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2020 ; 30
(11
): 6129-6138
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English Wikipedia
CT in coronavirus disease 2019 (COVID-19): a systematic review of chest CT
findings in 4410 adult patients
#MMPMID32474632
Ojha V
; Mani A
; Pandey NN
; Sharma S
; Kumar S
Eur Radiol
2020[Nov]; 30
(11
): 6129-6138
PMID32474632
show ga
OBJECTIVE: The objective of this systematic review was to evaluate the key
imaging manifestations of COVID-19 on chest CT in adult patients by providing a
comprehensive review of the published literature. METHODS: We performed a
systematic literature search from the PubMed, Google Scholar, Embase, and WHO
databases for studies mentioning the chest CT imaging findings of adult COVID-19
patients. RESULTS: A total of 45 studies comprising 4410 patients were included.
Ground glass opacities (GGO), in isolation (50.2%) or coexisting with
consolidations (44.2%), were the most common lesions. Distribution of GGOs was
most commonly bilateral, peripheral/subpleural, and posterior with predilection
for lower lobes. Common ancillary findings included pulmonary vascular
enlargement (64%), intralobular septal thickening (60%), adjacent pleural
thickening (41.7%), air bronchograms (41.2%), subpleural lines, crazy paving,
bronchus distortion, bronchiectasis, and interlobular septal thickening. CT in
early follow-up period generally showed an increase in size, number, and density
of GGOs, with progression into mixed areas of GGOs plus consolidations and crazy
paving, peaking at 10-11 days, before gradually resolving or persisting as patchy
fibrosis. While younger adults more commonly had GGOs, extensive/multilobar
involvement with consolidations was prevalent in the older population and those
with severe disease. CONCLUSION: This review describes the imaging features for
diagnosis, stratification, and follow-up of COVID-19 patients. The most common CT
manifestations are bilateral, peripheral/subpleural, posterior GGOs with or
without consolidations with a lower lobe predominance. It is pertinent to be
familiar with the various imaging findings to positively impact the management of
these patients. KEY POINTS: ? Ground glass opacities (GGOs), whether isolated or
coexisting with consolidations, in bilateral and subpleural distribution, are the
most prevalent chest CT findings in adult COVID-19 patients. ? Follow-up CT shows
a progression of GGOs into a mixed pattern, reaching a peak at 10-11 days, before
gradually resolving or persisting as patchy fibrosis. ? Younger people tend to
have more GGOs. Older or sicker people tend to have more extensive involvement
with consolidations.