Infection and Drug Resistance (Aug 2020)
Follow-Up CT Results of COVID-19 Patients with Initial Negative Chest CT
Abstract
Binjie Fu1 ,* Liangbo Hu2 ,* Fajin Lv,1 Junhao Huang,2 Wangjia Li,1 Yu Ouyang,1 Zhigang Chu1 1Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 2Department of Radiology, Yongchuan Hospital of Chongqing Medical University, Chongqing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhigang ChuDepartment of Radiology, The First Affiliated Hospital of Chongqing Medical University, 1# Youyi Road, Yuanjiagang, Yuzhong District, Chongqing 400016, People’s Republic of ChinaTel +86 18723032809Fax +86 23 68811487Email [email protected]: To determine whether new pulmonary lesions will develop in COVID-19 patients with negative initial chest CT findings and to investigate their CT features and outcome during treatment.Patients and Methods: Data were collected retrospectively from 29 patients who had tested positive for COVID-19 by reverse-transcription polymerase chain reaction testing but negative by initial chest CT from January 22 to February 17, 2020. Clinical manifestations, laboratory indicators, and follow-up CT data were evaluated.Results: Among 317 confirmed COVID-19 patients, 29 (9.1%) (mean ± SD, 38.5 ± 20.5 years; 12 women) with negative initial chest CT findings were evaluated. New pulmonary lesions developed in 10 (34.5%) patients on follow-up CT. Mean time from onset of new lesions to initial CT was 5.8 ± 3.0 days (range: 2– 12 days). New lesions (mean involved lobes and segments: 2.5 ± 1.6 [range: 1– 5] and 4.5 ± 4.5 [range: 1– 13]) were mainly spherical/patchy ground-glass opacities frequently located in the left lower lobe (9, 90.0%). Among the 10 patients, lesions in 6 (60.0%) indicated progression after occurrence, and those in 10 (100.0%) indicated significant absorption on latest CT. When new lesions developed, 6 (60.0%) patients developed new symptoms or had aggravated symptoms and 3 (30.0%) had decreased lymphocyte count. Patients with worsening symptoms had higher involvement of lung segments (mean: 6.5 ± 5.0, range: 1– 13) than asymptomatic patients (mean: 1.5 ± 0.6, range: 1– 2) (P = 0.057).Conclusion: In COVID-19 patients with negative initial chest CT findings, new pulmonary lesions may develop during treatment. Repeat CT is necessary for monitoring the disease, especially when patients have worsening symptoms or laboratory indicators.Keywords: coronavirus disease 2019, SARS-CoV-2, follow-up, CT imaging
