Computed Tomographic Features and Short-term Prognosis of Coronavirus Disease 2019 (COVID-19) Pneumonia: A Single-Center Study from Kashan, Iran

Tabatabaei, Seyed Mohammad Hossein; Talari, Hamidreza; Moghaddas, Fahimeh; Rajebi, Hamid

BACKGROUND: Radiologists play a pivotal role in the era of COVID-19 pneumonia although our knowledge of the imaging features is expeditiously evolving. PURPOSE: We assessed the CT chest features of confirmed cases from Iran, the first published report from the country. We hypothesized that certain CT features may have short-term prognostic value. MATERIALS AND METHODS: 120 consecutive symptomatic cases of COVID-19 infection who had undergone chest CT were enrolled in this retrospective study. Patients were categorized into three groups; routine inward hospitalization, ICU admission and expired based on a short-term follow-up. Detailed initial CT features and distributional evaluation were recorded. RESULTS: The mean age in the expired group was 70.7, significantly higher than the other two groups (p-value <0.05). Ninety-four percent (113/120) of the cases had ground-glass opacities (GGO). There was peripheral and lower zone predilection in majority of cases. Subpleural sparing and pleural effusion were seen in approximately twenty-three percent (28/120) and seventeen percent (20/120) of the cases respectively. The combined ICU group and expired cases had significantly more consolidation, air-bronchograms, crazy paving and central involvement of the lungs when compared to routinely hospitalized patients (all p-values < 0.05). CONCLUSION: Our study supports the previously described typical CT appearance of COVID-2019 pneumonia with bilateral GGO, in peripheral distribution and lower lung zone predilection. Subpleural sparing and pleural effusion were seen approximately in one-fifth and one-sixth of our COVID-19 cases respectively. Consolidation, air-bronchograms, central lung involvement, crazy paving and pleural effusion on initial CT chest have potential prognostic values, the features more commonly observed in critically ill patients.