Comparison of temporal evolution of computed tomography imaging features in COVID-19 and influenza infections in a multicenter cohort study.
COPD, Chronic obstructive pulmonary disease
COVID-19
COVID-19, Coronavirus disease 2019
CT, Computed tomography
Computed tomography
GGO, Ground glass opacity
HIV, Human immunodeficiency virus
HSCT, Haematopoietic stem cell transplantation
ICC, Intraclass correlation coefficient
ICU, Intensive care unit
IQR, Interquartile range
Influenza
Lung
PCR, Polymerase chain reaction
Pneumonia
SD, Standard deviation
SOT, Solid organ transplantation
Journal
European journal of radiology open
ISSN: 2352-0477
Titre abrégé: Eur J Radiol Open
Pays: England
ID NLM: 101650225
Informations de publication
Date de publication:
2022
2022
Historique:
received:
13
04
2022
revised:
15
06
2022
accepted:
21
06
2022
entrez:
29
6
2022
pubmed:
30
6
2022
medline:
30
6
2022
Statut:
ppublish
Résumé
To compare temporal evolution of imaging features of coronavirus disease 2019 (COVID-19) and influenza in computed tomography and evaluate their predictive value for distinction. In this retrospective, multicenter study 179 CT examinations of 52 COVID-19 and 44 influenza critically ill patients were included. Lung involvement, main pattern (ground glass opacity, crazy paving, consolidation) and additional lung and chest findings were evaluated by two independent observers. Additional findings and clinical data were compared patient-wise. A decision tree analysis was performed to identify imaging features with predictive value in distinguishing both entities. In contrast to influenza patients, lung involvement remains high in COVID-19 patients > 14 days after the diagnosis. The predominant pattern in COVID-19 evolves from ground glass at the beginning to consolidation in later disease. In influenza there is more consolidation at the beginning and overall less ground glass opacity (p = 0.002). Decision tree analysis yielded the following: Earlier in disease course, pleural effusion is a typical feature of influenza (p = 0.007) whereas ground glass opacities indicate COVID-19 (p = 0.04). In later disease, particularly more lung involvement (p < 0.001), but also less pleural (p = 0.005) and pericardial (p = 0.003) effusion favor COVID-19 over influenza. Regardless of time point, less lung involvement (p < 0.001), tree-in-bud (p = 0.002) and pericardial effusion (p = 0.01) make influenza more likely than COVID-19. This study identified differences in temporal evolution of imaging features between COVID-19 and influenza. These findings may help to distinguish both diseases in critically ill patients when laboratory findings are delayed or inconclusive.
Identifiants
pubmed: 35765661
doi: 10.1016/j.ejro.2022.100431
pii: S2352-0477(22)00038-7
pmc: PMC9226197
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100431Informations de copyright
© 2022 The Authors.
Déclaration de conflit d'intérêts
The authors declare that they have no conflict of interests.
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