Severe coronavirus disease 2019: CT changes based on prognosis

Purpose: To determine the characteristics of CT changes in patients with severe coronavirus disease 2019 (COVID-19) based on prognosis. Method: Serial CT scans in 47 patients with severe COVID-19 were reviewed. The patterns, distribution and CT score of lung abnormalities were assessed. Scans were classified according to duration in weeks after onset of symptoms. These CT abnormalities were compared between discharged and dead patients. Results: : Twenty-six patients were discharged, whereas 21 passed away. Discharged patients were characterized by a rapid rise in CT score in the first 2 weeks followed by a slow decline, presence of reticular and mixed patterns from the second week, and prevalence of subpleural distribution of opacities in all weeks. In contrast, dead patients were characterized by a progressive rise in CT score, persistence of ground-glass opacity and consolidation patterns in all weeks, and prevalence of diffuse distribution from the second week. CT scores of death group were significantly higher than those of discharge group ( P < .05). Significant differences were also noted in abnormality pattern ( P < .05) and opacity distribution ( P < .05) between groups. Conclusions: : The severe COVID-19 patients presented with characteristic CT changes and the CT changes varied with prognosis.Authors Bin Liang, Lingli Xie contributed equally to this work.