Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 12/2020

01-12-2020 | Adenovirus | Computed Tomography

Comparison of the computed tomography findings in COVID-19 and other viral pneumonia in immunocompetent adults: a systematic review and meta-analysis

Authors: Stephan Altmayer, Matheus Zanon, Gabriel Sartori Pacini, Guilherme Watte, Marcelo Cardoso Barros, Tan-Lucien Mohammed, Nupur Verma, Edson Marchiori, Bruno Hochhegger

Published in: European Radiology | Issue 12/2020

Login to get access

Abstract

Objectives

To compare the chest computed tomography (CT) findings of coronavirus disease 2019 (COVID-19) to other non-COVID viral pneumonia.

Methods

MEDLINE, EMBASE, and Cochrane databases were searched through April 04, 2020, for published English language studies. Studies were eligible if they included immunocompetent patients with up to 14 days of viral pneumonia. Subjects had a respiratory tract sample test positive for COVID-19, adenovirus, influenza A, rhinovirus, parainfluenza, or respiratory syncytial virus. We only included observational studies and case series with more than ten patients. The pooled prevalence of each chest CT pattern or finding was calculated with 95% confidence intervals (95% CI).

Results

From 2263 studies identified, 33 were eligible for inclusion, with a total of 1911 patients (COVID-19, n = 934; non-COVID, n = 977). Frequent CT features for both COVID-19 and non-COVID viral pneumonia were a mixed pattern of ground-glass opacity (GGO) and consolidation (COVID-19, 0.37; 0.17–0.56; non-COVID, 0.46; 0.35–0.58) or predominantly GGO pattern (COVID-19, 0.42; 0.28–0.55; non-COVID 0.25; 0.17–0.32), bilateral distribution (COVID-19, 0.81; 0.77–0.85; non-COVID, 0.69; 0.54–0.84), and involvement of lower lobes (COVID-19, 0.88; 0.80–0.95; non-COVID, 0.61; 0.50–0.82). COVID-19 pneumonia presented a higher prevalence of peripheral distribution (COVID-19 0.77; 0.67–0.87; non-COVID 0.34; 0.18–0.49), and involvement of upper (COVID-19, 0.77; 0.65–0.88; non-COVID 0.18; 0.10–0.27) and middle lobes (COVID-19, 0.61; 0.47–0.76; non-COVID 0.24; 0.11–0.38).

Conclusion

Except for a higher prevalence of peripheral distribution, involvement of upper and middle lobes, COVID-19, and non-COVID viral pneumonia had overlapping chest CT findings.

