Thin-Section Chest CT Imaging of COVID-19 Pneumonia: A Comparison Between Patients with Mild and Severe Disease

PURPOSE: To compare radiologic characteristics of coronavirus disease 2019 (COVID-19) pneumonia at thin-section CT on admission between patients with mild and severe disease. MATERIALS AND METHODS: Seventy patients with COVID-19 pneumonia who were admitted to Zhongnan Hospital of Wuhan University between January 20, 2020 and January 27, 2020 were enrolled. On the basis of the World Health Organization guidelines, 50 patients were categorized with the mild form and 20 with the severe form based on clinical conditions. Imaging features, clinical, and laboratory data were reviewed and compared. RESULTS: Patients with the severe form (median age, 65 years; interquartile range [IQR]: 54.75–75.00 years) were older than those with the mild form of disease (median age, 42.5 years; IQR: 32.75–58.50 years) (P < .001). Patients with the severe form of disease had more lung segments involved (median number of segments: 17.5 vs 7.5, P ≤ .001) and also larger opacities (median number of segments with opacities measuring 3 cm to less than 50% of the lung segment: 5.5 vs 2.0, P = .006; ≥ 50% of lung segment: 7.5 vs 0.0, P < .001). They also had more interlobular septal thickening (75% vs 28%, P < .001), higher prevalence of air bronchograms (70% vs 32%, P = .004), and pleural effusions (40% vs 14%, P = .017). CONCLUSION: Ground-glass opacities with or without consolidation in a peripheral and basilar predominant distribution were the most common findings in COVID-19 pneumonia. Patients with the severe form of the disease had more extensive opacification of the lung parenchyma than did patients with mild disease. Interlobular septal thickening, air bronchograms, and pleural effusions were also more prevalent in severe COVID-19. © RSNA, 2020