Temporal lung changes in high-resolution chest computed tomography for coronavirus disease 2019
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Updated: Dec 8, 2025
Lung CT Segmentation to Identify Consolidations and Ground Glass Areas for Quantitative Assesment of SARS-CoV Pneumonia
Published on: December 19, 2020
Chengyang Chen1, Xing Wang1, Jia Dong1
1Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Insights
High-resolution computed tomography (HRCT) for coronavirus disease 2019 (COVID-19) shows lung changes peaking around 12 days and resolving by 23-36 days. Optimal follow-up CT scans are recommended during these periods to monitor disease progression.
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.
Objective:
To evaluate temporal lung changes in coronavirus disease 2019 (COVID-19) in high-resolution computed tomography (HRCT) and to determine the appropriate computed tomographic (CT) follow-up time.
Methods:
Eighty-six patients with two or more HRCT scans who were diagnosed with COVID-19 were included. The CT score and major CT findings were evaluated.
Results:
Eighty-two (95.3%) patients had lesions on the initial HRCT scans. Most scans showed bilateral, multifocal lung lesions, with multiple lobes involved and diffuse distribution. For fifty-seven patients with type I (progress compared with the initial CT score), the CT score reached a peak at 12 days and the nadir at 36 days. For twenty-nine patients with type II (no progress compared with the initial CT score), the lowest CT score was reached at 23 days. On the final HRCT scans (>21 days), patients with a reticular pattern were older than those without a reticular pattern.
Conclusion:
The appropriate follow-up time of CT scans is during the second week (approximately 12 days) and the fourth to fifth weeks (approximately 23-36 days) from the onset of illness. These times could help reduce the CT radiation dose and show timely changes in the course of the disease by CT.
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