Common clinical manifestations and the Thorax CT features of Coronavirus Disease 2019 (Covid-19) by stages

Abstract

Backround: The aim of this study is to report the clinical course of the disease and the correlation of thorax computed tomography (CT) feaures in patients with clinically suspected and laboratory confirmed COVID-19 pneumonia by reviewing the limited datas of literatüre. Materials and Methods: Totally 104 patients (39 females and 65 males; age range, 22-91 years) admitted to our hospital with suspicion of COVID-19 pneumonia were retrospectively reviewed for common thorax CT features, laboratory findings and clinical manifestations.. All patients were positive in reverse transcriptase polymerase chain reaction test (RT-PCR) indicating Covid 19 pnemonia and all had abnormal CT findings. The main clinical signs, common laboratory findings and expressing the stages of the disease by CT findings were examined. Results: 18 (17.3%) of the 104 patients with Covid 19 were as single, the remaining 86 (82.7%) were as multiple lesions on initial CT scans. The spread of these lesions were predominantly peripheral in 80 patients (76.9%) and peripheral-central in 24 patients (23.1%). In the early stage of the disease,lesions identified as ground glass opacites (GGO) whereas in the advanced stages, GGO and reticular pattern, air bubbles, subpleural fibrotic bands, air bronchograms, traction bronchiectasis and pleural effusion were observed. 52 patients who underwent routine blood tests, all (%100) had elevated C reactive protein (CRP) counts. 11patients (21.1%) had decreased leukocyte count. 48 patients (92.3%) had decreased lymphocyte count. 14 patients (28%) had increased d-dimer levels. Conclusions: Various lesions were detected in the CT examine like parenchyma and/or interstitium involvement of patients with Covid 19 pneumonia. In early stages, parenchymal involvement were more frequent identified as a single or multiple GGO. Multilobar involvement, consolidation areas with air bubbles and bronchograms, widespread GGO and reticular pattern which is called crazy pavings were much more detected in the late stage of the disease. Prominent decrease in the lymphocyte count,and higher C-reactive protein levels were the most frequent laboratory findings.