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Minerva Respiratory Medicine 2022 March;61(1):16-26

DOI: 10.23736/S2784-8477.21.01937-4


language: English

Chest imaging features of Coronavirus disease 2019 pneumonia: a systematic review and meta-analysis

Soon K. LOW 1, 2, Mai N. LUU 1, 3, Le H. MINH 1, 4, Abdelaziz ABDELAAL 1, 5, Sze JIA NG 1, 6, Abdelrahman G. GAD 1, 7, Le H. NHI 1, 8, Tran N. LE 1, 9, Nguyen T. HUY 1, 10

1 Online Research Club, Nagasaki, Japan; 2 School of Medicine, Taylor’s University, Subang Jaya, Selangon, Malaysia; 3 Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam; 4 Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam; 5 Faculty of Medicine, Tanta University, Tanta, Egypt; 6 School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia; 7 Faculty of Medicine, Ain Shams University, Cairo, Egypt; 8 Department of Radiology, Vinmec International Hospital, Vinmec Healthcare System, Ho Chi Minh City, Vietnam; 9 Hue University of Medicine and Pharmacy, Hue, Vietnam; 10 School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan

INTRODUCTION: This study aimed to systematically review the evidence reporting the key imaging findings in confirmed COVID-19 pneumonia.
EVIDENCE ACQUISITION: A systematic search for articles reporting the prevalence of imaging findings in patients with COVID-19 pneumonia was conducted in seven databases up to April 10, 2020. The study protocol was registered in PROSPERO (CRD42020172528).
EVIDENCE SYNTHESIS: A total of 25 imaging features were identified in 29 studies. The most characteristic radiographic features of COVID-19 pneumonia include peripheral distribution (92.4%, 95% CI: 86.8-95.8), bilateral involvement (82.8%, 95% CI: 76.0-87.9), and ground-glass opacities (GGO) (76.0%, 95% CI: 59.5-87.3). Right lower lobe (RLL) was the most frequently involved lobe (89.0%, 95% CI: 79.6-94.4), followed by left lower lobe (LLL) in 86.5% (95% CI: 74.8-93.2) of patients. The atypical imaging features included bronchial wall thickening, lymphadenopathy, and pleural effusion, which were observed more commonly in severe and critical COVID-19 pneumonia compared to mild and moderate condition.
CONCLUSIONS: Chest imaging can help to diagnose COVID-19 pneumonia, especially in regions where the availability of RT-PCR testing kits is limited. Recognition of key radiographic features of COVID-19 pneumonia is essential to identify patients at early stages, monitor disease progression, and optimize their management plan.

KEY WORDS: COVID-19; Pneumonia; Lung; Systematic review; Meta-analysis

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