Radiology Features of Chest Imaging and Its Correlation to Clinical Severity in Patients with COVID-19

Sarfraz Saleemi; Fawaz Skaff; Faisal Albaiz; Reem Almaghrabi; Fahad Alrabiah; Mohammed Alhajji

doi:doi:10.11648/j.ijmi.20200802.13

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Radiology Features of Chest Imaging and Its Correlation to Clinical Severity in Patients with COVID-19

Sarfraz Saleemi, Fawaz Skaff, Faisal Albaiz, Reem Almaghrabi, Fahad Alrabiah, Mohammed Alhajji

Published in International Journal of Medical Imaging (Volume 8, Issue 2)

Received: 27 May 2020 Accepted: 10 June 2020 Published: 20 June 2020

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Abstract

Background: COVID-19 caused by SARS CoV-2 involves respiratory system leading to respiratory failure and Acute Respiratory Distress Syndrome (ARDS) in critical patients. Several chest imaging features have been reported in patients with COVID-19 ranging from focal to diffuse lung opacities. There is no data from Saudi Arabia on the chest imaging findings in these patients. Material and Methods: CT chest data of 29 patients who were admitted with confirmed diagnosis of COVID-19 by real-time reverse transcriptase polymerase chain reaction (RT-PCR) was reviewed. Radiology abnormality was categorized based upon pattern and distribution. Clinical and laboratory data of patients were collected by reviewing the electronic medical record. Patients were divided into mild and severe group based on clinical assessment and laboratory criteria. Radiology changes were compared with disease severity. Results: Median (Q1, Q3) age was 58 (41,70) years and median (Q1, Q3) time from symptom onset to CT scan was 6.5 (3.0, 9.75) days. Bilateral ground glass opacities were the most common CT scan feature in patients with COVID-19 (76%). Opacities were dominant in the lower zone (72%) and frequently distributed peripherally (48%). Severe disease was most likely to have bilateral opacities compared with mild (p = 0.001) and it was correlated with rise of inflammatory markers, Ferritin (p=0.014) and C-reactive protein (p=0.0003). Conclusion: Most patients with COVID-19 who have abnormal CT scan of chest show ground glass opacities. Bilateral opacities are more common in severe disease and is correlated with elevated inflammatory markers.

Published in	International Journal of Medical Imaging (Volume 8, Issue 2)
DOI	10.11648/j.ijmi.20200802.13
Page(s)	35-38
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

COVID-19, SARS CoV-2, CT Scan, Ground Glass, Opacity

References

[1]	WHO. Coronavirus disease (COVID-19) outbreak. 2020. https://www.who.int/emergencies/diseases/novel-coronavirus-2019 (accessed Apr 30, 2020).
[2]	N. Zhu, D. Zhang, W. Wang, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med, 382 (8) (2020), pp. 727-733.
[3]	Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15; 395 (10223): 497-506.
[4]	Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020 Feb 15; 395 (10223): 507-513.
[5]	Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020; 323 (11): 1061-1069.
[6]	Pan F, Ye T, Sun P, Gui S, Liang B, Li L, et al. Time Course of Lung Changes On Chest CT During Recovery From 2019 Novel Coronavirus (COVID-19) Pneumonia. Radiology 2020 295: 3, 715-721.
[7]	Wu J, Wu X, Zeng W, et al. Chest CT Findings in Patients With Coronavirus Disease 2019 and Its Relationship With Clinical Features. Invest Radiol. 2020; 55 (5): 257-261.
[8]	Yueying Pan, Hanxiong Guan, Shuchang Zhou, Yujin Wang, Qian Li, Tingting Zhu, et al. Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China. European Radiology 2020, 30: 3306-3309.
[9]	Wei Zhao, Zheng Zhong, Xingzhi Xie, Qizhi Yu, Jun Liu. Relation Between Chest CT Findings and Clinical Conditions of Coronavirus Disease (COVID-19) Pneumonia: A Multicenter Study. American Journal of Roentgenology, 2020; 214: 5, 1072-1077.
[10]	Z. Cheng, Y. Lu, Q. Cao, et al. Clinical features and chest CT manifestations of coronavirus disease 2019 (COVID-19) in a single-center study in Shanghai, China. Am J Roentgenol (2020), pp. 1-6.
[11]	Guan WJ, Ni ZY, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020; 382 (18): 1708-1720.
[12]	Shuchang Zhou, Yujin Wang, Tingting Zhu, Liming Xia. CT Features of Coronavirus Disease 2019 (COVID-19) Pneumonia in 62 Patients in Wuhan, China. AJR 2020; 214: 1–8.
[13]	Meng H, Xiong R, He R, et al. CT imaging and clinical course of asymptomatic cases with COVID-19 pneumonia at admission in Wuhan, China. J Infect. 81 (2020); 33-39.
[14]	Ran Yang, Xiang Li, Huan Liu, Yanling Zhen, Xianxiang Zhang, Qiuxia Xiong, Yong Luo, Cailiang Gao, and Wenbing Zeng. Chest CT Severity Score: An Imaging Tool for Assessing Severe COVID-19. Radiology: Cardiothoracic Imaging. 2020; 2: 2.
[15]	Yin X, Min X, Nan Y, Feng Z, Li B, Cai W, Xi X, Wang L. Assessment of the Severity of Coronavirus Disease: Quantitative Computed Tomography Parameters versus Semiquantitative Visual Score. Korean J Radiol. 2020 Jan; 21: e91.

