Distinguishing COVID-19 from influenza pneumonia in the early stage through CT imaging and clinical features

Zhiqi Yang; Daiying Lin; Xiaofeng Chen; Jinming Qiu; Shengkai Li; Ruibin Huang; Hongfu Sun; Yuting Liao; Jianning Xiao; Yanyan Tang; Guorui Liu; Renhua Wu; Xiangguang Chen; Zhuozhi Dai

The GGO in the periphery has become a recognized indicator of COVID-19 in the early stage (5, 16, 17) . In line with previous studies, we found that in the early stage of COVID-19, about 78% of patients had mixed GGO. However, this feature only ranked the third among the 26 extracted features for distinguishing COVID-19 from influenza. Crazy paving pattern, which also been reported in previous studies (3, 18, 19) , was considered to be the most powerful feature for the differential diagnosis. These two features were also reported in other coronavirus diseases, such as severe acute respiratory syndrome (SARS) and middle east respiratory syndrome (MERS) (20, 21) . The pathology of COVID-19 was confirmed to greatly resemble those of SARS and MERS (22, 23) . Tian et al. reported that the lungs of COVID-19 patients exhibited edema, proteinaceous exudate, focal reactive hyperplasia of pneumocytes with patchy inflammatory cellular infiltration, and multinucleated giant cells (24) , which can cause the thickening of interlobular septa, and represented as crazy paving pattern. Consistent with previous reports (25) , the pleural effusions are very rare in COVID-19 . CC-BY 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity.