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Temporal radiographic changes in COVID-19 patients: relationship to disease severity and viral clearance

Temporal radiographic changes in COVID-19 patients: relationship to disease severity and viral clearance
Temporal radiographic changes in COVID-19 patients: relationship to disease severity and viral clearance
Background: COVID-19 is “public enemy number one” and has placed an enormous burden on health authorities across the world. Given the wide clinical spectrum of COVID-19, understanding the factors that can predict disease severity will be essential since this will help frontline clinical staff to stratify patients with increased confidence.

Purpose: To investigate the diagnostic value of the temporal radiographic changes, and the relationship to disease severity and viral clearance in COVID-19 patients. Methods: In this retrospective cohort study, we included 99 patients admitted to the Renmin Hospital of Wuhan University, with laboratory confirmed moderate or severe COVID-19. Temporal radiographic changes and viral clearance were explored using appropriate statistical methods.

Results: Radiographic features from HRCT scans included ground-glass opacity, consolidation, air bronchogram, nodular opacities and pleural effusion. The HRCT scores (peak) during disease course in COVID-19 patients with severe pneumonia (median: 24.5) were higher compared to those with pneumonia (median: 10) (p=3.56×10-12), with more frequency of consolidation (p=0.025) and air bronchogram (p=7.50×10-6). The median values of days when the peak HRCT scores were reached in pneumonia or severe pneumonia patients were 12 vs. 14, respectively (p=0.048). Log-rank test and Spearman's Rank-Order correlation suggested temporal radiographic changes as a valuable predictor for viral clearance. In addition, follow up CT scans from 11 pneumonia patients showed full recovery.

Conclusion: Given the values of HRCT scores for both disease severity and viral clearance, a standardised HRCT score system for COVID-19 is highly demanded.
2045-2322
Liu, Xiaofan
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Zhou, Hong
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Zhou, Yilu
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Wu, Xiaojun
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Zhao, Yang
d58b840a-c058-43ab-b265-fdf4af9f9597
Lu, Yang
df74c363-eeef-4df8-91b7-e11c438a86eb
Tan, Weijun
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Yuan, Mingli
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Ding, Xuhong
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Zou, Jinjing
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Li, Ruiyun
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Li, Hailing
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Ewing, Robert
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Hu, Yi
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Nie, Hanxiang
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Wang, Yihua
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Liu, Xiaofan
63ada03c-0c3f-4743-b427-b28fa491c522
Zhou, Hong
6c81a017-0f09-4dc7-9060-a4cd1665f380
Zhou, Yilu
1878565d-39e6-467d-a027-7320bf4cdaf2
Wu, Xiaojun
a2faef0c-7469-4011-ac10-9c291108cd6c
Zhao, Yang
d58b840a-c058-43ab-b265-fdf4af9f9597
Lu, Yang
df74c363-eeef-4df8-91b7-e11c438a86eb
Tan, Weijun
61987df6-7ca1-4876-b3ba-4e7a16bc33dd
Yuan, Mingli
c66b5393-893a-4ad8-ac2b-5e29a432f944
Ding, Xuhong
5ea70763-16de-48b0-8e55-1b085ba5c11b
Zou, Jinjing
9a6f03d1-b9c2-4c64-b5a5-24e81f53a034
Li, Ruiyun
7508a9c8-c90f-4325-9a1f-2c608c79a51d
Li, Hailing
6d172849-b568-4c2d-9917-4b23a9eed6a5
Ewing, Robert
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Hu, Yi
847cadeb-0ed0-4598-92c5-6021d81905dd
Nie, Hanxiang
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Wang, Yihua
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Liu, Xiaofan, Zhou, Hong, Zhou, Yilu, Wu, Xiaojun, Zhao, Yang, Lu, Yang, Tan, Weijun, Yuan, Mingli, Ding, Xuhong, Zou, Jinjing, Li, Ruiyun, Li, Hailing, Ewing, Robert, Hu, Yi, Nie, Hanxiang and Wang, Yihua (2020) Temporal radiographic changes in COVID-19 patients: relationship to disease severity and viral clearance. Scientific Reports, 10, [10263]. (doi:10.1038/s41598-020-66895-w).

Record type: Article

Abstract

Background: COVID-19 is “public enemy number one” and has placed an enormous burden on health authorities across the world. Given the wide clinical spectrum of COVID-19, understanding the factors that can predict disease severity will be essential since this will help frontline clinical staff to stratify patients with increased confidence.

Purpose: To investigate the diagnostic value of the temporal radiographic changes, and the relationship to disease severity and viral clearance in COVID-19 patients. Methods: In this retrospective cohort study, we included 99 patients admitted to the Renmin Hospital of Wuhan University, with laboratory confirmed moderate or severe COVID-19. Temporal radiographic changes and viral clearance were explored using appropriate statistical methods.

Results: Radiographic features from HRCT scans included ground-glass opacity, consolidation, air bronchogram, nodular opacities and pleural effusion. The HRCT scores (peak) during disease course in COVID-19 patients with severe pneumonia (median: 24.5) were higher compared to those with pneumonia (median: 10) (p=3.56×10-12), with more frequency of consolidation (p=0.025) and air bronchogram (p=7.50×10-6). The median values of days when the peak HRCT scores were reached in pneumonia or severe pneumonia patients were 12 vs. 14, respectively (p=0.048). Log-rank test and Spearman's Rank-Order correlation suggested temporal radiographic changes as a valuable predictor for viral clearance. In addition, follow up CT scans from 11 pneumonia patients showed full recovery.

Conclusion: Given the values of HRCT scores for both disease severity and viral clearance, a standardised HRCT score system for COVID-19 is highly demanded.

Text
COVID19- CT features - SR - Accepted Manuscript
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More information

Accepted/In Press date: 29 May 2020
e-pub ahead of print date: 24 June 2020

Identifiers

Local EPrints ID: 441091
URI: http://eprints.soton.ac.uk/id/eprint/441091
ISSN: 2045-2322
PURE UUID: a3826d5c-43bf-4e7f-97c8-39e25bc0546e
ORCID for Robert Ewing: ORCID iD orcid.org/0000-0001-6510-4001
ORCID for Yihua Wang: ORCID iD orcid.org/0000-0001-5561-0648

Catalogue record

Date deposited: 01 Jun 2020 16:30
Last modified: 07 Oct 2020 02:08

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