• Stephan Altmayer, Matheus Zanon, Gabriel Sartori Pacini, Guilherme Watte, Marcelo Cardoso Barros, Tan-Lucien Mohammed, Nupur Verma, Edson Marchiori, and Bruno Hochhegger.
• Medical Imaging Research Lab, LABIMED, Department of Radiology, Pavilhão Pereira Filho Hospital, Irmandade Santa Casa de Misericórdia de Porto Alegre, Av. Independência, 75, Porto Alegre, 90020160, Brazil.
• Eur Radiol. 2020 Dec 1; 30 (12): 6485-6496.

ObjectivesTo compare the chest computed tomography (CT) findings of coronavirus disease 2019 (COVID-19) to other non-COVID viral pneumonia.MethodsMEDLINE, EMBASE, and Cochrane databases were searched through April 04, 2020, for published English language studies. Studies were eligible if they included immunocompetent patients with up to 14 days of viral pneumonia. Subjects had a respiratory tract sample test positive for COVID-19, adenovirus, influenza A, rhinovirus, parainfluenza, or respiratory syncytial virus. We only included observational studies and case series with more than ten patients. The pooled prevalence of each chest CT pattern or finding was calculated with 95% confidence intervals (95% CI).ResultsFrom 2263 studies identified, 33 were eligible for inclusion, with a total of 1911 patients (COVID-19, n = 934; non-COVID, n = 977). Frequent CT features for both COVID-19 and non-COVID viral pneumonia were a mixed pattern of ground-glass opacity (GGO) and consolidation (COVID-19, 0.37; 0.17-0.56; non-COVID, 0.46; 0.35-0.58) or predominantly GGO pattern (COVID-19, 0.42; 0.28-0.55; non-COVID 0.25; 0.17-0.32), bilateral distribution (COVID-19, 0.81; 0.77-0.85; non-COVID, 0.69; 0.54-0.84), and involvement of lower lobes (COVID-19, 0.88; 0.80-0.95; non-COVID, 0.61; 0.50-0.82). COVID-19 pneumonia presented a higher prevalence of peripheral distribution (COVID-19 0.77; 0.67-0.87; non-COVID 0.34; 0.18-0.49), and involvement of upper (COVID-19, 0.77; 0.65-0.88; non-COVID 0.18; 0.10-0.27) and middle lobes (COVID-19, 0.61; 0.47-0.76; non-COVID 0.24; 0.11-0.38).ConclusionExcept for a higher prevalence of peripheral distribution, involvement of upper and middle lobes, COVID-19, and non-COVID viral pneumonia had overlapping chest CT findings.Key Points• Most common CT findings of coronavirus disease 2019 (COVID-19) were a predominant pattern of ground-glass opacity (GGO), followed by a mixed pattern of GGO and consolidation, bilateral disease, peripheral distribution, and lower lobe involvement. • Most frequent CT findings of non-COVID viral pneumonia were a predominantly mixed pattern of GGO and consolidation, followed by a predominant pattern of GGO, bilateral disease, random or diffuse distribution, and lower lobe involvement. • COVID-19 pneumonia presented a higher prevalence of peripheral distribution, and involvement of upper and middle lobes compared with non-COVID viral pneumonia.

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