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A Quantitative Lung Computed Tomography Image Feature for
Multi-Center Severity Assessment of COVID-19
Biswajoy Ghosh1,*, Nikhil Kumar1, Nitisha Singh2, Anup K. Sadhu3, Nirmalya Ghosh1,
Pabitra Mitra1, and Jyotirmoy Chatterjee1
1Indian Institute of Technology Kharagpur, India
2National Institute of Technology Durgapur, India
3EKO CT & MRI Scan Centre, Medical College and Hospitals Campus, Kolkata, India
*correspondence email: biswajoyghosh@smst.iitkgp.ac.in
SUPPLEMENTARY INFORMATION
1
SUPPLEMENTARY FIGURES
Figure S1: Illustration of multi-center lung CT lesion detection for mild (severity S-1) COVID-19 associated
pneumonia..
2
Figure S2: Illustration of multi-center lung CT lesion detection for moderate (severity S-2) COVID-19
associated pneumonia.
3
Figure S3: Illustration of multi-center lung CT lesion detection for severe (severity S-3) COVID-19 associated
pneumonia.
4
Figure S4: Representative histograms of the four CT image data-set and their masks denoting the lesion
areas.
5
Figure S5: Performance evaluation of lesion detection by the deep learning framework showing (a) Tversky
index, (b) F1-score, (c) Precision, (d) Recall, (e) Loss, and (f) Mean IoU (intersection over union).
6
Figure S6: Representative CT images with detected lesion areas from training, validation and testing using
the deep-learning framework. (a) Images from training, (b) images from validation, (c) prediction of model
on validation set, and (d) prediction of model on test set. For the prediction of validation set in (c) the color
code is—Yellow=true positive, Red=false-positive, Green=false-negative.
7
SUPPLEMENTARY TABLES
8
Table S1: Patient clinical data-sheet
Case # Age Sex Clinical Findings Radiological Features
Clinical
Severity
C2 62 M pO2:97%
fever, cough and asthenia
scattered blurred ground-glass opacities suspected
for early-stage interstitial pneumonia S1
C10 60 M fever for three days defined ground glass opacities S1
C11 55
persistant fever
recently underwent
prostatectomy
consistent with interstitial pneumonia S1
C16
cough and fever for one week
not responding to antibiotics
admitted to the ED for respiratory
distress
consistent with interstitial pneumonia S1
C21 71 M Temp:37.8◦C
pO2: 97%
ground-glass opacities with predominant subpleural
distribution in upper lobes and in the apical segment
of the lower lobes.
S1
C28 48 F Fever
Blood test: leukopenia. ground-glass opacifcations S1
C33 55 M multiple ground-glass opacities, no pleural
effusion or mediastinal adenopathies. S1
C56 52 F
4 days fever
Normal blood count,
PCR 10.12 mg / L,
PCT 0.13 ng / mL;
LDH 279 U / L.
affecting the postero-basal segment of the left lower
lung lobe, ground-glass pseudonodular thickening of
the parenchyma, suspected for initial phase
of SARS-CoV2. Small dorsal subpleural striae
affecting the upper segment of the
right lower lung lobe.
S1
C61 70 M
Temp:37.8◦C
pO2:97%
presence of multiple ¨emery glass parenchymal
thickenings, located in the upper lobe of both lungs, in
the middle lobe and in the lower lobe of both lungs,
especially on the right, arranged sub-pleurally.
S1
C62 56 M
pO2:97%
reports fever in the last week
even though he has been apyretic
for a day, however anosmia,
ageusia, pharyngodynia and
arthralgias persist
demonstrates two ¨emery glass parenchymal
thickenings located in correspondence of the
apical segment of the lower lobe of the right lung
subpleurally and of the mediobasal segment of
the lower lobe of the left lung
S1
9
C63 49 M
Temp:39◦C
pO2:94%
fever and dyspnea for about 4 days;
reports hyperpyrexia
presence of multiple nuanced emery glass
parenchymal thickenings located in the
upper lobe of the right lung, in the middle
lobe and in the lower lobe of both lungs in
the subpleural area.
S1
C69 58 F pO2:99%
Temp:36.8◦C
multiple and bilateral areas of increased
peri-broncovasal ground glass density,
prevalent in the lower right lung lobe,
suspected for localization of interstitial
pneumonia; concomitant bilateral pleural
effusion of modest entity on the right and
minimal entity on the left, with multiple ilo-
mediastinal lymphadenomegalies,
the major right pulmonary hilar with a
maximum short axis of 13 mm.
