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Inspiratory and Expiratory Chest High-Resolution CT: Small-Airway Disease Evaluation in Patients with COVID-19

Author(s):

Renjun Huang, Jingfen Zhu, Jianguo Zhou, Yalei Shang, Xiaoming Lin, Shengbin Gong, Lan Gu, Hui Dai and Yonggang Li*  

Abstract:


Background: An outbreak of coronavirus disease 2019 (COVID-19) has occurred worldwide. However, the small-airway disease in patients with COVID-19 has not been explored.

Aim: This study aimed to explore the small-airway disease in patients with COVID-19 using inspiratory and expiratory chest high-resolution computed tomography (CT).

Methods: This multicenter study included 108 patients with COVID-19. The patients were classified into five stages (0–IV) based on the CT images. The clinical and imaging data were compared among CT images in different stages. Patients were divided into three groups according to the time interval from the initial CT scan, and the clinical and air trapping data were compared among these groups. The correlation between clinical parameters and CT scores was evaluated.

Results: The clinical data, including age, frequency of breath shortness and dyspnea, neutrophil percentage, lymphocyte count, PaO2, PaCO2, SaO2, and time interval between the onset of illness and initial CT, showed significant differences among CT images in different stages. A significant difference in the CT score of air trapping was observed between stage I and stage III. A low negative correlation was found between the CT score of air trapping and time interval between the onset of symptoms and initial CT. No significant difference was noted in the frequency and CT score of air trapping among different groups.

Conclusions: Some patients with COVID-19 developed small-airway disease. Air trapping was more distinguished in the early stage of the disease and persisted during the 2-month follow-up. Longer-term follow-up studies are needed to confirm the findings.

Keywords:

Coronavirus, infections, pneumonia, small airway, tomography, X-ray computed.

Affiliation:

Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou city, Jiangsu province 215000,, Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou city, Jiangsu province 215000,, Department of Radiology, Nanjing University of Chinese Medicine Affiliated Lianyungang Hospital, Lianyungang City, Jiangsu province 222004,, Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou city, Jiangsu province 215000,, Department of Radiology, The Fifth People's Hospital of Wuxi, Wuxi City, Jiangsu province 225000,, Department of Radiology, the Third People's Hospital of Yangzhou, Yangzhou city, Jiangsu province 225000,, Department of Radiology, The Fifth People's Hospital of Wuxi, Wuxi City, Jiangsu province 225000,, Institute of Medical Imaging, Soochow University, Suzhou city, Jiangsu province 215000,, Institute of Medical Imaging, Soochow University, Suzhou city, Jiangsu province 215000



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