Key Points

• Most common CT findings of coronavirus disease 2019 (COVID-19) were a predominant pattern of ground-glass opacity (GGO), followed by a mixed pattern of GGO and consolidation, bilateral disease, peripheral distribution, and lower lobe involvement.
• Most frequent CT findings of non-COVID viral pneumonia were a predominantly mixed pattern of GGO and consolidation, followed by a predominant pattern of GGO, bilateral disease, random or diffuse distribution, and lower lobe involvement.
• COVID-19 pneumonia presented a higher prevalence of peripheral distribution, and involvement of upper and middle lobes compared with non-COVID viral pneumonia
Appendix
Available only for authorised users
Literature
1.
Zhu N, Zhang D, Wang W et al (2020) A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 382:727–733CrossRef
2.
Cao B, Wang Y, Wen D et al (2020) A trial of lopinavir–ritonavir in adults hospitalized with severe Covid-19. N Engl J Med 382:1787–1799CrossRef
3.
4.
Huang C, Wang Y, Li X et al (2020) Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 395:497–506CrossRef
5.
Guan W, Ni Z, Hu Y et al (2020) Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 382:1708–1720CrossRef
6.
7.
8.
9.
10.
11.
Li Y, Xia L (2020) Coronavirus disease 2019 (COVID-19): role of chest CT in diagnosis and management. AJR Am J Roentgenol 4:1–7
12.
13.
14.
15.
Song F, Shi N, Shan F et al (2020) Emerging 2019 novel coronavirus (2019-nCoV) pneumonia. Radiology 295:210–217CrossRef
16.
Shi H, Han X, Jiang N et al (2020) Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis 20:425–434CrossRef
17.
Amorim VB, Rodrigues RS, Barreto MM, Zanetti G, Hochhegger B, Marchiori E (2013) Influenza A (H1N1) pneumonia: HRCT findings. J Bras Pneumol 39:323–329CrossRef
18.
Cho WH, Kim YS, Jeon DS et al (2011) Outcome of pandemic H1N1 pneumonia: clinical and radiological findings for severity assessment. Korean J Intern Med 26:160CrossRef
19.
Li P, Su DJ, Zhang JF, Xia XD, Sui H, Zhao DH (2011) Pneumonia in novel swine-origin influenza A (H1N1) virus infection: high-resolution CT findings. Eur J Radiol 80:146–152CrossRef
20.
Li H, Weng H, Lan C et al (2018) Comparison of patients with avian influenza A (H7N9) and influenza A (H1N1) complicated by acute respiratory distress syndrome. Medicine (Baltimore) 97:e0194CrossRef
21.
Marchiori E, Zanetti G, Hochhegger B et al (2010) High-resolution computed tomography findings from adult patients with influenza A (H1N1) virus-associated pneumonia. Eur J Radiol 74:93–98CrossRef
22.
Nicolini A, Ferrera L, Rao F, Senarega R, Ferrari-Bravo M (2012) Chest radiological findings of influenza A H1N1 pneumonia. Rev Port Pneumol 18:120–127CrossRef
23.
Park CK, Kwon H, Park JY (2017) Thin-section computed tomography findings in 104 immunocompetent patients with adenovirus pneumonia. Acta Radiol 58:937–943CrossRef
24.
Qi W, Gao S, Liu C, Shinong P, Guo Q (2014) Computed tomographic features of pregnant women with pandemic H1N1 virus infection. Radiol Infect Dis 1:23–27CrossRef
25.
Shiley KT, Van Deerlin VM, Miller WT (2010) Chest CT features of community-acquired respiratory viral infections in adult inpatients with lower respiratory tract infections. J Thorac Imaging 25:68–75CrossRef
26.
Sohn CH, Ryoo SM, Yoon JY et al (2013) Comparison of clinical features and outcomes of hospitalized adult patients with novel influenza A (H1N1) pneumonia and other pneumonia. Acad Emerg Med 20:46–53CrossRef
27.
Son JS, Kim YH, Lee YK et al (2011) Pandemic influenza A/H1N1 viral pneumonia without co-infection in Korea: Chest CT findings. Tuberc Respir Dis 70:397–404CrossRef
28.
Song JY, Cheong HJ, Heo JY et al (2011) Clinical, laboratory and radiologic characteristics of 2009 pandemic influenza A/H1N1 pneumonia: primary influenza pneumonia versus concomitant/secondary bacterial pneumonia. Influenza Other Respi Viruses 5:535–543CrossRef
29.
Grieser C, Goldmann A, Steffen IG et al (2012) Computed tomography findings from patients with ARDS due to influenza A (H1N1) virus-associated pneumonia. Eur J Radiol 81:389–394CrossRef
30.
Tanaka N, Emoto T, Suda H et al (2012) High-resolution computed tomography findings of influenza virus pneumonia: a comparative study between seasonal and novel (H1N1) influenza virus pneumonia. Jpn J Radiol 30:154–161CrossRef
31.
Valente T, Lassandro F, Marino M, Squillante F, Aliperta M, Muto R (2012) Polmonite H1N1: La nostra esperienza in 50 pazienti con decorso clinico grave dell’influenza virale A di origine suina (S-OIV). Radiol Med 117:165–184CrossRef
32.
Henzler T, Meyer M, Kalenka A et al (2010) Image findings of patients with H1N1 virus pneumonia and acute respiratory failure. Acad Radiol 17:681–685CrossRef
33.
