Temporal lung changes in high-resolution chest computed tomography for coronavirus disease 2019

J Int Med Res. 2020 Sep;48(9):300060520950990. doi: 10.1177/0300060520950990.

Abstract

Objective: To evaluate temporal lung changes in coronavirus disease 2019 (COVID-19) in high-resolution computed tomography (HRCT) and to determine the appropriate computed tomographic (CT) follow-up time.

Methods: Eighty-six patients with two or more HRCT scans who were diagnosed with COVID-19 were included. The CT score and major CT findings were evaluated.

Results: Eighty-two (95.3%) patients had lesions on the initial HRCT scans. Most scans showed bilateral, multifocal lung lesions, with multiple lobes involved and diffuse distribution. For fifty-seven patients with type I (progress compared with the initial CT score), the CT score reached a peak at 12 days and the nadir at 36 days. For twenty-nine patients with type II (no progress compared with the initial CT score), the lowest CT score was reached at 23 days. On the final HRCT scans (>21 days), patients with a reticular pattern were older than those without a reticular pattern.

Conclusion: The appropriate follow-up time of CT scans is during the second week (approximately 12 days) and the fourth to fifth weeks (approximately 23-36 days) from the onset of illness. These times could help reduce the CT radiation dose and show timely changes in the course of the disease by CT.

Keywords: Coronavirus disease 19; computed tomography; fever; lung lesion; pneumonia; radiation dose.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Betacoronavirus
  • COVID-19
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / diagnostic imaging*
  • Coronavirus Infections / pathology*
  • Disease Progression
  • Female
  • Humans
  • Lung / diagnostic imaging
  • Lung / pathology*
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / diagnostic imaging*
  • Pneumonia, Viral / pathology*
  • Radiation Dosage
  • SARS-CoV-2
  • Tomography, X-Ray Computed
  • Young Adult