Systematic Reviews
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Sep 28, 2021; 13(9): 294-306
Published online Sep 28, 2021. doi: 10.4329/wjr.v13.i9.294
Review on radiological evolution of COVID-19 pneumonia using computed tomography
Chiara Casartelli, Fabiana Perrone, Maurizio Balbi, Veronica Alfieri, Gianluca Milanese, Sebastiano Buti, Mario Silva, Nicola Sverzellati, Melissa Bersanelli
Chiara Casartelli, Fabiana Perrone, Sebastiano Buti, Melissa Bersanelli, Medical Oncology Unit, University Hospital of Parma, Parma 43126, Italy
Chiara Casartelli, Fabiana Perrone, Nicola Sverzellati, Melissa Bersanelli, Department of Medicine and Surgery, University of Parma, Parma 43126, Italy
Maurizio Balbi, Gianluca Milanese, Mario Silva, Nicola Sverzellati, Division of Radiology, University of Parma, Parma 43126, Italy
Veronica Alfieri, Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Parma 43126, Italy
Author contributions: Bersanelli M, Perrone F and Casartelli C designed the work, planned the literature review according to PRISMA methods and identified the areas of interests to discuss; Perrone F and Casartelli C collected the data; Casartelli C, Balbi M and Alfieri V wrote the first draft of the manuscript; Bersanelli M revised the manuscript for relevant scientific content and copyediting; Buti S, Milanese G, Silva M and Sverzellati N revised the manuscript for relevant scientific content; All authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: Bersanelli M received honoraria as a speaker at scientific events by Bristol-Myers Squibb (BMS), Novartis, Astra Zeneca, Pierre Fabre, and Pfizer and as a consultant for advisory role by Novartis, BMS, IPSEN, and Pfizer; she also received fees for copyright transfer by Sciclone Pharmaceuticals and research funding by Roche S.p.A., Seqirus UK, Pfizer, Novartis, BMS, Astra Zeneca, and Sanofi Genzyme. Buti S received honoraria as a speaker at scientific events and advisory role by Bristol-Myers Squibb (BMS), Pfizer; MSD, Ipsen, Roche, Eli-Lilly, AstraZeneca and Novartis; he also received research funding from Novartis. All the other authors declare they have no conflicts of interest to disclose.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fabiana Perrone, MD, Doctor, Medical Oncology Unit, University Hospital of Parma, Via A. Gramsci, 14, Parma 43126, Italy. fabiana.perrone89@libero.it
Received: February 26, 2021
Peer-review started: February 26, 2021
First decision: July 18, 2021
Revised: July 28, 2021
Accepted: August 13, 2021
Article in press: August 13, 2021
Published online: September 28, 2021
Processing time: 211 Days and 11.5 Hours
Abstract
BACKGROUND

Pneumonia is the main manifestation of coronavirus disease 2019 (COVID-19) infection. Chest computed tomography is recommended for the initial evaluation of the disease; this technique can also be helpful to monitor the disease progression and evaluate the therapeutic efficacy.

AIM

To review the currently available literature regarding the radiological follow-up of COVID-19-related lung alterations using the computed tomography scan, to describe the evidence about the dynamic evolution of COVID-19 pneumonia and verify the potential usefulness of the radiological follow-up.

METHODS

We used pertinent keywords on PubMed to select relevant studies; the articles we considered were published until October 30, 2020. Through this selection, 69 studies were identified, and 16 were finally included in the review.

RESULTS

Summarizing the included works’ findings, we identified well-defined stages in the short follow-up time frame. A radiographic deterioration reaching a peak roughly within the first 2 wk; after the peak, an absorption process and repairing signs are observed. At later radiological follow-up, with the limitation of little evidence available, the lesions usually did not recover completely.

CONCLUSION

Following computed tomography scan evolution over time could help physicians better understand the clinical impact of COVID-19 pneumonia and manage the possible sequelae; a longer follow-up is advisable to verify the complete resolution or the presence of long-term damage.

Keywords: COVID-19; Computed tomography; Pneumonia; Radiological evolution; Follow-up; Long-term consequences; Lung damage; SARS-CoV-2

Core Tip: Given the recent discovery and study of severe acute respiratory syndrome coronavirus 2 infection, the evolution of coronavirus disease 2019 pneumonia has not been entirely defined yet. Chest computed tomography is an effective method to identify and follow coronavirus disease 2019 pneumonia over time. In this review, we considered the radiological changes on computed tomography scan and described the possible clinical pulmonary sequelae in order to understand the long-term outcome of coronavirus disease 2019 pneumonia better.