S1
C71 88 M
Temp:37.1◦C
pO2:96%
diabetes and high blood
pressure,
pain in abdomen on deep
palpation, positive Murphy,
valid peristalsis, pure heart
tones with free breaks
ESR: 131 mm/hr, Fibrinogen: 487mg/dl,
Lymphocytes: 13.1%, AST: 114UI/L,
ALT: 114UI / L, GAMMA GT 188 IU/L,
12µg / dl Sideremia,
Ferritin: 4239.00 ng / ml,
PCR: 12.20 mg / L,
Procalcitonin: 0.13 ng / ml.
Mild respiratory alkalosis
(pH 7.44, pCO2 34 mmHg),
O2 Hb: 33.4% COHb: 1.7%.
ground glass, diffuse bronchitic finding S2
C72 77 M cough and dyspnoea,
thoraco-abdominal pain,
ground glass opacity with peripheral
distribution and associated thickening of the
interlobular septa, absence of pleural effusion
and absence of significant ilo-mediastinal
lymphadenopathies characterize the TC pattern
S2
10
C73 58 M lymphopenia, high PCR S2
C76 83 M
Temp:38.9◦C
pO2:92%
arterial hypertension,
diabetes mellitus, IPB.
nuanced parenchymal thickening in the middle
and lower field in the right hemithorax
and in the middle field on the left, multiple
”frosted glass” areoles with greater peripheral
and parascissural distribution tending towards
confluence, with initial consolidation
phenomena, in the context of which there is a
thickening of the mainly intralobular interstice
with ”crazy paving” aspects
S2
C77 56 M
Temp:37.1◦C
pO2:90%
arterial hypertension
lymphopenia, high PCR
multiple pseudo-nodular thickenings of para-
centimetric dimensions, multiple areas of
parenchymal thickening with “ground glass”
density involving both lungs.
S2
C78 44 F pO2:59%
dyspnea, cough and hyperpyrexia.
multiple parenchymal thickenings bilaterally,
with irregular margins, some with air
bronchogram and others with ground glass
associated intra- and inter-lobular septal
thickening, prevalently peribroncovasal and
subpleural distribution and with total
engagement of the lower lobes, in particular
the LID ; thin fibrotic stria in the LIS.
S2
C80 77 M
Temp: 37.2◦C
pO2:89%
neutrophilic leukocytosis,
lymphopenia, modest
monocytopenia,
progressive and marked rise in PCR.
in the lower lobes, extensive ground-glass patches
are observed, with initial thickening of
the inter- and intra-lobular septa (“crazy paving”
pattern) and aerial bronchogram; the major,
subpleural, are appreciated in the dorsal sectors
(LIS, LID), the minor ones in the LID, in the
infracardiac (paravertebral and epidiaphragmatic
subpleural) and posterobasal (both central
and epidiaphragmatic subpleural) segments,
respectively.glass with prevalently peri-
broncovasal and subpleural distribution and
higher level in the lower lobes, particularly LID.
S2
11
C82 49 F pO2:85%
leukopenia (especially lymphopenia);
increase in PCR and LDH.
presence of multiple and nuanced areas of
hypodiaphaly, partly pseudonodular in
appearance, borne by both hemithorax, with a
predominantly peribronchial distribution, with
associated reinforcement of the interstitial texture
and peribronchial thickening, more
evident in the ilo-peri-ilar and mediobasal, bilaterally.
In the basal center there are some
areas delimited by radiopaque streaks,
possible emphysematic manifestations.
Follow up:compared to the previous examination,
there is a clear reduction in the extension
of the previously reported densities; focal areas
of altered density remain with a”ground glass”
appearance at the level of the upper lobes and
thickening with a lamellar appearance in the left
basal area (the latter due to partial re-expansion
of the previous lung parenchyma involved).
The remaining finds are unchanged.
S2
C84 61 M
pO2:88%
fever for about 10 days,
cough and respiratory failure
a significant increase in the values
of procalcitonin, LDH and PCR.
widespread picture of ground glass is documented
in both pulmonary parenchymes with peripheral
distribution, mainly affecting the lingula and the
lower lobes (in particular in the posterior segments).
S2
C85 47 F fever and dyspnea
alveolar infiltrates are recognized in the bilateral
intercleidoilary site and in the right middle field. No
pleural effusion. Cardiac transverse diameter increase
S2
C89 44 F pO2:59%
dyspnea, cough and hyperpyrexia
Multiple parenchymal thickenings bilaterally, with
irregular margins, some with air bronchogram
and others with ”ground glass associated intra- and
inter-lobular septal thickening, with prevalent peri-
broncovasal and subpleural distribution and prevalent
peribroncovascular and subpleural distribution and
with subtotal lobe engagement lower, in particular of
the LID; thin fibrotic stria of the LIS.
S2
12
C93 66 M
pO2:88%
reported fever (for at least 5 days)
and worsening dyspnea
a widespread ground glass picture is documented in
both lungs, mainly affecting the middle lobe, the lingula
and the lower lobes.
