Radiology
Radiological Society of North America
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Pre- and Posttreatment Chest CT Findings: 2019 Novel Coronavirus (2019-nCoV) Pneumonia
DOI 10.1148/radiol.2020200323
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Duan and Qin: Pre- and Posttreatment Chest CT Findings: 2019 Novel Coronavirus (2019-nCoV) Pneumonia

A 46-year-old woman presented to the hospital with a 7-day history of fever without chills and rigor, nasal discharge, cough, and myalgia. She had stayed with a friend who had been diagnosed with 2019 novel coronavirus (2019-nCoV) pneumonia in Wuhan, China, 5 days previously.

At presentation, her body temperature was elevated to 38.3°C (100.9°F) with normal pulmonary auscultation. Laboratory studies showed a normal total white blood cell count of 4.2 × 109/L (normal range, 4.0–10.0 × 109/L), and the differential count showed 52.9% neutrophils (normal range, 40.0%–74.0%) and 28.3% lymphocytes (normal range, 18.0%–43.0%). There were elevated blood levels for C-reactive protein (6.4 mg/L; normal range, 0–6 mg/L), erythrocyte sedimentation rate (27 mm/h; normal range, 0–20 mm/h), and D-dimer (566 ng/mL; normal range, 500 ng/mL).

Unenhanced chest CT showed multiple bilateral and peripheral ground-glass opacities (Figure a) in the superior segments of both lower lobes without sparing of subpleural regions (1,2). Real-time fluorescence polymerase chain reaction of the patient’s pharyngeal swab was positive for 2019-nCoV nucleic acid 2 days after hospitalization.

CT scans (slice thickness = 1 mm) in a 46-year-old woman with the 2019 novel coronavirus (2019-nCoV). (a) Transverse thin-section CT scan obtained at first day after admission shows multiple ground-glass opacities in both lungs. Ground-glass opacities are seen in the superior segment of both lower lobes. (b) Follow-up CT scan obtained on day 7 after admission shows ground-glass opacities are completely resolved in the superior segment of right lower lobe and partly resolved in the superior segment of left lower lobe. (c) Follow-up CT scan obtained at day 13 after admission shows ground-glass opacities are completely resolved in the superior segment of right lower lobe and partly resolved in the superior segment of left lower lobe.
CT scans (slice thickness = 1 mm) in a 46-year-old woman with the 2019 novel coronavirus (2019-nCoV). (a) Transverse thin-section CT scan obtained at first day after admission shows multiple ground-glass opacities in both lungs. Ground-glass opacities are seen in the superior segment of both lower lobes. (b) Follow-up CT scan obtained on day 7 after admission shows ground-glass opacities are completely resolved in the superior segment of right lower lobe and partly resolved in the superior segment of left lower lobe. (c) Follow-up CT scan obtained at day 13 after admission shows ground-glass opacities are completely resolved in the superior segment of right lower lobe and partly resolved in the superior segment of left lower lobe.
CT scans (slice thickness = 1 mm) in a 46-year-old woman with the 2019 novel coronavirus (2019-nCoV). (a) Transverse thin-section CT scan obtained at first day after admission shows multiple ground-glass opacities in both lungs. Ground-glass opacities are seen in the superior segment of both lower lobes. (b) Follow-up CT scan obtained on day 7 after admission shows ground-glass opacities are completely resolved in the superior segment of right lower lobe and partly resolved in the superior segment of left lower lobe. (c) Follow-up CT scan obtained at day 13 after admission shows ground-glass opacities are completely resolved in the superior segment of right lower lobe and partly resolved in the superior segment of left lower lobe.
CT scans (slice thickness = 1 mm) in a 46-year-old woman with the 2019 novel coronavirus (2019-nCoV). (a) Transverse thin-section CT scan obtained at first day after admission shows multiple ground-glass opacities in both lungs. Ground-glass opacities are seen in the superior segment of both lower lobes. (b) Follow-up CT scan obtained on day 7 after admission shows ground-glass opacities are completely resolved in the superior segment of right lower lobe and partly resolved in the superior segment of left lower lobe. (c) Follow-up CT scan obtained at day 13 after admission shows ground-glass opacities are completely resolved in the superior segment of right lower lobe and partly resolved in the superior segment of left lower lobe.
CT scans (slice thickness = 1 mm) in a 46-year-old woman with the 2019 novel coronavirus (2019-nCoV). (a) Transverse thin-section CT scan obtained at first day after admission shows multiple ground-glass opacities in both lungs. Ground-glass opacities are seen in the superior segment of both lower lobes. (b) Follow-up CT scan obtained on day 7 after admission shows ground-glass opacities are completely resolved in the superior segment of right lower lobe and partly resolved in the superior segment of left lower lobe. (c) Follow-up CT scan obtained at day 13 after admission shows ground-glass opacities are completely resolved in the superior segment of right lower lobe and partly resolved in the superior segment of left lower lobe.
CT scans (slice thickness = 1 mm) in a 46-year-old woman with the 2019 novel coronavirus (2019-nCoV). (a) Transverse thin-section CT scan obtained at first day after admission shows multiple ground-glass opacities in both lungs. Ground-glass opacities are seen in the superior segment of both lower lobes. (b) Follow-up CT scan obtained on day 7 after admission shows ground-glass opacities are completely resolved in the superior segment of right lower lobe and partly resolved in the superior segment of left lower lobe. (c) Follow-up CT scan obtained at day 13 after admission shows ground-glass opacities are completely resolved in the superior segment of right lower lobe and partly resolved in the superior segment of left lower lobe.

After the patient received 7 days of treatment, combined with interferon inhalation, real-time fluorescence polymerase chain reaction of the patient’s pharyngeal swab became negative for 2019-nCoV nucleic acid. At 7 days, chest CT showed decreasing ground-glass opacities (Figure b). At day 13 after admission, the ground-glass opacities in the right lung had resolved; the left ground-glass opacities showed partial resolution (Figure c).

Notes

Disclosures of Conflicts of Interest: Y.D. disclosed no relevant relationships. J.Q. disclosed no relevant relationships.This work was supported by grants from the National Natural Science Foundation of China (grant 81101096), the Medical Scientific Research Foundation of Guangdong Province (grant B2011102), the Science and Technology Planning Project of Guangdong Province (grant 2015A020212017), and the Natural Science Foundation of Guangdong Province (grant 2016A030313323).

References

1. 

Lei J, , Li J, , Qi X. . CT Imaging of the 2019 Novel Coronavirus (2019-nCoV) Pneumonia. Radiology 2020. , doi: 10.1148/radiol.2020200236. Published online January 30, 2020.

2. 

Kanne J. . Chest CT findings in 2019-nCoV infections from Wuhan, China: What is Currently Known. Radiology 2020. , doi: 10.1148/radiol.2020200241. Published online February 4, 2020.

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