The Spectrum of CT Findings of COVID-19 Pneumonia: Acute Alveolar Insult and Organizing Pneumonia as Different Phases of Lung Injury and Repair

The Spectrum of CT Findings of COVID-19 Pneumonia: Acute Alveolar Insult and Organizing Pneumonia as Different Phases of Lung Injury and Repair

Ung Rae Kang, Young Hwan Kim, Yun Su Kim

Purpose To analyze the findings and serial changes in chest CT lesions in 123 symptomatic patientswith coronavirus disease 2019 (COVID-19).Materials and Methods From February 19 to April 7, 2020, a total of 123 confirmed COVID-19patients (male, 44; female, 79; mean age, 59.2 ± 18.6) were enrolled in this retrospective study.A total of 234 CT scans were reviewed for the following patterns: acute alveolar insult (AAI) patterns:ground-glass opacity (GGO), crazy-paving appearance, mixed pattern, and consolidation;organizing pneumonia (OP) patterns: perilobular patterns, band opacity, curvilinear opacity,reversed halo opacity, and small nodular consolidation; resolving patterns: pure GGO, remnantcurvilinear, small nodular consolidation, and serial changes of lung abnormalities. We comparedthe proportions of AAI pattern, OP pattern, or resolving pattern with time progression andanalyzed the association between the patterns and disease severity using Pearson chi-squareand Fisher’s exact test.Results Predominant CT patterns were AAI pattern (87%) in the early hospital period group (0-10 days, after the onset of symptoms), OP pattern (45.7%) in the later hospital period group (after10 days), and resolving pattern in discharge and follow-up group (47.2% and 84.8%, respectively).The difference in the proportions of predominant CT patterns with time progression wasstatistically significant (p < 0.001, Pearson’s chi-square test). No statistically significant associationwas observed between the patterns and disease severity (p = 0.055, Fisher’s exact test). Nofibrous changes in the lesions were observed on follow-up CT scans.Conclusion The serial CT scans of COVID-19 patients showed the spectrum of COVID pneumoniaCT manifestations as different phases of lung injury and repair.

2021

covid-19, pneumonia, computed tomography, acute lung injury, x-ray

https://doi.org/10.3348/jksr.2020.0142

대한영상의학회지

The Korean Society of Radiology

Medical physics. Medical radiology. Nuclear medicine