S2
C96 45 F pO2:92%
bilaterally there are some patches of parenchymal
thickening with a “ground glass” appearance,
with a prevalently subpleural distribution. There are
multiple areas of parenchymal consolidation
bilaterally, particularly at the level of the dorsal
segment of the right upper lobe and the
postero-basal parenchyma of both lower lobes.
Absence of pleural, pericardial effusion and
mediastinal lymphadenopathy. The presence of
three solid nodular formations is also noted, the largest
of which (10 mm) is located in the lateral-basal segment
of the left lower lobe.
S2
C98 77 M
pO2:95%
ischemic heart disease,
high blood pressure
and diabetes (being treated).
Troponin: 0.315 ng / ml -
Myoglobin: 416.97 ng / ml -
CPK: 354 U / l;
Severe lymphopenia; High PCR
bilaterally, multiple and widespread parenchymal
thickening patches with ”ground glass” appearance
and confluent character are observed, with mantle
and peribronchial distribution with associated
widespread thickening of the interlobular septa
(”crazy paving pattern”). Cluster bronchiectasis is
appreciated in the upper lobar region on both sides,
particularly on the right.
S2
C99 75 M
pO2:94%
trilinear cytopenia,
only lymphopenia is marked
(540 / mmc).
Altered inflammation indices
(in particular ferritin 5723 mcg / L,
PCR 59 mg / L).
Fibrinogen 5.36 g / L.
Creatinine 1.65 mg / dL.
Mild hypoalbuminemia (32.8 g / L).
parenchymal thickening and crazy-paving patterns. S2
13
C100 51 M pO2:90%
the thickenings which previously had a ”ground-glass”
character, now appear to be replaced by diffuse reticular
bands similar to fibrotic which are associated with
thickening of the small interstitium. These findings appear
ubiquitously localized, but particularly evident in the
bilateral mantle with distribution tending to confluence.
These also appeared in the left apical area, where
previously the lung parenchyma was scarcely affected
by the pathology
S2
C101 75 F
fever and dyspnea, diabetic
increased PRC, LDH, D-dimer
and IL-6 values
frosted glass thickenings with prevailing bilateral mantle
arrangement, more evident on the left, where they tend to
confluence. On the right, conversely, these thickening have
a pseudonodular, patchy appearance.
S2
C103 71 M
Temp:37.8◦C
pO2:95%
diabetic
Laboratory tests show leukopenia
with neutrophilia, increase in PCR
values
presence of different ”ground glass” parenchymal
thickenings with mainly subpleural mantle
distribution, particularly evident in the postero-lower
sectors of bothlungs, compatible with
medium-high viral pneumonia.
S2
C105 57 M
suffering from fever, cough
and hyperpyrexia refractory
to antipyretics.
acute inflammatory lung damage in fibrotic structural
modifications of the parenchyma with honey-comb
like pattern.
S2
C111 57 M
Temp:38.5◦C
pO2:85%
leukopenia; significant increase in PCR,
procalcitonin and LDH values. The
values of D-Dimero and Troponina
were within the limits.
HRCT has documented, in both lung parenchyma,
the presence of multiple thickenings with a “ground
glass” appearance and some areas with a “crazy-
paving” pattern, due to the coexistence of “ground-
glass” areas, of interstitial consolidation and thickening.
A few small reactive lymph
nodes in the ilo-mediastinal area. Cardiac mage within
limits. No evidence of pericardial effusion. Minimal
bilateral basal pleural effusion.
S2
14
C112 70 M
Temp:39◦C
pO2:80%
Arterial hypertension and
carotid atheromasia.
chest X-ray worsened compared to the entrance, as
pulmonary parenchymal thickening increased, now
presenting an aspect tending to confluence, up to
complete bilateral pulmonary opacification (more
evident on the right). There was also bilateral
interstitial involvement of a reticulo-micronodular character.
Heart shadow within limits.
S2
C74 38 M leukopenia (especially lymphopenia),
PCR at the upper limits ground-glass opacifications observed S1
C75 66 F pO2:92%
multiple confluent parenchymal thickenings, with
¨emery glass density at the level of both lungs, with a
predominantly subpleural distribution, with thickening
of the inter-lobular andintra-lobular septa.
S1
C91 78 F
widespread moderate interstitial peribroncovasal
pulmonary reinforcement with nuanced reduction of the
diaphanous to mantle site of the left upper lung field
(alveolar-interstitial engagement); Deserving of diagnostic
study by means of chest CT; no radiographic signs
of pleural effusion and PNX bilaterally.
