CoV-2
  • Thorax
  • Tomography, X-Ray Computed*