Department of Thoracic Surgery, Chuiyangliu Hospital, Beijing, ChinaFulltext PDF
Purpose: Chest Computed Tomographic (CT) scans play an important part in diagnosing and treating novel Coronavirus Disease (COVID-19). However, studies on the long-time changes in chest CT are scarce. The present work aimed to assess those longitudinal alterations in COVID-19 from the chest CT images. Methods: COVID-19 cases were recruited into this work in a retrospective manner between January 30th, 2020 and March 20th, 2020, in the COVID-19 designated hospital, Chaoyang district, Beijing. Novel coronavirus nucleic acid test detected by RT-PCR was essential for diagnosis. For the discharged cases, two follow-up visits were performed at an interval of 2 weeks. The associations of chest CT characteristics and clinical factors with progression were examined. Results: Altogether, 16 confirmed COVID-19 cases (including 9 male and 7 female cases) were assessed, with the age ranging from 26 to 68 years. All patients had at least one clinical symptom. These symptoms include fever (15/16, 93.75%), sputum (10/16, 62.5%), fatigue (8/16, 50%), diarrhea (5/16, 31.25%), dyspnea (4/16, 25%), cough (2/16, 12.5%), chest pain (1/16, 6.25%), and vomiting (1/16, 6.25%). Pulmonary opacifications were observed in chest CT in almost all patients (15/16, 93.75%). There was one patient with normal imaging of CT. The lesions were unilateral pulmonary in three cases (one in right lower while two in right middle lobes) and bilateral pulmonary in 12 cases, observed in both lower lobes. The chest CT features included ground-glass opacities (15/15, 100%), consolidation (14/15, 93.33%), reticular pattern (12/15, 80%), subpleural linear opacity (11/15, 73.33%), bronchial dilatation (5/15, 33.33%), adjacent pleura thickening (4/15, 26.67%), and centrilobular nodular (3/15, 20%). All patients received antiviral (Arbidol Hydrochloride), antibacterial therapy (moxifloxacin), and traditional Chinese medicine. All patients were cured and discharged after symptoms were decreased, and the nucleic acid test for novel coronavirus was negative in at least two tests. Most of the lesions presented by the chest CT imaging were absorbed. However, nucleic acid test results of sputum and stool in two patients were consistently positive, even though the chest CT imaging lesions had been completely absorbed or showed fibrous cords. For cases who had negative results in two nucleic acid tests performed between 24 h, they were finally discharged home. For the discharged cases, the length of stay ranged from 11 to 45 (average, 24 ? 12) days and were followed up for four weeks (once every two weeks). The mean interval between the initial symptoms to last chest CT examination ranged from 31 to 61 (average, 48 ? 9) days. Each case received 4 ? 1 CT scans on average (range, 3 to 6). No abnormal changes in chest CT were observed in one patient from admission to the end of follow-up. In 15 patients with imaging manifestations, chest CT was regularly reviewed during the observation period. Finally, seven patients had completely absorbed lung lesions, two patients presented as light ground glass shadow, one presented as line spline shadow, and five were accompanied by both light ground glass and line spline shadows. Conclusion: Chest CT may be adopted to help diagnose and treat COVID-19, but not to determine whether the patient is contagious or requires isolation. After long-term observation, regardless of the initial imaging findings, most pulmonary lesions could be well absorbed.
2019 novel coronavirus pneumonia; Infection; Imaging features; Computed tomography; Ground-glass opacity
Cui J. The Longitudinal Changes in the Chest CT in Novel Coronavirus Disease Pneumonia Patients. Clin Surg. 2021; 6: 3031..