S1
C95 39 F
Hematochemical tests substantially
normal, with the exception of
monocytosis (monocytes 16.0%),
in particular WBC and C-RP
within limits.
multiple nuanced mantle areoles with ground glass in
the dorsal sectors of both lower lung lobes are
appreciable, without parenchymal consolidation. In the
lung segments not affected by the findings described
above, there are no widespread alterations of the
interstitium. No pleural effusion.
S1
C97 31 F Temp:39◦C
pO2:96%
multiple areas of parenchymal thickening with a “ground-
glass” appearance and some focal areas of
consolidation, available bilaterally and mainly sub-mantle,
in particular on the right. Autonomous origin from the
trachea of the bronchi for the apical and anterior segments
of the LSD. Absence of pleural, pericardial effusion and
mediastinal lymphadenopathy.
S1
C102 51 M fever, irritating cough, dyspnea
increase in PCR and LDH values
documents some circumscribed ground-glass pseudo-
nodular parenchymal thickening in both lungs, with a
prevalent mantle distribution, compatible with mild
viral pneumonia.
S1
15
C104 48 F
the examination demonstrates extensive ground-glass
thickening, involving part of the anterior segment of
the upper lobe and part of the medial segment of the
middle lobe. On the left, only a circumscribed
subpleural thickening is seen in the lateral segment of
the lower lobe. The finding seems to be
attributable to an atypical form of viral pneumonia.
S1
C106 42 M
there are multiple areas with ground glass, partly confluent,
with subpleural distribution, from the apexes to the
bases, more evident on the right
S1
C107 20 F pO2:99%
demonstrates the presence of three millimetric pseudo-
nodular thickenings (arrows) in the posterior slopes
of the lower right lobe with subpleural arrangement,
which, although unspecific, are to be referred to viral
pneumonia in the mild phase. Minimal thickening of the
adjacent pulmonary interstitium. No parenchymal lesions
on the left. Pleural effusion and mediastinal adenopathies
are not appreciated.
S1
C108 61 F
Temp:37.3◦C
cardiac, hypertensive
and diabetic patient
there are some ground-glass parenchymal thickenings with
a prevalent ”patchy” subpleural distribution, more numerous
on the left (anterior and posterior segment of the upper lobe,
lingula, lateral segment lower lobe) than on the right (lateral
segment of the middle lobe and, pseudonodular, in the
lateral basal segment of the lower lobe). In reconstructions
with mediastinal filter various lymphadenopathies in the
superior and prevascular paratracheal area are also detected,
the largest of which has a short axis of about 17 mm and
causes compression on the adjacent lung parenchyma
(anterior segment upper left lobe, fig. 10, arrow). Other
more limited lymphadenopathy is documented in the lower
paracaval area.
S1
C109 47 M pO2:95%
increase in fibronogen (511 mg / dl)
and ESR (23 mm / h) values
parenchymal thickening in frosted glass with associated
thickening of the interlobular septa, with peripheral
distribution
S1
16
C110 39 M
increase in transaminase values
and a decrease in CK-MB values
(0.88 ng / ml) and myoglobin
(23 ng / ml).
demonstrates nuanced ground-glass thickenings at the
anterior and posterior segments of the upper right lobe,
in the apicodorsal segment of the upper left lobe and in
the upper segment of the lower left lobe. At this level,
concomitant thickening of the interlobular septa is observed.
S1
C115 51 M
Temp:38.9◦C
fever, chest tightness
and mild dyspnea
tests showed normal values,
especially white blood cells,
neutrophils and lymphocytes.
partial regression of the known GGO alterations
previously reported to the LSS and lingula S1
C81 74 F
Temp:38.5◦C
pO2:90%
EGA performed with PO2 of 51mmHg,
PCO2 36mmHg, PH 7.48 Sat O2 88%.
WBC 3.7 ×1000, Hb 12.6 g / dL,
PCR 2.22 mg / dL,
creatininemia 0.95mg / dL,
blood sugar 119mg / dL,
Procalcitonin 0.04 ug / L.
small ground glass areoles on the pulmonary periphery,
center-lobular, of phlogistic-inflammatory significance are reported
C113 90 F
Temp:38◦C
pO2:88%
Alzheimer’s disease,
COPD, arterial hypertension
and widespread multi-district
calcific parietal atheromasia.
Anemia. Increase in PCR, LDH and
procalcitonin values. The D-Dimer and
troponin values were within the limits
prominent GGOs observed S1
C114 20 F Temp:38.5◦C
pO2:90%
in correspondence of the apico-dorsal segment of the LIS, the
presence of a parenchymal consolidation area with
subpleural distribution extending caudally to the postero-
basal segment, with air bronchiologram in the
context, which is associated with nuanced parenchymal
thickening with a ”frosted glass” appearance.
Located in the adjacent seat.
