Early Chest CT Features of Patients with 2019 Novel Coronavirus (COVID-19) Pneumonia: Relationship to Diagnosis and Prognosis

Objective: To elucidate the consistency between CT findings and real time reverse-transcription–polymerase chain- reaction (RT-PCR) results and investigate the relationship between CT features and clinical prognosis in COVID-19. Methods: : The clinical manifestations, laboratory parameters and CT imaging findings were analyzed in thirty-four patients with COVID-19 confirmed by RT-PCR from January 20 to February 4 in Hainan province. CT score was compared between the discharged patients and ICU patients. Results: : Fever (85%) and cough (79%) were most commonly seen. 10 (29%) patients demonstrated negative results on their first RT-PCR.22/34(65%) patients showed pure ground glass opacity (GGO). 17/34 (50%) patients had five lobes of lung involvement, while the 23(68%) patients had lower lobes were involved and 24/34 (71%) were subpleural. Lesions of 24 (71%) patients were distributed mainly in the subpleural. During follow-up, the initial CT lesions of ICU patients are distributed in both subpleural and parenchyma (80%) and the lesions are scattered. 60% of ICU patients had five lobes involved, while this was seen in only 25% discharged patients. Lesions of discharged patients are mainly in the subpleural (75%). 62.5% of discharged patients showed pure ground-glass opacity. 80% ICU demonstrated progressive stage on their first CT scan. 75 % discharged patients were at an early stage. CT score of ICU patients were significantly higher than that of the discharged patients. Conclusion: Chest CT plays a crucial role in the early diagnosis of COVID-19, particularly for those patients with negative RT-PCR. The initial features in CT may be associated with prognosis.Authors Hui Juan Chen and Jie Qiu contributed equally to this work.