(New York, NY – February 26, 2020) – Mount Sinai Health System physicians—the first experts in the country to analyze chest computed tomography (CT) scans of patients from China with coronavirus disease (COVID-19)—have identified specific patterns in the lungs as markers of the disease as it develops over the course of a week and a half. The finding, published in the February issue of Radiology, could lead to quicker diagnosis in patients who come in with possible COVID-19 symptoms, and help keep patients isolated in early stages when the lung disease may not show up in initial scans.
"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. 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," said co-author Michael Chung, MD, Assistant Professor of Diagnostic, Molecular and Interventional Radiology at the Icahn School of Medicine at Mount Sinai. "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."
The study encompassed scans of 94 patients that Mount Sinai received from institutional collaborators at hospitals in China. The patients were admitted to four medical centers in four Chinese provinces between January 18 and February 2. Most either had recently traveled to Wuhan, China, where the outbreak began, or had contact with an infected COVID-19 patient. The cardiothoracic radiologists from Mount Sinai's BioMedical Engineering and Imaging Institute and its Department of Radiology evaluated each case, took notes of imaging findings, and correlated them with infection time course based on the number of days between symptom onset and the CT scan. Of the 36 patients scanned zero to two days after reporting symptoms, more than half showed no evidence of lung disease—an important finding suggesting that CT scans cannot reliably rule out COVID-19 early in the disease course. For the 33 patients scanned three to five days after symptoms developed, radiologists started to see more patterns of "ground glass opacities" (hazy findings in the lungs), and the abnormalities became more round in shape and more dense. In the 25 patients scanned six to 12 days after symptoms, the scans analysis showed fully involved lung disease. Patterns seen in these images are similar to patterns in related coronavirus outbreaks earlier this century, including SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome).
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