Initial computed tomography features of known inpatient ward versus intensive care admission COVID-19 cases: is there any difference?

Year 2022, Volume: 8 Issue: 2, 181 - 190, 04.03.2022

Ozlem Unal , Ural Koç Erdem Özkan , İmran Hasanoğlu , Aziz Ahmet Surel Rahmet Güner

https://doi.org/10.18621/eurj.874193

Abstract

Objectives: The aim of this study was to evaluate initial computed tomography (CT), basic clinical and demographic features of cases with COVID-19 pneumonia with known inpatient ward and intensive care unit hospitalization.

Methods: A total of 200 cases (103 males, 97 females; age range: 18-92 years) were retrospectively and randomly collected whom were hospitalized and followed up at infectious disease inpatient ward and intensive care unit (ICU). The initial CT findings were interpreted by two radiologists at the same session by consensus.

Results: Cough (61%) and fever (54%) were the main symptoms at the onset presentation. Initial chest CT imaging revealed that 79.5% ground-glass opacities. Bilateral distribution (62.5%), peripheral and central distribution (45.5%), dorsal and ventral involvement (52.5%) were identified in all cases. CT features predominantly were at right and left lower lobes (69.5%, 62.5%; respectively). Cases with known ICU admission had statistically significant differences with inpatient ward admission cases in regards to CT features included mixed GGO and consolidation, bronchial wall thickening, pleural effusion, subpleural band, emphysema, coronary calcification, cardiothoracic ratio, aorta diameter.

Conclusions: Initial CT features may be helpful for foreseeing admission to ICU as in clinical features.

Keywords

COVID-19, CT, ICU, inpatient, features

References

• 1. World Health Organization website. Coronavirus disease 2019 (COVID-19) situation report-1. World Health Organization, Geneva. Available via https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200211-sitrep-22-ncov.pdf?sfvrsn=fb6d49b1_2. Accessed June 01 Jun 2020
• 2. World Health Organization website. Coronavirus disease 2019 (COVID-19) situation report-22. World Health Organization, Geneva. Available via https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200121-sitrep-1-2019-ncov.pdf?sfvrsn=20a99c10_4 . Accessed 01 Jun 2020
• 3. World Health Organization website. Coronavirus disease 2019 (COVID-19) situation report-51. World Health Organization, Geneva. Available via https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200311-sitrep-51-covid-19.pdf?sfvrsn=1ba62e57_10 . Accessed 01 Jun 2020
• 4. Coronavirus disease 2019 (COVID-19) Daily Reports. The Ministry of Health, Turkey. Available via https://covid19.saglik.gov.tr . Accessed 01 Jun 2020
• 5. World Health Organization website. Coronavirus disease 2019 (COVID-19) situation report-131. World Health Organization, Geneva. Available via https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200601-covid-19-sitrep-133.pdf?sfvrsn=9a56f2ac_4 . Accessed 01 Jun 2020
• 6. Huang P, Liu T, Huang L, Liu H, Lei M, Wangdong X, et al. Use of chest CT in combination with negative RT-PCR assay for the 2019 novel coronavirus but high clinical suspicion. Radiology 2020;295:22-3.
• 7. Xie X, Zhong Z, Zhao W, Zheng C, Wang F, Liu J. Chest CT for typical coronavirus disease 2019 (COVID-19) pneumonia: relationship to negative RT-PCR testing. Radiology 2020;296:E41-5.
• 8. Pan Y, Guan H, Zhou S, Wang Y, Li Q, Zhu T, et al. Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China. Eur Radiol 2020;30:3306-9.
• 9. Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, et al. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology 2020;296:E32-40.
• 10. CDC COVID-19 Resonse Team: Bialek S, Boundy E, Bowen V, Chow N, Cohn A, Dowling N, et al. Severe outcomes among patients with coronavirus disease 2019 (COVID‐19) - United States, February 12-March 16, 2020. MMWR Morb Mortal Wkly Rep 2020;69:343-6.
• 11. Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, et al. Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis. Int J Infect Dis 2020;94:91-5.
• 12. Wang Y, Dong C, Hu Y, Li C, Ren Q, Zhang X, et al. Temporal changes of CT findings in 90 patients with COVID-19 pneumonia: a longitudinal study. Radiology 2020;296:E55-64.
• 13. Hansell DM, Bankier AA, MacMahon H, McLoud TC, Müller NL, Remy J. Fleischner Society: glossary of terms for thoracic imaging. Radiology 2008;246:697-722.
• 14. Ojha V, Mani A, Pandey NN, Sharma S, Kumar S. CT in coronavirus disease 2019 (COVID-19): a systematic review of chest CT findings in 4410 adult patients. Eur Radiol 2020;30:6129-38.
• 15. Ajlan AM, Ahyad RA, Jamjoom LG, Alharthy A, Madani TA. Middle east respiratory syndrome coronavirus (MERS-CoV) infection: chest CT findings. AJR 2014; 203:778-82.
• 16. Zhao W, Zhong Z, Xie X, Yu Q, Liu J. Relation between chest CT findings and clinical conditions of coronavirus disease (COVID-19) pneumonia: a multicenter study AJR 2020;214:1072-7.
• 17. Xu B, Xing Y, Peng J, Zheng Z, Tang W, Sun Y, et al. Chest CT for detecting COVID-19:a systematic review and meta-analyis of diagnostic accuracy. Eur Radiol 2020;30:5720-7.
• 18. Wan S, Li M, Ye Z, Yang C, Cai Q, Duan S, et al. CT manifestations and clinical characteristics of 1115 patients with coronavirus disease 2019 (COVID-19): a systematic review and meta-analyis. Acad Radiol 2020;27:910-21.
• 19. Ufuk F, Savas R. Chest CT features of the novel coronavirus disease (COVID-19). Turk J Med Sci 2020;50:664-78.
• 20. Xu Z, Pan A, Zhou H. Rare CT feature in a COVID-19 patient: cavitation. Diagn Interv Radiol 2020;26:380-1.
• 21. Aydın S, Oz G, Dumanlı A, Balcı A, Gencer A. A case of spontaneous pneumothorax in COVID-19 pneumonia. J Surg Resh 2020;3:96-101.
• 22. Meng H, Xiong R, He R, Lin W, Hao B, Zhang L, et al. CT imaging and clinical course of asymptomatic cases with COVID-19 pneumonia at admission in Wuhan, China. J Infect 2020;81:e33-9.
• 23. Cinkooglu A, Hepdurgun C, Bayraktaroglu S, Ceylan N, Savas R. CT imaging features of COVID-19 pneumonia: initial experience from Turkey. Diagn Interv Radiol 2020;26:308-14.
• 24. Li K, Wu J, Wu F, Guo D, Chen L, Fang Z, et al. The clinical and chest CT features associated with severe and critical COVID-19 pneumonia. Invest Radiol 2020;55:327-31.
• 25. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395:1054-62.
• 26. Wang B, Li R, Lu Z, Huang Y. Does comorbidity increase the risk of patients with COVID-19:evidence from meta-analysis. Aging 2020;12:6049-57.
• 27. Liu F, Zhang Q, Huang C, Shi C, Wang L, Shi N, et al. CT quantification of pneumonia lesions in early days predicts progression to severe illness in a cohort of COVID-19 patients. Theranostics 2020;10:5613:22.