S1
17
C79 61 M pO2:59%
at LSD, LSS, LM and lingula multiple areas of increased
pulmonary density with ground glass opacity associated with
inter- and intra-lobular septal thickening, with prevalently
peri-broncovasal and subpleural distribution;parenchymal
thickening, with patent air-bronchogram, in the lower lobes.
S3
C86 78 M Temp:38.2◦C
pO2:92%
with confirmation of widespread and bilateral foci of
parenchymal consolidation, with relative saving of the apexes,
which are associated with areas with a ground glass
appearance; coexists modest bilateral pleural effusion, of
greater entity on the left: compatible with interstitial
pneumonia with consolidative aspects. No filling defects of a
thrombo-embolic nature are observed within the large
branches or main branches of the pulmonary artery.
S3
C90 61 M Temp:38.2◦C
pO2:92%
in LSD, LSS, LM and lingula plurime areas of increased
lung density ”with frosted glass which is associated with
inter- and intra-lobular septal thickening, with a prevalent
peribroncovasal and subpleural distribution; parenchymal
thickening, with patent air bronchogram, to the lower lobes.
S3
C94 64 F elevated fever,
persistent cough and dyspnoea
bilateral parenchymal thickening vidence of bilateral
involvement with ”frosted glass” areas, S3
C3 57 M hypoxemia and hypocapnia
subpleural ground-glass opacity with predominant subpleural
distribution and consolidations in all lobes, particularly
in the lower lobes
S3
C5 63 M ground-glass opacities in the lower lobes are more extended
and consolidations are also noted. S3
C6 32 F
treatment with steroids
for autoimmune disease
Fever and cough, leukocytosis
(hypoxemia and hypocapnia
diffuse bilateral consolidations partially sparing the upper
lobes and the apical segments of the lower lobes. S3
C9 73 F diffuse ground-glass opacity with confluent consolidations in
the dependent areas and peripheral band atelectasis S3
C17 80 M cardiac failure
fever, dyspnea and cough confluent consolidations S3
C20 75 M C-RP 15mg/dl, Procalcitonin: 8.9mg/dl
multiple and predominantly subpleural “ground-glass” opacities
with reticulation and consolidations, involving all
lobes, especially the upper lobes.
S3
18
C24 78 F
pO2:50%
asthenia, sick cough and fever
for 3 days
diffuse ground-glass opacities with reticulation in a “crazy-
paving” pattern, associated with alveolar consolidations
in the dependent regions.
S3
C25 71 F
COPD, Diabetes mellitus,
chronic renal failure, mitral
valve replacement
multiple and large ground glass with reticulations with
“crazy-paving” pattern associated with consolidations.
Right pleural effusion.
S3
C38 72 F
Temp:36.9◦
pO2:92%
diabetic
bilateral parenchymal consolidations in the posterior regions
of the lower lung lobes, bilaterally. Subpleural
nodules at the anterior segments of the left upper lung lobe.
Multiple ground glass opacities over the entire lung area
S3
C41 73 M
bilateral confluent consolidations prevalent in the upper
lung fields associated with ground glass areas configuring
a widespread picture of ”crazy paving” with relative saving
of the subpleural regions. Bilateral parenchymal bands
S3
C42 87 M
pO2:95%
diagnosis of right heart failure
in hypertensive heart disease
and PM, regressed with diuretic
therapy
large areas of ground-glass interstitial thickening with
initial areas of larger consolidation in the posterior basal
segments, in the absence of pleural effusion
S3
C44 65 M Temp:37.5◦C
pO2: 84%
wide and bilateral sloping and symmetrical “ground glass”
aspect, with aerial bronchogram and moderate tendency
to form small consolidations in the posterior subpleural
area. By sparing only the apices, the alterations extend
to the bases and have an antero-posterior thickness of
6-9 cm. Cortical regions are not spared. There is no pleural
or pericardial effusion and the interlobular septa are not
significantly thickened-imbibed. An emphysematous bulla
at the left base of the lung in the posterior median area of 2.7 cm
S3
C45 79 fever and cough
diabetic, cardiopathic bilateral interstitial pneumonia. S3
C46 61 M Temp:38.5◦C
pO2:85%
bilateral mantle consolidations with air bronchogram affect the
lower lobes of both lungs, especially the apical segments,
and the dorsal and apico-dorsal segments of the upper
lobes of the right and left respectively. The remaining
segments of the upper lobes present thickened areas with
ground glass opacity.
S3
19
C47 61 M
pO2:82%
WBC 11.2; PCR 301 mg / L
(VN <5);
LDH 738mg / dl
(VN 135-225);
Fibrinogen 798mg / dl
multiple areas of ground-glass extended diffusely in
both lungs with initial consolidation aspects in the basal
regions where subpleural sparing is highlighted; moderate
volume reduction of both lungs.
