Early Chest HRCT Findings and Dynamic Imaging Analysis of COVID-19 in Qinghai Province

Abstract

This study aimed to analyze the early high-resolution CT (HRCT) manifestations and dynamic imaging changes of coronavirus disease 2019 (COVID-19) in Qinghai Province. A total of 24 nucleic acid-positive COVID-19 patients admitted to our hospital between January 2020 and November 2021 were included. All patients underwent HRCT examinations, and lesion characteristics—including number, distribution, morphology, and surrounding involvement—were analyzed. Among the 24 patients, systemic and respiratory circulatory symptoms were more common than other symptoms (P < 0.05). There were no significant differences in the lung lobes, relative positions, quantity, size, and density of lesions across different stages of the disease course (P > 0.05). Within the same disease stage, lesions were primarily located in the lower lobes of both lungs, the peripheral lung fields, and a combination of peripheral and central regions, with single and multiple lesions being the most common. Lesion morphology varied significantly across disease stages (P < 0.05), including differences between patchy and striped lesions, striped and massive lesions (P < 0.05), and patchy and massive lesions (P < 0.05). The incidence of striped lesions was higher in the progressive and recovery stages than in the early stage, showing an upward trend. There were no significant differences in pleural thickening, pleural effusion, mediastinal lymph node enlargement, or pericardial effusion across different disease stages (P > 0.05). Common HRCT signs observed at all stages included air bronchograms, paving stone patterns, halo signs, subpleural lines, and grid-like patterns. The main patterns of lesion progression were an increase in lesion size (16/24, 66.67%), an increase in the number of lesions (17/24, 70.83%), changes in lesion density (20/24, 80.33%), and localized lesion increase and partial absorption (6/24, 25.00%). In conclusion, the HRCT manifestations and evolution of lung lesions in COVID-19 patients are complex and varied, with a progressive increase in striped lesions potentially serving as a characteristic imaging feature of the disease.