Temporal lung changes in high-resolution chest computed tomography for coronavirus disease 2019

Area of Science:

• Radiology
• Infectious Diseases
• Pulmonary Medicine

Background:

• Coronavirus disease 2019 (COVID-19) is a significant global health concern.
• Understanding the temporal evolution of lung abnormalities in COVID-19 is crucial for patient management.
• High-resolution computed tomography (HRCT) is a key imaging modality for assessing COVID-19 lung involvement.

Purpose of the Study:

• To analyze the dynamic changes in lung findings on HRCT in patients with COVID-19.
• To establish optimal timing for follow-up computed tomography (CT) scans in COVID-19 patients.

Main Methods:

• Retrospective analysis of HRCT scans from 86 COVID-19 patients with at least two scans.
• Evaluation of CT scores and major CT findings to characterize disease progression and resolution.
• Categorization of patients into groups based on disease progression (Type I) or stability (Type II).

Main Results:

• 95.3% of patients exhibited lung lesions on initial HRCT, predominantly bilateral, multifocal, and diffuse.
• For patients with disease progression (Type I), CT scores peaked around 12 days and reached their lowest point at 36 days.
• Patients with stable disease (Type II) showed their lowest CT scores around 23 days. Older patients were more likely to have a reticular pattern on later scans.

Conclusions:

• Recommended follow-up CT scan timing for COVID-19 patients is around 12 days (second week) and 23-36 days (fourth to fifth weeks) post-illness onset.
• These follow-up intervals can help optimize radiation exposure by avoiding unnecessary scans.
• Timely CT evaluation aids in monitoring the disease course and assessing lung changes effectively.