S3
C51 55 F
pO2:50%
dyspnea, fever and cough
High PCR; Procalcitonin and
normal laboratory tests
multiple parenchymal thickenings of the pseudonodular
type with density ”ground glass” at the upper lobes,
with a predominantly peribroncovasal and subpleural distribution,
with associated areas of parenchymal thickening with an air
bronchogram at the LID and
LIS.
S3
C52 57 M pO2:50%
acute dyspnea and therapy-
resistant hypepyrexia
multiple areas of increased “frosted glass” lung density,
in particular in the upper and middle lobes, with a prevalent
peribroncovasal and subpleural distribution, which is
associated with inter- and intra-lobular septal thickening;
areas of parenchymal thickening, with patent air
bronchogram in context, at the level of the lower
lobes.
S3
C58 60 M
Dyspnea and hyperthermia
APR: DMT2, dyslipidemia,
high blood pressure,
ex-heavy smoker
multiple “frosted glass” thickening areas, prevalent in
the lower lobes and in the posterior
seat, with iteress of the intralobular interstitium,
findings compatible with acute inflammation
S3
C65 74 M
pO2:94%
history of ischemic heart
disease, bronchial asthma
and NAO therapy.
pattern characterized by the presence of “emery glass”
areas superimposed on smooth thickening of the interlobular
and intralobular interstitium; concomitant area of parenchymal
consolidation in the posterior cavity of the right hemithorax
and fibrotic outcomes in the posterior cavity of the left hemithorax
S3
C67 83 M
Temp:38.9◦C
pO2:92%
ex-smoker with a history
of remote pathology positive
for arterial hypertension,
diabetes mellitus, IPB.
increase in PCR,
LDH and transaminases
multiple ”frosted glass” areoles with greater peripheral and
parascissural distribution tending to confluence, with initial
consolidation phenomena, in the context of which there is a
thickening of the intralobular interstice with ”crazy
paving” aspects.
S3
20
C1 80 M fever and dyspnea
multiple ground-glass opacities associated with reticulations
in a “crazy-paving pattern” – particularly in the
lower lobes. Subpleural consolidation
S2
C4 45 M fever, cough
multiple diffuse ground-glass opacities in all lobes, with
random distribution, predominant subpleural and peri-
bronchial in the upper lobes
S2
C7 43 M
Respiratory failure (hypoxemia
and hypercapnia
Leukopenia
subpleural ground-glass opacity with consolidations in the
LLL; scattered ground-glass opacities in the upper lobes
and more extended in the lower lobes
S2
C14 50 M
pO2:93%
sick cough asthenia
and fever for two days
crazy paving patterns observed S2
C15 46 F pO2:98%
Multiple and bilateral consolidations at different stages, with
predominant peribronchial and
subpleural distribution. No pleural effusion
S2
C18
Cough, fever and progressive
dyspnea
Colon cancer
ground glass opacifications and septal thickening S2
C19
Temp:39◦C
Acute sinusitis fever and cough.
Onset of asthenia, diarrhea and
hyporexia since the day before the
admission to the ED.
ground glass opacifications and septal thickening S2
C22 69 F Temp:36.9◦C
pO2:96%
multiple ground-glass opacities with predominant sub-
pleura distribution associated with areas of “crazy-paving”
pattern.
S2
C23 27 M pO2:92
multiple ground-glass opacities and alveolar consolidations
with predominant subpleural distribution in the upper and
lower lobes.
S2
C27 58 F dyspnea and fever interstitial markings with alveolar consolidations in the
upper lobes. Cardiomegaly. No pleural effusion S2
C29 68 M
fever, dyspnea and diarrhea
eukocytosis, increased C-PR,
procalcitonin in the range
chronic lymphocytic leukemia
under follow-up, Dyslipidemia
multiple and bilateral scatterd ground-glass opacities
with predominant subpleural distribution associated
with reticulations and alveolar consolidations
S2
21
C30 64 M
dyspnea, cough and fever
C-PR 13.44 mg/dl,
procalcitonin and CBC
unremarkable.
Diabetes mellitus
bilateral scatterd ground-glass opacities with
predominant subpleural distribution S2
C31 63 M
fever, pharyngalgia asthenia and
diarrhoea
C-PR 16.27 mg/dl,
procalcitonin and CBC
unremarkable.
Obstructive sleep apnea
syndrome
multiple and bilateral ground-glass opacities
with consolidations S2
C32 43 M fever and asthenia
large ground-glass opacity with reticulations
and small peripheral consolidations in
the RLL; scattered GGOs in the LUL.
S2
C34 47 M Temp:39◦C
pO2:95%
development of a dense consolidative pattern
and interstitial bands, consistent with
good evolution of the disease.
