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Open Access Similarities and Differences of CT Features between COVID-19 Pneumonia and Heart Failure

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This article is Open Access under the terms of the Creative Commons CC BY licence.

Aims: 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 an overwhelmed health system. However, there has not been a full comparison of CT for diagnosis of heart failure or COVID-19 pneumonia.

Methods: Patients with heart failure (n=23) or COVID-19 pneumonia (n=23) and one patient with both diseases were retrospectively enrolled. Clinical information and chest CT images were obtained and analyzed.

Results: There was no difference 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. Importantly, 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. Besides, more fibrous lesions were found in the COVID-19 group, although there was no statistical difference (22% vs. 4%, P=0.080).

Conclusions: 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.

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Keywords: COVID-19; Computed tomography; heart failure; pneumonia

Document Type: Research Article

Affiliations: 1: Department of Cardiovascular Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China 2: Department of Emergency, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China 3: Department of Radiology, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China

Publication date: September 1, 2021

This article was made available online on June 23, 2021 as a Fast Track article with title: "Similarities and Differences of CT Features between COVID-19 Pneumonia and Heart Failure".

More about this publication?
  • Cardiovascular Innovations and Applications (CVIA) publishes focused articles and original clinical research that explore novel developments in cardiovascular disease, effective control and rehabilitation in cardiovascular disease, and promote cardiovascular innovations and applications for the betterment of public health globally. The journal publishes basic research that has clinical applicability in order to promote timely communication of the latest insights relating to coronary artery disease, heart failure, hypertension, cardiac arrhythmia, prevention of cardiovascular disease with a heavy emphasis on risk factor modification. Cardiovascular Innovations and Applications is the official journal of the Great Wall International Congress of Cardiology (GW-ICC). It aims to continue the work of the GW-ICC by providing a global scientific communication platform for cardiologists that bridges East and West.

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