Radiological findings in 136 patients suspected of Coronavirus disease 2019 (COVID-19)

Purpose: To describe and study the chest computed tomography (CT) and x-ray (CXR) radiological findings in 136 patients with clinical suspicion for COVID-19 infection. Material and Methods: A total number of 136 patients , 84 males and 52 females, aged 21 to 90 years old, who came to the emergency department of our hospital complaining of symptoms similar to Coronavirus disease (COVID-19). After clinical examination and evaluation all these patients underwent PCR Test for COVID-19 and some basic blood tests as well. Since their clinical picture made them suspects for COVID-19 the next step included CXR and CT. The evaluation of CXRs and CTs was performed by three radiologists, without a specific scoring system, in consensus mainly for ground glass opacity (GGO), consolidation, location, lymphadenopathy, pleural effusion and pleural thickening. Results: 66/136 (48.5%) patients were positive to COVID-19, while 70 had negative PCR Test. 52/66 (78.8%) positive patients were over 51 years old (up to 90 years). Radiological findings on chest CT in the 66 positive patients included GGOs (60 cases, 90.9%), while in 6 cases (9.1%) there were no abnormal findings. In most cases (52, 78.8%) the opacities were bilateral and in only 14 cases (21.2%) they were unilateral. GGOs were found mainly in middle and peripheral pulmonary zones, as well as middle and lower lung lobes. Besides GGO, imaging findings commonly included lymphadenopathy (34, 51.5%), pleural effusion and thickening (18, 27.3%). Less frequent findings included crazy paving (10, 15.1 %), septal thickening and lines ( 7 , 10.6 %), air-space consolidation (5, 7.5 %) and reticular pattern (9, 13,6 %). 44/66 (66.7%) positive patients showed abnormal findings on CXR, while 22 (33.3%) had normal CXR. Chest CT in 14/70 (20.0%) negative patients demonstrated lung consolidation and GGO. 54/70 of the negative patients (77.1%) had normal chest x-rays. Conclusions: The majority of patients with positive PCR Test had abnormal findings on CXRs and CT. Abnormal CT findings were mainly bilateral, multi-focal GGO. Abnormal findings in patients with COVID-19 were related to their age, in particular these were milder in younger patients.