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

摘要

Aims:During the COVID-19 epidemic,chest computed tomography(CT)has been highly recommended for screen-ing 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 fi ssural 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 fi brous 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.