Diagnostic and Interventional Radiology
Chest Imaging - Review

Chest CT findings in patients with coronavirus disease 2019 (COVID-19): a comprehensive review


Department of Radiology, the First Hospital of Lanzhou University, Intelligent Imaging Medical Engineering Research Center, Accurate Image Collaborative Innovation International Science and Technology Cooperation, Lanzhou, China


The first Hospital of Lanzhou University, Lanzhou, Gansu, China

Diagn Interv Radiol 2021; 27: 621-632
DOI: 10.5152/dir.2020.20212
Read: 86 Downloads: 36 Published: 01 September 2021

The objective of this review was to summarize the most pertinent CT imaging findings in patients with coronavirus disease 2019 (COVID-19). A literature search retrieved eligible studies in PubMed, EMBASE, Cochrane Library and Web of Science up to June 1, 2020. A comprehensive review of publications of the Chinese Medical Association about COVID-19 was also performed. A total of 84 articles with more than 5340 participants were included and reviewed. Chest CT comprised 92.61% of abnormal CT findings overall. Compared with real-time polymerase chain reaction result, CT findings has a sensitivity of 96.14% but a low specificity of 40.48% in diagnosing COVID-19. Ground glass opacity (GGO), pure (57.31%) or mixed with consolidation (41.51%) were the most common CT features with a majority of bilateral (80.32%) and peripheral (66.21%) lung involvement. The opacity might associate with other imaging features, including air bronchogram (41.07%), vascular enlargement (54.33%), bronchial wall thickening (19.12%), crazy-paving pattern (27.55%), interlobular septal thickening (42.48%), halo sign (25.48%), reverse halo sign (12.29%), bronchiectasis (32.44%), and pulmonary fibrosis (26.22%). Other accompanying signs including pleural effusion, lymphadenopathy and pericardial effusion were rare, but pleural thickening was common. The younger or early stage patients tended to have more GGOs, while extensive/multilobar involvement with consolidation was prevalent in the older or severe population. Children with COVID-19 showed significantly lower incidences of some ancillary findings than those of adults and showed a better performance on CT during follow up. Follow-up CT showed GGO lesions gradually decreased, and the consolidation lesions first increased and then remained relatively stable at 6–13 days, and then absorbed and fibrosis increased after 14 days. Chest CT imaging is an important component in the diagnosis, staging, disease progression and follow-up of patients with COVID-19.

You may cite this article as: Li J, Yan R, Zhai Y, Qi X, Lei J. Chest CT findings in patients with coronavirus disease 2019 (COVID-19): a comprehensive review. Diagn Interv Radiol 2021; 27: 621–632

EISSN 1305-3612