S2
C35 63 leukopenia, an increase in
transaminases
interstitial-alveolar pneumonia with widespread
bilateral mosaic alteration with crazy paving pattern. S2
C36 76 M
multiple Pulmonary thickenings, mainly of the
”ground glass” type with ubiquitous bilateral
distribution. Air flap in the peritoneal cavity
compatible with intestinal perforation and free
intra-abdominal effusion.
S2
C37 86 M dyspnea, fever and cough
“frosted glass” type thickening with bilateral
subpleural distribution. Concomitant thickening of
the interlobular septa (crazy paving pattern).
S2
22
C40 56
Temp:38.5
slight reduction in white blood
cells (3.47 x103/ ul; vn 4.5 -10.0)
in the absence of significant lympho-
penia,increased fibrinogen
(650 mg / dl; vn 150-450 ),
negative troponin,
ESR within the limits (
13 mm / h; vn <15).
the CT examination documents in both lung
areas the presence of multiple areas
of increased and altered parenchymal density
with ”frosted glass tending to confluence
with consolidation, of which the largest at the
apical segment of the right upper lobe, apico-
dorsal lobe upper left, lower lingular and more
extended to the basal pyramids on both sides,
with predominantly mantle arrangement. No
signs of pleural or pericardial effusion. Regular
patency of the trunk and main pulmonary arteries.
Diffuse sub-and peri-centimetric reactive
lymphadenopathy in the peritracheo-broncho-hilar
chains on both sides.
S2
C43 82 F
WBC 6.84; PCR 106.93 mg / L
(limit 5);
VES 45 (limit 15); LDH 314 mg / dl
(limit 214); Glucose 137mg / dl
Slight hypo-expansion of the left lung in which
context multiple areas of ground glass are
recognized with associated smooth thickening
of the inter- and intra-lobular interstitium.
The alterations are prevalent in the subpleural
interstitium and mainly localized to the
dorsal and lateral sectors of the upper left lobe;
on the lower left lobe some consolidated
supbleuric aspects are found
S2
C49 84 M
High fever, recent onset of
moderate respiratory failure
since 2 weeks.
widespread ”crazy paving areas of ”ground-glass”
with aspects of confluence at the bases.
Thin bilateral pleural effusion and small sub-
centimetric mediastinal oval lymph nodes are
associated,
S2
C50 60 M abdominal pain and hyperpyrexia
lymphocytes 1.1 x 109/ L S2
C53 78
pO2:84%
fever and cough for one week
and respiratory failure
multiple frosted glass opacities affecting all the
lobes to a greater extent the upper lobes and the
lower left lobe m, in the context of which there is
widespread thickening of the interstitial septa.
Mediastinal adenopathies.
S2
23
C54 M arterial hypertension
frosted glass thickenings with peripheral distribution
and associated thickening of the interlobular
septa, absence of pleural effusion and in the
absence of significant ilo-mediastinal
lymphadenopathies characterize the TC pattern
S2
C55 65 F bariatric surgery, bipolar
syndrome
all lung segments are affected by numerous patches
of parenchymal thickening with emery glass
density, some with confluent appearance,
without pleural effusion or signs of pulmonary
thrombo-embolism
S2
C57 40 M
Temp:40◦C
Previous pneumonia,
former smoker.
fever and from now dyspnea
hypoxemia (PaO2 63.4 mmHg),
mild respiratory alkalosis (pH 7.5,
pCO2 35 mmHg) and to blood
tests increase in inflammation
indexes with: PCR: 87.16 mg / L,
Fibrinogen: 621 mg / dL,
Procalcitonin: 0.16 ng / ml,
LDH: 328 U / L
confirms multiple thickenings largely with a ground
glass appearance, arranged in patches and
involving almost all the lung lobes, with ilo-parailary
and partly sub-pleural distribution: strongly
suspected finding for COVID 19 pulmonary infection.
No pleural effusion is documented.
The trachea and the main bronchi remain patent.
On the right, in the anterior territory of the
superior lobe there is a voluminous pulmonary cyst
devoid of inclusions with an axial diameter
of about 8 cm and craniocaudal of 10 cm.
S2
C64 Temp:39◦C
pO2:90%
the image demonstrates the presence of multiple
parenchymal thickenings with emery glass
and some areas with ”crazy-paving” patterns
characterized by the presence of superimposed
emery glass” areas with smooth thickening of the
interlobular and intralobular interstitium with
associated areas of parenchymal consolidation
S2
C66 Temp:39◦C
pO2:93%
the CT survey demonstrates some small nuanced
parenchymal “¨emery glass” thickenings
located at the apicodorsal segment of the upper lobe
of the left lung and in the middle lobe.