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APA Style

Sarfraz Saleemi, Fawaz Skaff, Faisal Albaiz, Reem Almaghrabi, Fahad Alrabiah, et al. (2020). Radiology Features of Chest Imaging and Its Correlation to Clinical Severity in Patients with COVID-19. International Journal of Medical Imaging, 8(2), 35-38. https://doi.org/10.11648/j.ijmi.20200802.13

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ACS Style

Sarfraz Saleemi; Fawaz Skaff; Faisal Albaiz; Reem Almaghrabi; Fahad Alrabiah, et al. Radiology Features of Chest Imaging and Its Correlation to Clinical Severity in Patients with COVID-19. Int. J. Med. Imaging 2020, 8(2), 35-38. doi: 10.11648/j.ijmi.20200802.13

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AMA Style

Sarfraz Saleemi, Fawaz Skaff, Faisal Albaiz, Reem Almaghrabi, Fahad Alrabiah, et al. Radiology Features of Chest Imaging and Its Correlation to Clinical Severity in Patients with COVID-19. Int J Med Imaging. 2020;8(2):35-38. doi: 10.11648/j.ijmi.20200802.13

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@article{10.11648/j.ijmi.20200802.13,
  author = {Sarfraz Saleemi and Fawaz Skaff and Faisal Albaiz and Reem Almaghrabi and Fahad Alrabiah and Mohammed Alhajji},
  title = {Radiology Features of Chest Imaging and Its Correlation to Clinical Severity in Patients with COVID-19},
  journal = {International Journal of Medical Imaging},
  volume = {8},
  number = {2},
  pages = {35-38},
  doi = {10.11648/j.ijmi.20200802.13},
  url = {https://doi.org/10.11648/j.ijmi.20200802.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20200802.13},
  abstract = {Background: COVID-19 caused by SARS CoV-2 involves respiratory system leading to respiratory failure and Acute Respiratory Distress Syndrome (ARDS) in critical patients. Several chest imaging features have been reported in patients with COVID-19 ranging from focal to diffuse lung opacities. There is no data from Saudi Arabia on the chest imaging findings in these patients. Material and Methods: CT chest data of 29 patients who were admitted with confirmed diagnosis of COVID-19 by real-time reverse transcriptase polymerase chain reaction (RT-PCR) was reviewed. Radiology abnormality was categorized based upon pattern and distribution. Clinical and laboratory data of patients were collected by reviewing the electronic medical record. Patients were divided into mild and severe group based on clinical assessment and laboratory criteria. Radiology changes were compared with disease severity. Results: Median (Q1, Q3) age was 58 (41,70) years and median (Q1, Q3) time from symptom onset to CT scan was 6.5 (3.0, 9.75) days. Bilateral ground glass opacities were the most common CT scan feature in patients with COVID-19 (76%). Opacities were dominant in the lower zone (72%) and frequently distributed peripherally (48%). Severe disease was most likely to have bilateral opacities compared with mild (p = 0.001) and it was correlated with rise of inflammatory markers, Ferritin (p=0.014) and C-reactive protein (p=0.0003). Conclusion: Most patients with COVID-19 who have abnormal CT scan of chest show ground glass opacities. Bilateral opacities are more common in severe disease and is correlated with elevated inflammatory markers.},
 year = {2020}
}

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TY - JOUR
T1 - Radiology Features of Chest Imaging and Its Correlation to Clinical Severity in Patients with COVID-19
AU - Sarfraz Saleemi
AU - Fawaz Skaff
AU - Faisal Albaiz
AU - Reem Almaghrabi
AU - Fahad Alrabiah
AU - Mohammed Alhajji
Y1 - 2020/06/20
PY - 2020
N1 - https://doi.org/10.11648/j.ijmi.20200802.13
DO - 10.11648/j.ijmi.20200802.13
T2 - International Journal of Medical Imaging
JF - International Journal of Medical Imaging
JO - International Journal of Medical Imaging
SP - 35
EP - 38
PB - Science Publishing Group
SN - 2330-832X
UR - https://doi.org/10.11648/j.ijmi.20200802.13
AB - Background: COVID-19 caused by SARS CoV-2 involves respiratory system leading to respiratory failure and Acute Respiratory Distress Syndrome (ARDS) in critical patients. Several chest imaging features have been reported in patients with COVID-19 ranging from focal to diffuse lung opacities. There is no data from Saudi Arabia on the chest imaging findings in these patients. Material and Methods: CT chest data of 29 patients who were admitted with confirmed diagnosis of COVID-19 by real-time reverse transcriptase polymerase chain reaction (RT-PCR) was reviewed. Radiology abnormality was categorized based upon pattern and distribution. Clinical and laboratory data of patients were collected by reviewing the electronic medical record. Patients were divided into mild and severe group based on clinical assessment and laboratory criteria. Radiology changes were compared with disease severity. Results: Median (Q1, Q3) age was 58 (41,70) years and median (Q1, Q3) time from symptom onset to CT scan was 6.5 (3.0, 9.75) days. Bilateral ground glass opacities were the most common CT scan feature in patients with COVID-19 (76%). Opacities were dominant in the lower zone (72%) and frequently distributed peripherally (48%). Severe disease was most likely to have bilateral opacities compared with mild (p = 0.001) and it was correlated with rise of inflammatory markers, Ferritin (p=0.014) and C-reactive protein (p=0.0003). Conclusion: Most patients with COVID-19 who have abnormal CT scan of chest show ground glass opacities. Bilateral opacities are more common in severe disease and is correlated with elevated inflammatory markers.
VL - 8
IS - 2
ER -

