Similarities and Differences of CT Features Between COVID-19 Pneumonia and Heart Failure

Transverse view of as lung CT showing heavy areas of COVID pneumonia in the lungs

Transverse view of as lung CT showing heavy areas of COVID pneumonia in the lungs. The heart is in the center on the image. Getty Images

August 19, 2021 — In a new publication from Cardiovascular Innovations and Applications; DOI, Zhaowei Zhu, Jianjun Tang, Xiangping Chai and colleagues from Central South University, Changsha, Hunan, China analyse the similarities and differences of computed tomography (CT) features between COVID-19 pneumonia and heart failure.

During the COVID-19 epidemic, chest computed tomography (CT) has been highly recommended for screening of patients with suspected COVID-19 because of an unclear contact history, overlapping clinical features, and overwhelmed health systems. However, there has not been a full comparison of CT for diagnosis of heart failure or COVID-19 pneumonia.

This paper describes how patients with heart failure (n = 23) or COVID-19 pneumonia (n = 23) and one patient with both diseases were assessed with clinical information and chest CT images being obtained and analyzed. No difference was found in ground-glass opacity, consolidation, crazy paving pattern, the lobes affected, and septal thickening between heart failure and COVID-19 pneumonia. However, a less rounded morphology (4% vs. 70%, P = 0.00092), more peribronchovascular thickening (70% vs. 35%, P = 0.018) and fissural thickening (43% vs. 4%, P = 0.002), and less peripheral distribution (30% vs. 87%, P = 0.00085) were found in the heart failure group than in the COVID-19 group. Notably, there were also more patients with upper pulmonary vein enlargement (61% vs. 4%, P = 0.00087), subpleural effusion (50% vs. 0%, P = 0.00058), and cardiac enlargement (61% vs. 4%, P = 0.00075) in the heart failure group than in the COVID-19 group. More fibrous lesions were also found in the COVID-19 group, although there was no statistical difference (22% vs. 4%, P = 0.080).

Although there is some overlap of CT features between heart failure and COVID-19, CT is still a useful tool for differentiating COVID-19 pneumonia.

For more information: https://cvia-journal.org/