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
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

100431

Informations de copyright

© 2022 The Authors.

Déclaration de conflit d'intérêts

The authors declare that they have no conflict of interests.

Références

BMC Infect Dis. 2019 Jan 10;19(1):40
pubmed: 30630424
Acad Radiol. 2021 Oct;28(10):1331-1338
pubmed: 34024714
Turk Kardiyol Dern Ars. 2013 Mar;41(2):157-60
pubmed: 23666306
FASEB J. 2020 Oct;34(10):13877-13884
pubmed: 32856766
Biometrics. 1977 Mar;33(1):159-74
pubmed: 843571
Radiology. 2020 Jun;295(3):715-721
pubmed: 32053470
JAMA Intern Med. 2020 Oct 1;180(10):1345-1355
pubmed: 32667669
Eur Radiol. 2020 Sep;30(9):4910-4917
pubmed: 32323011
Ann Intern Med. 2017 Sep 19;167(6):394-409
pubmed: 28869986
BMC Med Imaging. 2021 Feb 17;21(1):31
pubmed: 33596844
J Chiropr Med. 2016 Jun;15(2):155-63
pubmed: 27330520
AJR Am J Roentgenol. 2003 Feb;180(2):513-8
pubmed: 12540463
Respiration. 2020;99(7):598-605
pubmed: 32640453
Radiographics. 2020 Nov-Dec;40(7):1848-1865
pubmed: 33095680
Arch Cardiol Mex. 2019;89(4):412-414
pubmed: 31834328
Virol J. 2020 Oct 21;17(1):159
pubmed: 33087181
Infect Dis Poverty. 2020 Dec 2;9(1):163
pubmed: 33261654
Eur Radiol. 2020 Dec;30(12):6485-6496
pubmed: 32594211
BMC Infect Dis. 2021 Feb 10;21(1):167
pubmed: 33568104
Ann Transl Med. 2021 Jan;9(2):111
pubmed: 33569413
Diagnostics (Basel). 2021 Feb 08;11(2):
pubmed: 33567507
Eur Radiol. 2020 Aug;30(8):4407-4416
pubmed: 32215691
Respir Investig. 2022 May;60(3):364-368
pubmed: 35000879
Anesthesiology. 2016 May;124(5):1100-8
pubmed: 26872367
Eur Radiol. 2020 Oct;30(10):5463-5469
pubmed: 32399710
Pediatr Infect Dis J. 2010 Aug;29(8):782-3
pubmed: 20661108
Front Public Health. 2020 May 15;8:206
pubmed: 32574297
AJR Am J Roentgenol. 2020 Jul;215(1):87-93
pubmed: 32174129
Radiology. 2020 Aug;296(2):E55-E64
pubmed: 32191587
Biomed Res Int. 2020 Jun 05;2020:6928368
pubmed: 32596354
Sci Rep. 2021 Mar 19;11(1):6422
pubmed: 33742041
JAMA. 2021 Feb 9;325(6):529-531
pubmed: 33404586
JAMA Intern Med. 2022 Jul 1;182(7):701-709
pubmed: 35486394

Auteurs

Tim Fischer (T)

Division of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.

Yassir El Baz (Y)

Division of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.

Giulia Scanferla (G)

Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.

Nicole Graf (N)

Clinical Trials Unit, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.

Frederike Waldeck (F)

Division of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.

Gian-Reto Kleger (GR)

Division of Intensive Care, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.

Thomas Frauenfelder (T)

Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.

Jens Bremerich (J)

Department of Radiology, University of Basel Hospital, Basel, Switzerland.

Sabine Schmidt Kobbe (SS)

Department of Diagnostic and Interventional Radiology, University Hospital of Lausanne (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.

Jean-Luc Pagani (JL)

Adult Intensive Care Service, University Hospital and University of Lausanne, Lausanne, Switzerland.

Sebastian Schindera (S)

Department of Radiology, Cantonal Hospital Aarau, Aarau, Switzerland.

Anna Conen (A)

Department of Infectious Diseases and Infection Prevention, Cantonal Hospital Aarau, Switzerland.

Simon Wildermuth (S)

Division of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.

Sebastian Leschka (S)

Division of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.

Carol Strahm (C)

Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.

Stephan Waelti (S)

Division of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.

Tobias Johannes Dietrich (TJ)

Division of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.

Werner C Albrich (WC)

Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.

Classifications MeSH