Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study
Open accessAbstract
Background A cluster of patients with coronavirus disease 2019 (COVID-19) pneumonia caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were successively reported in Wuhan, China. We aimed to describe the CT findings across different timepoints throughout the disease course.Methods Patients with COVID-19 pneumonia (confirmed by next-generation sequencing or RT-PCR) who were admitted to one of two hospitals in Wuhan and who underwent serial chest CT scans were retrospectively enrolled. Patients were grouped on the basis of the interval between symptom onset and the first CT scan: group 1 (subclinical patients; scans done before symptom onset), group 2 (scans done ≤1 week after symptom onset), group 3 (>1 week to 2 weeks), and group 4 (>2 weeks to 3 weeks). Imaging features and their distribution were analysed and compared across the four groups.Findings 81 patients admitted to hospital between Dec 20, 2019, and Jan 23, 2020, were retrospectively enrolled. The cohort included 42 (52%) men and 39 (48%) women, and the mean age was 49·5 years (SD 11·0). The mean number of involved lung segments was 10·5 (SD 6·4) overall, 2·8 (3·3) in group 1, 11·1 (5·4) in group 2, 13·0 (5·7) in group 3, and 12·1 (5·9) in group 4. The predominant pattern of abnormality observed was bilateral (64 [79%] patients), peripheral (44 [54%]), ill-defined (66 [81%]), and ground-glass opacification (53 [65%]), mainly involving the right lower lobes (225 [27%] of 849 affected segments). In group 1 (n=15), the predominant pattern was unilateral (nine [60%]) and multifocal (eight [53%]) ground-glass opacities (14 [93%]). Lesions quickly evolved to bilateral (19 [90%]), diffuse (11 [52%]) ground-glass opacity predominance (17 [81%]) in group 2 (n=21). Thereafter, the prevalence of ground-glass opacities continued to decrease (17 [57%] of 30 patients in group 3, and five [33%] of 15 in group 4), and consolidation and mixed patterns became more frequent (12 [40%] in group 3, eight [53%] in group 4).Interpretation COVID-19 pneumonia manifests with chest CT imaging abnormalities, even in asymptomatic patients, with rapid evolution from focal unilateral to diffuse bilateral ground-glass opacities that progressed to or co-existed with consolidations within 1-3 weeks. Combining assessment of imaging features with clinical and laboratory findings could facilitate early diagnosis of COVID-19 pneumonia.Funding None.
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A spectrum of pulmonary fibrotic disease has been observed in COVID-19 pneumonia from fibrosis associated with organizing pneumonia to severe acute lung injury and widespread fibrosis.
“A spectrum of pulmonary fibrotic disease has been observed in COVID-19 pneumonia from fibrosis associated with organizing pneumonia to severe acute lung injury and widespread fibrosis (52).”
From Lung epithelial and endothelial damage, loss of tissue repair, inhibition of fibrinolysis, and cellular senescence in fatal COVID-19 (2021) · cites this paper as [52]
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- Authors
- Shi, H., Han, X., Jiang, N., Cao, Y., Alwalid, O., Gu, J., Fan, Y., & Zheng, C.
- Affiliations
- Wuhan Union Hospital (CN)
- Jinyintan Hospital (CN)
- Corresponding author
- Fan, Yanqing
- Zheng, Chuansheng
- Venue
- The Lancet Infectious Diseases
- Publisher
- Elsevier BV
- Published
- 2020-04
- Volume
- 20
- Issue
- 4
- Pages
- 425-434
- ISSN
- 1473-3099 (ISSN-L)
- PMC
- PMC7159053
- OpenAlex
- W3007273493
- Cited by
- 3,664
- References
- 28
- Citations by year
- 2026: 25 · 2025: 43 · 2024: 134 · 2023: 281 · 2022: 487 · 2021: 1077 · 2020: 1608 · 2019: 3 · 2018: 1 · 2017: 1 · 2012: 1
- FWCI
- 113.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Lancet Infectious Diseases (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Washington
- Huazhong University of Science and Technology
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › COVID-19 diagnosis using AI
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Keywords
- COVID-19 pneumonia, SARS-CoV-2, chest CT findings, serial CT imaging, ground-glass opacities, asymptomatic infection, disease progression, right lower lobe, Wuhan outbreak, time since symptom onset, differential diagnosis of pneumonia
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Adult, Aged, China, Female, Humans, Lung, Male, Middle Aged, Pneumonia, Viral, Tomography, X-Ray Computed, Coronavirus Infections, Pandemics
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