U.S. researchers report they have spotted early, subtle signs in the lungs that point to coronavirus infection.
This could help doctors diagnose patients in the early stages of the disease, when it may not be obvious on lung scans, according to the Mount Sinai Health System doctors.
They say they're the first U.S. experts to analyze chest CT scans of 94 patients in China with COVID-19. Their findings appear in the February issue of the journal Radiology.
"This work augments our initial study, which was the first published research study on the imaging findings of COVID-19, and now we are able to provide a more comprehensive evaluation of how lung disease in coronavirus patients manifests and develops," said study co-author Dr. Michael Chung. He's an assistant professor of diagnostic, molecular and interventional radiology at Mount Sinai's Icahn School of Medicine, in New York City.
"If coronavirus should continue to spread and impact the United States or elsewhere more significantly, this study equips radiologists with the knowledge to recognize and more confidently suggest if a patient has COVID-19 or pneumonia due to another cause," Chung said in a school news release.
"This is necessary for prompt diagnosis for any individual patient (which will lead to more rapid and effective care), but also for patient isolation to prevent the spreading of the highly contagious disease," Chung explained.
Of 36 patients who had CT lung scans zero to two days after reporting symptoms, more than half had no evidence of lung disease, which suggests that CT scans cannot reliably rule out COVID-19 that early in the disease, the study authors noted.
Among the 33 patients scanned three to five days after they developed symptoms, there were patterns of hazy findings in the lungs, and these abnormalities became more round in shape and more dense, according to the report.
Among the 25 patients scanned six to 12 days after they developed symptoms, the researchers could see fully involved lung disease. The patterns in those lung scans resembled those in related coronavirus outbreaks, including SARS, or severe acute respiratory syndrome, and MERS, or Middle East respiratory syndrome.
According to study lead author Dr. Adam Bernheim, "Just as clinicians are evaluating more patients suspected of COVID-19, radiologists are similarly interpreting more chest CTs in those suspected of infection." Bernheim is an assistant professor of diagnostic, molecular and interventional radiology at Mount Sinai.
"Chest CT is a vital component in the diagnostic algorithm for patients with suspected infection, particularly given the limited availability and, in some cases, reliability of test kits," Bernheim added.
"These investigative efforts not only show patterns of imaging findings in a large number of patients, but they also demonstrate that frequency of CT findings is related to disease time course," he added. "Recognizing imaging patterns based on infection time course is paramount for not only understanding the disease process and natural history of COVID-19, but also for helping to predict patient progression and potential complication development."
The U.S. Centers for Disease Control and Prevention has more on COVID-19.
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