Normal chest CT in 1091 symptomatic patients with confirmed Covid-19: frequency, characteristics and outcome - Ecole Nationale du Génie de l'Eau et de l'Environnement de Strasbourg Accéder directement au contenu
Article Dans Une Revue European Radiology Année : 2021

Normal chest CT in 1091 symptomatic patients with confirmed Covid-19: frequency, characteristics and outcome

Ian Leonard-Lorant
  • Fonction : Auteur
Pascal Bilbault
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Joris Muller
  • Fonction : Auteur
Pierre Leyendecker
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Catherine Roy
  • Fonction : Auteur

Résumé

Objective Frequency of normal chest CT in symptomatic COVID-19 patients as well as the outcome of these patients remains unknown. The objectives of this work were to assess the incidence of initially normal chest CT in a cohort of consecutive confirmed COVID-19 patients with respiratory symptoms and to compare their clinical characteristics and their outcome to matched patients with typical COVID-19 lesions at initial CT. Methods From March 6(th) to April 22(nd), all consecutive adult patients referred to the COVID-19 clinic of our Emergency Department were retrospectively analyzed. Each patient with a positive SARS-CoV-2 RT-PCR and a normal initial chest CT after second reading was 1:1 matched based on sex, age and date of CT acquisition to a patient with positive RT-PCR and initial chest CT with typical COVID-19 lesions. Clinical data, laboratory results and outcomes (major being mechanical ventilation and/or death) were compared between both groups, using Wilcoxon signed-rank test, McNemar's chi-squared test and/or exact McNemar's test where appropriate. Results Fifty-seven chest CT out of 1091 (5.2%, 95% CI 4.0-6.7) in symptomatic patients with positive RT-PCR were normal, with a median onset of symptoms of 4.5 days (IQR [1.25-10.25]). After a median follow-up of 43 days, death and/or mechanical ventilation occurred in 3 patients (5.3%) in the study group, versus 11 (19.3%) in the control group (p = 0.011). Conclusions Normal initial chest CT occurred in 5.2% of symptomatic confirmed COVID-19 cases in our cohort. While better than those with abnormal chest CT, outcome was not entirely benign with 5.3% death and/or mechanical ventilation.

Dates et versions

hal-03593368 , version 1 (01-03-2022)

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Ian Leonard-Lorant, François Severac, Pascal Bilbault, Joris Muller, Pierre Leyendecker, et al.. Normal chest CT in 1091 symptomatic patients with confirmed Covid-19: frequency, characteristics and outcome. European Radiology, 2021, 31 (7), pp.5172-5177. ⟨10.1007/s00330-020-07593-z⟩. ⟨hal-03593368⟩
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