How to differentiate COVID-19 pneumonia from heart failure with computed tomography at initial medical contact during epidemic period

Zhaowei Zhu; Jianjun Tang; Xiangping Chai; Zhenfei Fang; Qiming Liu; Xinqun Hu; Danyan Xu; Jia He; Liang Tang; Shi Tai; Yuzhi Wu; Shenghua Zhou

of the two kinds of diseases were significantly different. Heart failure were more likely to have a central and gravity associated gradient distribution, while COVID-19 usually have more peripheral distribution. Importantly, there are more lesions with rounded morphology in COVID-19 than that in heart failure. In detail, although both diseases have septal thickening, heart failure usually has more peribronchovascular thickening and interlobular septal even fissural thickening. While COVID-19 usually affected the smaller septum. This may be attributed to the different severity of the 2 disease at the beginning, which means heart failure may progress more rapidly at first. COVID-19 usually progresses with different imaging features at different stages last for about 2-3 weeks (7). At first GGO is the predominant feature and gradually spread and consolidated, at last stage, the consolidation will be absorbed. This study was just focus on the initial medical contact, and the CT imaging showed here were almost belong to the early stage. So predominated GGO and some consolidation were most popular in COVID-19. Although fibrous lesions rare reported by now, 3 cases with COVID-19 were found with such lesions in this study, which is still consistent with current research (8) . Interestingly, the CT imaging characteristics of both diseases may be mixed in one patient with heart failure and COVID-19, or the features of COVID-19 at initial medical contact will be covered by more progressively heart failure. So it should be more careful to contact with a patient with heart failure in epidemic area. author/funder, who has granted medRxiv a license to display the preprint in perpetuity.