Hwang SM, Park DE, Yang YI et al (2013) Outbreak of febrile respiratory illness caused by adenovirus at a south Korean military training facility: clinical and radiological characteristics of adenovirus pneumonia. Jpn J Infect Dis 66:359–365CrossRef
34.
Kang H, Lee KS, Jeong YJ, Lee HY, Kim KI, Nam KJ (2012) Computed tomography findings of influenza a (H1N1) pneumonia in adults: pattern analysis and prognostic comparisons. J Comput Assist Tomogr 36:285–290CrossRef
35.
Karadeli E, Koç Z, Ulusan Ş, Erbay G, Demiroǧlu YZ, Şen N (2011) Chest radiography and CT findings in patients with the 2009 pandemic (H1N1) influenza. Diagn Interv Radiol 17:216–222
36.
Kim SY, Kim JS, Park CS (2011) Various computed tomography findings of 2009 H1N1 influenza in 17 patients with relatively mild illness. Jpn J Radiol 29:301–306CrossRef
37.
Ishiguro T, Takayanagi N, Kanauchi T et al (2016) Clinical and radiographic comparison of influenza virus-associated pneumonia among three viral subtypes. Intern Med 55:731–737CrossRef
38.
Lee JE, Choe KW, Lee SW (2013) Clinical and radiological characteristics of 2009 H1N1 influenza associated pneumonia in young male adults. Yonsei Med J 54:927–934CrossRef
39.
Yoon H, Jhun BW, Kim H, Yoo H, Park SB (2017) Characteristics of adenovirus pneumonia in Korean military personnel, 2012-2016. J Korean Med Sci 32:287–295CrossRef
40.
Winter DH, Manzini M, Salge JM et al (2015) Aging of the lungs in asymptomatic lifelong nonsmokers: findings on HRCT. Lung 193:283–290CrossRef
41.
Copley SJ, Wells AU, Hawtin KE et al (2009) Lung morphology in the elderly: comparative CT study of subjects over 75 years old versus those under 55 years old. Radiology 251:566–573CrossRef
42.
Jain S, Self WH, Wunderink RG et al (2015) Community-acquired pneumonia requiring hospitalization among U.S. adults. N Engl J Med 373:415–427CrossRef
43.
Jennings LC, Anderson TP, Beynon KA et al (2008) Incidence and characteristics of viral community-acquired pneumonia in adults. Thorax 63:42–48CrossRef
44.
de Roux A, Marcos MA, Garcia E et al (2004) Viral community-acquired pneumonia in nonimmunocompromised adults. Chest 125:1343–1351CrossRef
45.
Oosterheert JJ, van Loon AM, Schuurman R et al (2005) Impact of rapid detection of viral and atypical bacterial pathogens by real-time polymerase chain reaction for patients with lower respiratory tract infection. Clin Infect Dis 41:1438–1444CrossRef
46.
Hansell DM, Bankier AA, MacMahon H, McLoud TC, Müller NL, Remy J (2008) Fleischner Society: glossary of terms for thoracic imaging. Radiology 246:697–722CrossRef
47.
48.
49.
Kooraki S, Hosseiny M, Myers L, Gholamrezanezhad A (2020) Coronavirus (COVID-19) outbreak: what the department of radiology should know. J Am Coll Radiol 17:447–451CrossRef
50.
Simpson S, Kay FU, Abbara S et al (2020) Radiological Society of North America Expert Consensus Statement on Reporting Chest CT Findings Related to COVID-19. Endorsed by the Society of Thoracic Radiology, the American College of Radiology, and RSNA. Radiology: Cardiothoracic Imaging. https://​doi.​org/​10.​1097/​RTI.​0000000000000524​
51.
52.
53.
Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A (2020) Coronavirus disease 2019 (COVID-19): a systematic review of imaging findings in 919 patients. AJR Am J Roentgenol 14:1–7
54.
55.
Cohen JF, Korevaar DA, Altman DG et al (2016) STARD 2015 guidelines for reporting diagnostic accuracy studies: explanation and elaboration. BMJ Open 6:e012799CrossRef
Metadata
Title
Comparison of the computed tomography findings in COVID-19 and other viral pneumonia in immunocompetent adults: a systematic review and meta-analysis
Authors
Stephan Altmayer
Matheus Zanon
Gabriel Sartori Pacini
Guilherme Watte
Marcelo Cardoso Barros
Tan-Lucien Mohammed
Nupur Verma
Edson Marchiori
Bruno Hochhegger
Publication date
01-12-2020
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-020-07018-x

Other articles of this Issue 12/2020

European Radiology 12/2020 Go to the issue

Editorial Comment

Dental MRI: a road beyond CBCT

Urogenital

Comparison of machine learning algorithms to predict clinically significant prostate cancer of the peripheral zone with multiparametric MRI using clinical assessment categories and radiomic features

Computed Tomography

Validation of the revised 2018 AAST-OIS classification and the CT severity index for prediction of operative management and survival in patients with blunt spleen and liver injuries

Hepatobiliary-Pancreas

Does transient arterial-phase respiratory-motion-related artifact impact on diagnostic performance? An intra-patient comparison of extracellular gadolinium versus gadoxetic acid

Editorial

Intimate partner violence crisis in the COVID-19 pandemic: how can radiologists make a difference?

Computed Tomography

COVID-19 impact assessment on the French radiological centers: a nationwide survey