title: CT correlation with outcomes in 15 patients with acute Middle East respiratory syndrome coronavirus.
abstract: OBJECTIVE
  The purpose of this article is to retrospectively analyze chest CT findings for 15 patients with Middle East respiratory syndrome coronavirus and to identify features associated with survival.
  
  
  METHODS
  Patients were assigned to group 1 if they died (n=9) and to group 2 if they made a full recovery (n=6). Two reviewers scored chest radiographs and CT examinations for segmental involvement, ground-glass opacities, consolidation, and interstitial thickening.
  
  
  RESULTS
  Eight patients had ground-glass opacity (53%), five had ground-glass and consolidation in combination (33%), five had pleural effusion (33%), and four patients had interlobular thickening (27%). Of 281 CT findings, 151 (54%) were peripheral, 68 (24%) were central, and 62 (22%) had a mixed location. The number of involved lung segments was higher in group 1. The lower lobe was more commonly involved (mean, 12.2 segments) than in the upper and middle lobes combined (mean, 6.3 segments). The mean number of lung segments involved was 12.3 segments in group 1 and 3.4 segments in group 2. The CT lung score (mean±SD, 15.78±7.9 vs 7.3±5.7, p=0.003), chest radiographic score (20.8±1.7 vs 5.6±5.4; p=0.001), and mechanical ventilation duration (13.11±8.3 vs 0.5±1.2 days; p=0.002) were higher in group 1. All nine group 1 patients and three of six group 2 patients had pleural effusion (p=0.52).
  
  
  CONCLUSIONS
  CT of patients with Middle East respiratory syndrome coronavirus predominantly showed ground-glass opacities, with peripheral lower lobe preference. Pleural effusion and higher CT lung and chest radiographic scores correlate with poor prognosis and short-term mortality.
authors.affiliation: 1 Department of Medical Imaging, King Fahad Medical City, Riyadh 11525, Kingdom of Saudi Arabia.
authors.forename: Karuna M
authors.initials: KM
authors.lastname: Das
authors.forename: Edward Y
authors.initials: EY
authors.lastname: Lee
authors.forename: Mushira A
authors.initials: MA
authors.lastname: Enani
authors.forename: Suhaila E
authors.initials: SE
authors.lastname: AlJawder
authors.forename: Rajvir
authors.initials: R
authors.lastname: Singh
authors.forename: Salman
authors.initials: S
authors.lastname: Bashir
authors.forename: Nizar
authors.initials: N
authors.lastname: Al-Nakshbandi
authors.forename: Khalid
authors.initials: K
authors.lastname: AlDossari
authors.forename: Sven G
authors.initials: SG
authors.lastname: Larsson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003287:Contrast Media; D018352:Coronavirus Infections / Q000000981:diagnostic imaging* / Q000401:mortality; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D065207:Middle East Respiratory Syndrome Coronavirus; D011379:Prognosis; D011857:Radiographic Image Interpretation, Computer-Assisted; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: CT; MERS-CoV; ground-glass opacities; lung changes; pleural effusion; prognosis