2019 Novel Coronavirus (COVID-19) Pneumonia: Serial Computed Tomography Findings.

From December 2019, Coronavirus disease 2019 (COVID-19) pneumonia (formerly known as the 2019 novel Coronavirus [2019-nCoV]) broke out in Wuhan, China. In this study, we present serial CT findings in a 40-year-old female patient with COVID-19 pneumonia who presented with the symptoms of fever, chest tightness, and fatigue. She was diagnosed with COVID-19 infection confirmed by real-time reverse-transcriptase-polymerase chain reaction. CT showed rapidly progressing peripheral consolidations and ground-glass opacities in both lungs. After treatment, the lesions were shown to be almost absorbed leaving the fibrous lesions.

Differentiating pneumonia with and without COVID-19 using chest CT images: from qualitative to quantitative.

BACKGROUND: Pneumonia caused by COVID-19 shares overlapping imaging manifestations with other types of pneumonia. How to objectively and quantitatively differentiate pneumonia patients with and without COVID-19 virus remains clinical challenge. OBJECTIVE: To formulate standardized scoring criteria and an objective quantization standard to guide decision making in detection and diagnosis of COVID-19 virus induced pneumonia in clinical practice. METHODS: A retrospective dataset includes computed tomography (CT) images acquired from 43 pneumonia patients with COVID-19 virus detected by reverse transcription-polymerase chain reaction (RT-PCR) tests and 49 pneumonia patients without COVID-19 virus. All patients were treated during the same time period in two hospitals. Key indicators of differential diagnosis were identified in relevant literature and the scores were quantified namely, patients with more than 8 points were identified as high risk, those with 6-8 points as moderate risk, and those with fewer than 6 points as low risk for COVID-19 virus. In the study, 3 radiologists determined the scores for all patients. Diagnostic sensitivity and specificity were subsequently calculated. RESULTS: A total of 61 patients were determined as high risk, among which 42 were COVID-19 positive by RT-PCR tests. Next, 9 were identified as moderate risk, one of whom was COVID-19 positive. Last, 22 were classified into the low-risk group, all of them are COVID-19 negative. Based on these results, the sensitivity of detection COVID-19 positive cases between the high-risk group and the non-high-risk group was 0.98 with 95% confidence interval [0.88, 1.00], and the specificity was 0.61 [0.46, 0.75]. The detection sensitivity between the moderate-/high-risk group and the low-risk group was 1.00 [0.92, 1.00], and the specificity was 0.45 [0.31, 0.60]. CONCLUSION: The proposed quantitative scoring criteria showed high sensitivity and moderate specificity in detecting COVID-19 using CT images, which indicates that these criteria may be beneficial for screening in real-world practice and helpful for long-term disease control.

Diagnosis of the Coronavirus disease (COVID-19): rRT-PCR or CT?

PURPOSE: To evaluate the diagnostic value of computed tomography (CT) and real-time reverse-transcriptase-polymerase chain reaction (rRT-PCR) for COVID-19 pneumonia. METHODS: This retrospective study included all patients with COVID-19 pneumonia suspicion, who were examined by both CT and rRT-PCR at initial presentation. The sensitivities of both tests were then compared. For patients with a final confirmed diagnosis, clinical and laboratory data, in addition to CT imaging findings were evaluated. RESULTS: A total of 36 patients were finally diagnosed with COVID-19 pneumonia. Thirty-five patients had abnormal CT findings at presentation, whereas one patient had a normal CT. Using rRT-PCR, 30 patients were tested positive, with 6 cases initially missed. Amongst these 6 patients, 3 became positive in the second rRT-PCR assay(after 2 days, 2 days and 3 days respectively), and the other 3 became positive only in the third round of rRT-PCR tests(after 5 days, 6 days and 8 days respectively). At presentation, CT sensitivity was therefore 97.2%, whereas the sensitivity of initial rRT-PCR was only 83.3%. CONCLUSION: rRT-PCR may produce initial false negative results. We suggest that patients with typical CT findings but negative rRT-PCR results should be isolated, and rRT-PCR should be repeated to avoid misdiagnosis.