Clinical and CT characteristics which indicate timely radiological reexamination in patients with COVID-19: A retrospective study in Beijing, China

Objective

Chest CT is useful in assessing the disease course of coronavirus disease-19 (COVID-19). This study aims to identify the characteristics of patients in whom imaging progression occurred while clinical symptoms were relieved and to guide radiological reexamination.

Methods

This retrospective study included 73 patients with reverse transcription-polymerase chain reaction (RT-PCR) confirmed severe acute respiratory syndrome-2 (SARS-CoV-2) infection. All patients received CT reexaminations within 24 h after symptomatic remission. We divided patients into two groups according to the matching degree between clinical and imaging outcomes.

Results

21 patients displayed imaging progression while symptoms relieved. Patients with imaging progression were prone to be advanced in age [years: 60 (46–65) v 47 (37–60.75), P = 0.030]; lymphopenia (66.7% v 40.4%, P = 0.042) and low level of C-reactive protein [mg/L: 5.7 (1.9–20.2) v 18.9 (6.7–38.9), P = 0.038]. An age over 50 was an independent risk factor for imaging progression (OR = 3.41, 95%CI 1.14–10.20, P = 0.028). In CT images, they were inclined to present lesions with clear border (94.7% v 64.7%, P = 0.012), pure peripheral distribution (89.5% v 39.2%, P < 0.001), without bilateral lungs involved (57.9% v 29.4%, P = 0.028) especially with left lung involved only (42.1% v 17.6%, P = 0.034).

Conclusion

In order to improve the therapeutic effect, the interval before radiological follow-up should be shortened appropriately especially in patients over the age of 50. It is essential to proceed to CT reexamination before symptomatic remission.