Computed Tomography (CT) Imaging Features of Patients with COVID-19: Systematic Review and Meta-Analysis

Abstract

Introduction. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly contagious disease, and its first outbreak was reported in Wuhan, China. A coronavirus disease (COVID-19) causes severe respiratory distress (ARDS). Due to the primary involvement of the respiratory system, chest CT is strongly recommended in suspected COVID-19 cases, for both initial evaluation and follow-up. Objective. The aim of this review was to systematically analyze the existing literature on CT imaging features of patients with COVID-19 pneumonia. Methods. A systematic search was conducted on PubMed, Embase, Cochrane Library, Open Access Journals (OAJ), and Google Scholar databases until April 15, 2020. All articles with a report of CT findings in COVID-19 patients published in English from the onset of COVID-19 outbreak to April 20, 2020, were included in the study. Result. From a total of 5041 COVID-19-infected patients, about 98% (4940/5041) had abnormalities in chest CT, while about 2% have normal chest CT findings. Among COVID-19 patients with abnormal chest CT findings, 80% (3952/4940) had bilateral lung involvement. Ground-glass opacity (GGO) and mixed GGO with consolidation were observed in 2482 (65%) and 768 (18%) patients, respectively. Consolidations were detected in 1259 (22%) patients with COVID-19 pneumonia. CT images also showed interlobular septal thickening in about 691 (27%) patients. Conclusion. Frequent involvement of bilateral lung infections, ground-glass opacities, consolidation, crazy paving pattern, air bronchogram signs, and intralobular septal thickening were common CT imaging features of patients with COVID-19 pneumonia.