Fair share of pleural effusion in the large cavity on
the right with a thin layer of effusion also
on the left. Widespread manifestations of
centrilobular and subpleural paraseptal emphysema
in the lung parenchyma.
S2
24
Table S2: List of CT imaging centers and corresponding case numbers in the dataset
#Hospital/CT Imaging Centers Case Numbers
1 U.O.C. Diagnostica per immagini – Ospedale “Dono Svizzero” Formia DEA I livello– Asl Latina 21,22,23,24,25,27,61,62,63,64,65
2 Radiologia ASST Cremona 3,4,5,6,7
3 UOC di Radiologia Diagnostica e Interventistica, Ospedale Madonna delle Grazie, ASL 4 – Matera 10,16,53
4 UOC Radiologia ASST Bergamo Est 2,9,14,15,33
5 SS Oncological Radiology San Giuseppe Moscati Hospital, Taranto 51,52,78,79,89,90,91,115
6 Radiologia IRCCS Reggio Emilia 29,30,31,32
7 ASST Pavia, hospital of Vigevano 41,43,44,95
8 SC Radiodiagnostics - AO “S. Croce e Carle”- Cuneo 42,56,57,86
9 Ospedaliera San Camillo-Forlanini, Roma 17,49
10 General and breast diagnosis of the West - Sanremo Hospital 36,37
11 Fondazione Poliambulanza Istituto Ospedaliero, Brescia 18,19,85
12 UOC Diagnostica per Immagini, AO Riuniti Marche Nord 20
13 Radiology - IRCSS Sacro Cuore Don Calabria Hospital - Veneto Region - Negrar (VR) 38,50
14 UOC Radiology, San Paolo Hospital, Savona 45
15 Diagnostics for images, Aorn SG Moscati, Avellino 46
16 AOU Careggi, Florence 47
17 AOU San Luigi Gonzaga, Orbassano 58
18 SOC Radiodiagnostics San Jacopo Pistoia 67
19 UOC Radiologia – AO Sant’Orsola – Bologna 11
20 Filippo Barbiera – ASP Agrigento Presidio Ospedaliero di Sciacca (AG) 28
21 U.O di Radiologia ASST CREMA – Ospedale Maggiore di Crema 33
22 Sergio MargariASST Fatebenefratelli Sacco - Milan 69
23 Dipartimento di Scienze Radiologiche – Scuola di Specializzazione in Radiologia 1
24 ASL Verbano-Cusio-Ossola 35
25 AORN ¨
Antonio Cardarelli” - Naples 40
26 Radiology AOU Policlinico Umberto I - Sapienza University of Rome 54,77,82
27 UOC of Diagnostic and Interventional Radiology, Carlo Poma ASST Mantua Hospital 55
28 Milano, Radiologia Fatebenefratelli 70
29 UOC di Radiologia: Direttore: Dott. F. Pinto P.O. “Anastasia Guerriero” – Marcianise, ASL Caserta. 71
30 Radiologia – AOU Policlinico Umberto I – Sapienza Universit`a di Roma 72,73,74,75
31 1. SOC Radiodiagnostica Ospedale San Jacopo Pistoia
2. Reparto Malattie Infettive Ospedale San Jacopo Pistoia 76
32 USC Radiologia ASST Lodi – Presidi Ospedalieri di Codogno e Casalpusterlengo 80
33 Reparto di Diagnostica per Immagini Ospedale Regionale “Piccole Figlie Hospital” Parma 81
34 UOC Radiologia Pediatria PO G. Di Cristina ARNAS Civico Palermo 83
25
35 Dipartimento dei Servizi Sanitari – U.O. Radiologia – P.O. “G. Jazzolino”, Vibo Valentia – ASP Vibo Valentia 84,93,100,101,102,103,104
107,108,109,110
36 1. SOC Radiodiagnostica Ospedale San Jacopo Pistoia ASL Toscana Centro.
2. Reparto Malattie Infettive Ospedale San Jacopo Pistoia ASL Toscana Centro 94
37 “Pineta Grande Hospital” – Castel Volturno (CE), Dipartimento di Diagnostica per Immagini 96,97,98
38 Policlinico G.B. Rossi “Borgo Roma” – Universit`a degli Studi di Verona – Verona (VR) 99
39 Dipartimento di Radiologia Asl VCO 105
40 Dipartimento di Radiodiagnostica e Radiologia Interventistica, Direttore D. MessanaARNAS,
Ospedali Civico, Di Cristina e Benfratelli, Palermo 106
41
Dipartimento Tecnologie Avanzate Diagnostiche e Terapeutiche,
U.O.C. di Radiologia – Ospedale Riuniti,
Azienda Ospedaliera Grande Ospedale Metropolitano (G.O.M.) “Bianchi-Melacrino-Morelli”, Reggio Calabria
111,112,113,114
26