Emerging Coronavirus 2019-nCoV Pneumonia (2020/02/06)

Background

The chest CT findings of patients with coronavirus 2019-nCoV pneumonia have not previously been described in detail.

 

Purpose

To investigate the clinical, laboratory, and imaging findings of emerging coronavirus 2019-nCoV pneumonia in humans.

 

Materials and Methods

Fifty-one patients (25 men and 26 women, 16-76 years old) with 2019-nCoV pneumonia confirmed with the positive new coronavirus nucleic acid antibody underwent thin-section CT. The imaging findings, clinical and laboratory data were evaluated.

 

Results

Fifty of 51 patients (98%) had a history of the endemic center Wuhan contact. Fever (49/51, 96%) and cough (24/51, 47%) were the most common symptoms. Most patients had a normal white blood cell count (37/51, 73%), neutrophil count (44/51, 86.3%) and normal (17/51, 35.3%) or reduced (33/51, 64.7%) lymphocyte count. CT images showed pure ground grass opacity (GGO) in 39/51 (77%) patients, GGO with reticular and/or interlobular septal thickening in 38/51 (75%) patients. GGO with consolidation was present in 30/51 (59%) and pure consolidation in 28/51 (55%) patients. 44/51 (86%) patients had bilateral lung involvement, while 41/51 (80%) involved the posterior part of the lungs and 44/51 (86%) were peripheral. There were more consolidated lung lesions in patients 5 or more days from disease onset to CT scan versus 4 or fewer days (431/712 lesions vs. 129/612 lesions, p < 0.001). Patients more than 50 years old had more consolidated lung lesions than those 50 years or younger (212/470 vs. 198/854, p < 0.001). Follow up CT in 13 patients showed improvement in 7 (54%) patients and progression in 4 (31%) patients.

 

Conclusions

Patients with fever and/or cough and with conspicuous ground grass opacity lesions in the peripheral and posterior lungs on CT images combined with normal or decreased white blood cells and a history of epidemic exposure are highly suspected of 2019-nCoV pneumonia.

 

Summary

Fever and/or cough, chest CT with bilateral ground glass opacities in the posterior and peripheral lungs and a history of exposure to individuals from Wuhan, China are characteristic of 2019-nCoV pneumonia.

 

Key results:

  • ■ Nearly all patients in this series with 2019-nCoV pneumonia (50/51 patients, 98%) had a history of the contact with individuals from Wuhan, China.

  • ■ Chest CT showed pure ground grass opacities (GGOs) in 77% patients, GGOs with interstitial and/or interlobular septal thickening in 75% patients, GGOs with consolidation in 59% cases.

  • ■ On chest CT, GGOs were bilateral in 88% of patients involving the posterior lungs in 82% and peripheral in 85% of patients.

Author: Fengxiang Song, Nannan Shi, Fei Shan, et al.

Link: https://pubs.rsna.org/doi/10.1148/radiol.2020200274