Preliminary investigation of relationship between clinical indicators and CT manifestation patterns of COVID-19 pneumonia improvement

Nannan Shi; Fengxiang Song; Fengjun Liu; Pengrui Song; Yang Lu; Qinguo Hou; Xinyan Hua; Yun Ling; Jiulong Zhang; Chao Huang; Lei Shi; Zhiyong Zhang; Fei Shan; Qi Zhang; Yuxin Shi

doi:10.21037/jtd-20-1420

Preliminary investigation of relationship between clinical indicators and CT manifestation patterns of COVID-19 pneumonia improvement

J Thorac Dis. 2020 Oct;12(10):5896-5905. doi: 10.21037/jtd-20-1420.

Authors

Nannan Shi¹, Fengxiang Song¹, Fengjun Liu¹, Pengrui Song¹, Yang Lu¹, Qinguo Hou¹, Xinyan Hua¹, Yun Ling², Jiulong Zhang¹, Chao Huang^{3

4}, Lei Shi^{3

4

5}, Zhiyong Zhang⁶, Fei Shan¹, Qi Zhang^{3

5

7}, Yuxin Shi^{1

8}

Affiliations

¹ Department of Radiology, Shanghai Public Health Clinical Center, Shanghai, China.
² Department of Infectious Disease, Shanghai Public Health Clinical Center, Shanghai, China.
³ Shanghai Key Laboratory of Artificial Intelligence for Medical Image and Knowledge Graph, Shanghai, China.
⁴ Hangzhou YITU Healthcare Technology Co., Ltd., Hangzhou, China.
⁵ Shanghai Yizhi Healthcare Technology Co., Ltd., Shanghai, China.
⁶ Fudan University, Shanghai, China.
⁷ The SMART (Smart Medicine and AI-based Radiology Technology) Lab, School of Communication and Information Engineering, Shanghai University, Shanghai, China.
⁸ Shanghai Key Laboratory of Molecular Imaging, Shanghai, China.

Abstract

Background: To retrospectively evaluate several clinical indicators related to the improvement of COVID-19 pneumonia on CT.

Methods: A total of 62 patients with COVID-19 pneumonia were included. The CT scores based on lesion patterns and distributions in serial CT were investigated. The improvement and deterioration of pneumonia was assessed based on the changes of CT scores. Grouped by using the temperature, serum lymphocytes and high sensitivity CRP (hs-CRP) on admission respectively, the CT scores on admission, at peak time and at discharge were evaluated. Correlation analysis was carried out between the time to onset of pneumonia resolution on CT images and the recovery time of temperature, negative conversion of viral nucleic acid, serum lymphocytes and hs-CRP.

Results: The CT scores of the fever group and lymphopenia group were significantly higher than those of normal group on admission, at peak time and at discharge; and the CT scores of normal hs-CRP group were significantly lower than those of the elevated hs-CRP group at peak time and at discharge (P all<0.05). The time to onset of pneumonia resolution on CT image was moderately correlated with negative conversion duration of viral nucleic acid (r =0.501, P<0.05) and the recovery time of hs-CPR (r =0.496, P<0.05).

Conclusions: COVID-19 pneumonia patients with no fever, normal lymphocytes and hs-CRP had mild lesions on admission, and presented with more absorption and fewer pulmonary lesions on discharge. The negative conversion duration of viral nucleic acid and the recovery time of hs-CPR may be the indicator of the pneumonia resolution.

Keywords: Coronavirus Disease 2019 (COVID-19); computed tomography; pneumonia improvement.