CT Manifestations of Two Cases of 2019 Novel Coronavirus (2019-nCoV) Pneumonia (2020/02/07)

We report two cases of 2019 novel coronavirus (2019-nCoV). Both patients are believed to have exposure related to Wuhan, China (14). We demonstrate change in the course of disease over time on CT scan (56).

Case 1: A 45-year-old woman living in Wuhan, China, was admitted to the hospital for 2 days due to cough and fever. On admission, her body temperature was elevated (38.2°C) and there were coarse breath sounds of both lungs at auscultation. Her laboratory studies showed: neutrophil ratio increased (81.2%,normal range 40.0%-75.0%), lymphocyte ratio decreased (12.8%, normal range 20.0%-50.0%), erythrocyte sedimentation rate was increased (24 mm/h, normal range < 20mm/h), D-dimer concentration was normal, Lymphokine IL-6 was increased (27.47 pg/ml, normal range 0.1-2.9 pg/ ml). Real-time fluorescence polymerase chain reaction of the patient’s sputum was positive for the 2019-nCoV nucleic acid. Unenhanced chest CT showed multiple bilateral areas of peripheral consolidation (Fig 1. A1-2). There was interlobular septal thickening with a crazy paving appearance and bronchiectasis. The adjacent pleura was thickened, without mediastinal lymphadenopathy or pleural fluid. Two days after admission, the patient’s temperature rose to 39.2°C and constitutional symptoms worsened. Repeat chest CT showed progressive consolidation with loss of the areas of crazy paving (Fig1. A3-4). After antiviral and symptomatic treatment, the patient remains under close observation with improvement in symptoms.

 

Author: Yicheng Fang, Huangqi Zhang, Yunyu Xu, et al.

Link: https://pubs.rsna.org/doi/10.1148/radiol.2020200280