Quantitative computed tomography of the coronavirus disease 2019 (COVID-19) pneumonia

To quantify coronavirus diseases 2019 (COVID-19) pneumonia and to explore whether quantitative computer tomography (CT) could be used to assess severity on admission.

From January 17 to February 9, 2020, 38 hospitalized patients with COVID-19 pneumonia were consecutively enrolled in our hospitals. All clinical data and the chest CT on admission were retrospectively reviewed and analyzed. Firstly, a quantitative method based on multi-scale convolutional neural networks was used to assess the infected lung segments and this was compared with the semi-quantitative method. Secondly, the quantitative method was tested with laboratory results and the pneumonia severity index (PSI) by correlation analyses. Thirdly, both quantitative and semi-quantitative parameters between patients with different PSI were compared.

Thirty cases were finally enrolled: 16 (53.33%) of them were male, and the mean age was 48 years old. The interval from onset symptoms to first chest CT scan was 8 days. The proportion of ground glass opacity (GGO), consolidation and the total lesion based on the quantitative method was positively correlated with the semi-quantitative CT score (P < 0.001 for all; rs = 0.88, 0.87, 0.90), CRP (P = 0.0278, 0.0168, 0.0078; rs = 0.40, 0.43, 0.48) and ESR (P = 0.0296, 0.0408, 0.0048; rs = 0.46, 0.44, 0.58), respectively, and was negatively correlated with the lymphocyte count (P = 0.0222, 0.0024, 0.0068; rs = -0.42, -0.53, -0.48). There was a positive correlation trend between the proportion of total infection and the pneumonia severity index (P = 0.0994; rs = 0.30) and a tendency that patients with severe COVID-19 pneumonia had higher percentage of consolidation and total infection (P = 0.0903, 0.0989).

Quantitative CT may have potential in assessing the severity of COVID-19 pneumonia on admission.