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Author Information

Sarfraz Saleemi

Department of Medicine, Section of Pulmonary Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
Fawaz Skaff

Department of Radiology, Section of Cardiothoracic Imaging, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
Faisal Albaiz

Department of Medicine, Section of Pulmonary Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
Reem Almaghrabi

Department of Medicine, Section of Infectious Diseases, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
Fahad Alrabiah

Department of Medicine, Section of Infectious Diseases, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
Mohammed Alhajji

Department of Medicine, Section of Pulmonary Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia

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Plain Text BibTeX RIS

APA Style

Sarfraz Saleemi, Fawaz Skaff, Faisal Albaiz, Reem Almaghrabi, Fahad Alrabiah, et al. (2020). Radiology Features of Chest Imaging and Its Correlation to Clinical Severity in Patients with COVID-19. International Journal of Medical Imaging, 8(2), 35-38. https://doi.org/10.11648/j.ijmi.20200802.13

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ACS Style

Sarfraz Saleemi; Fawaz Skaff; Faisal Albaiz; Reem Almaghrabi; Fahad Alrabiah, et al. Radiology Features of Chest Imaging and Its Correlation to Clinical Severity in Patients with COVID-19. Int. J. Med. Imaging 2020, 8(2), 35-38. doi: 10.11648/j.ijmi.20200802.13

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AMA Style

Sarfraz Saleemi, Fawaz Skaff, Faisal Albaiz, Reem Almaghrabi, Fahad Alrabiah, et al. Radiology Features of Chest Imaging and Its Correlation to Clinical Severity in Patients with COVID-19. Int J Med Imaging. 2020;8(2):35-38. doi: 10.11648/j.ijmi.20200802.13

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@article{10.11648/j.ijmi.20200802.13,
  author = {Sarfraz Saleemi and Fawaz Skaff and Faisal Albaiz and Reem Almaghrabi and Fahad Alrabiah and Mohammed Alhajji},
  title = {Radiology Features of Chest Imaging and Its Correlation to Clinical Severity in Patients with COVID-19},
  journal = {International Journal of Medical Imaging},
  volume = {8},
  number = {2},
  pages = {35-38},
  doi = {10.11648/j.ijmi.20200802.13},
  url = {https://doi.org/10.11648/j.ijmi.20200802.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20200802.13},
  abstract = {Background: COVID-19 caused by SARS CoV-2 involves respiratory system leading to respiratory failure and Acute Respiratory Distress Syndrome (ARDS) in critical patients. Several chest imaging features have been reported in patients with COVID-19 ranging from focal to diffuse lung opacities. There is no data from Saudi Arabia on the chest imaging findings in these patients. Material and Methods: CT chest data of 29 patients who were admitted with confirmed diagnosis of COVID-19 by real-time reverse transcriptase polymerase chain reaction (RT-PCR) was reviewed. Radiology abnormality was categorized based upon pattern and distribution. Clinical and laboratory data of patients were collected by reviewing the electronic medical record. Patients were divided into mild and severe group based on clinical assessment and laboratory criteria. Radiology changes were compared with disease severity. Results: Median (Q1, Q3) age was 58 (41,70) years and median (Q1, Q3) time from symptom onset to CT scan was 6.5 (3.0, 9.75) days. Bilateral ground glass opacities were the most common CT scan feature in patients with COVID-19 (76%). Opacities were dominant in the lower zone (72%) and frequently distributed peripherally (48%). Severe disease was most likely to have bilateral opacities compared with mild (p = 0.001) and it was correlated with rise of inflammatory markers, Ferritin (p=0.014) and C-reactive protein (p=0.0003). Conclusion: Most patients with COVID-19 who have abnormal CT scan of chest show ground glass opacities. Bilateral opacities are more common in severe disease and is correlated with elevated inflammatory markers.},
 year = {2020}
}

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