Int J Med Sci 2020; 17(15):2373-2378. doi:10.7150/ijms.47587

Research Paper

CT features and outcomes of newly developed pulmonary lesions in patients with Coronavirus Disease 2019 (COVID-19)

Wang Jia Li1*, Zhuo Ma Lv1*, Fa Jin Lv1, BinJie Fu1, Liang Bo Hu2, Zhi Gang Chu1✉

1. Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China, 40016.
2. Department of Radiology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China, 40016.
*Co-first authors with equal contributions to this work.

This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/). See http://ivyspring.com/terms for full terms and conditions.
Citation:
Li WJ, Lv ZM, Lv FJ, Fu B, Hu LB, Chu ZG. CT features and outcomes of newly developed pulmonary lesions in patients with Coronavirus Disease 2019 (COVID-19). Int J Med Sci 2020; 17(15):2373-2378. doi:10.7150/ijms.47587. Available from http://www.medsci.org/v17p2373.htm

File import instruction

Abstract

Background: In patients with coronavirus disease 2019 (COVID-19) pneumonia, whether new pulmonary lesions will continue to develop after treatment was unknown. This study aimed to determine whether new pulmonary lesions will develop after treatment in patients with COVID-19 pneumonia, and investigate their CT features and outcomes.

Methods: This retrospective study included 56 consecutive patients with confirmed COVID-19 pneumonia from January 20 to March 5, 2020. Their initial and follow-up CT images and clinical data were reviewed. The CT manifestations of primary and newly developed pulmonary lesions and their changes after treatment were mainly evaluated.

Results: Among the 56 patients (mean age: 48±15 years, 35 men) with COVID-19 pneumonia, 42 (75.0%) patients developed new pulmonary lesions during treatment. All new lesions developed before the nucleic acid test turned negative. Patients with new lesions were more likely to have lymphopenia (P=0.041) or increased C-reactive protein (CRP) levels (P<0.001) than those without new lesions. Of the 42 patients, 30 (71.4%) patients developed new lesions once, and 12 (28.6%) twice or thrice, which usually appeared when primary lesions were progressing (37, 88.1%) and 1-15 days after treatment. The newly developed lesions were usually multiple (38, 90.5%), distributed in the previously involved (39, 92.9%) or uninvolved (27, 64.3%) lobes, and manifested as ground-glass opacities (GGOs) with consolidation (23, 54.8%) or pure GGOs (19, 45.2%). After their occurrence, the new lesions in most patients (32, 76.2%) showed direct absorption, whereas those in some patients (10, 23.8%) progressed before absorption.

Conclusion: During treatment, most patients with COVID-19 pneumonia will develop new pulmonary lesions, which usually manifest as multiple GGOs distributed around the primary lesions or in previously uninvolved lobes, and are subsequently absorbed directly.

Keywords: Coronavirus Disease 2019, Pneumonia, New lesions, Primary lesions, CT