COVID-19 pneumonia: infection control protocol inside computed tomography suites
Identifieur interne : 000291 ( Pmc/Corpus ); précédent : 000290; suivant : 000292COVID-19 pneumonia: infection control protocol inside computed tomography suites
Auteurs : Kento Nakajima ; Hideaki Kato ; Tsuneo Yamashiro ; Toshiharu Izumi ; Ichiro Takeuchi ; Hideaki Nakajima ; Daisuke UtsunomiyaSource :
- Japanese Journal of Radiology [ 1867-1071 ] ; 2020.
Abstract
A novel coronavirus (severe acute respiratory syndrome coronavirus 2) causes a cluster of pneumonia cases in Wuhan, China. It spread rapidly and globally. CT imaging is helpful for the evaluation of the novel coronavirus disease 2019 (COVID-19) pneumonia. Infection control inside the CT suites is also important to prevent hospital-related transmission of COVID-19. We present our experience with infection control protocol for COVID-19 inside the CT suites.
Url:
DOI: 10.1007/s11604-020-00948-y
PubMed: NONE
PubMed Central: 7089199
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PMC:7089199Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">COVID-19 pneumonia: infection control protocol inside computed tomography suites</title><author><name sortKey="Nakajima, Kento" sort="Nakajima, Kento" uniqKey="Nakajima K" first="Kento" last="Nakajima">Kento Nakajima</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.470126.6</institution-id><institution-id institution-id-type="ISNI">0000 0004 1767 0473</institution-id><institution>Advanced Critical Care Medicine,</institution><institution>Yokohama City University Hospital,</institution></institution-wrap>Yokohama, Japan</nlm:aff></affiliation></author><author><name sortKey="Kato, Hideaki" sort="Kato, Hideaki" uniqKey="Kato H" first="Hideaki" last="Kato">Hideaki Kato</name><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.470126.6</institution-id><institution-id institution-id-type="ISNI">0000 0004 1767 0473</institution-id><institution>Infection Prevention and Control Department,</institution><institution>Yokohama City University Hospital,</institution></institution-wrap>Yokohama, Japan</nlm:aff></affiliation></author><author><name sortKey="Yamashiro, Tsuneo" sort="Yamashiro, Tsuneo" uniqKey="Yamashiro T" first="Tsuneo" last="Yamashiro">Tsuneo Yamashiro</name><affiliation><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="GRID">grid.470126.6</institution-id><institution-id institution-id-type="ISNI">0000 0004 1767 0473</institution-id><institution>Diagnostic Radiology,</institution><institution>Yokohama City University Hospital,</institution></institution-wrap>3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004 Japan</nlm:aff></affiliation><affiliation><nlm:aff id="Aff6"><institution-wrap><institution-id institution-id-type="GRID">grid.267625.2</institution-id><institution-id institution-id-type="ISNI">0000 0001 0685 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Utsunomiya</name><affiliation><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="GRID">grid.470126.6</institution-id><institution-id institution-id-type="ISNI">0000 0004 1767 0473</institution-id><institution>Diagnostic Radiology,</institution><institution>Yokohama City University Hospital,</institution></institution-wrap>3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004 Japan</nlm:aff></affiliation><affiliation><nlm:aff id="Aff4"><institution-wrap><institution-id institution-id-type="GRID">grid.470126.6</institution-id><institution-id institution-id-type="ISNI">0000 0004 1767 0473</institution-id><institution>Central Radiology,</institution><institution>Yokohama City University Hospital,</institution></institution-wrap>Yokohama, Japan</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmc">7089199</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7089199</idno><idno type="RBID">PMC:7089199</idno><idno type="doi">10.1007/s11604-020-00948-y</idno><idno type="pmid">NONE</idno><date when="2020">2020</date><idno type="wicri:Area/Pmc/Corpus">000291</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000291</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">COVID-19 pneumonia: infection control protocol inside computed tomography suites</title><author><name sortKey="Nakajima, Kento" sort="Nakajima, Kento" uniqKey="Nakajima K" first="Kento" last="Nakajima">Kento Nakajima</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.470126.6</institution-id><institution-id institution-id-type="ISNI">0000 0004 1767 0473</institution-id><institution>Advanced Critical Care Medicine,</institution><institution>Yokohama City University Hospital,</institution></institution-wrap>Yokohama, Japan</nlm:aff></affiliation></author><author><name sortKey="Kato, Hideaki" sort="Kato, Hideaki" uniqKey="Kato H" first="Hideaki" last="Kato">Hideaki Kato</name><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.470126.6</institution-id><institution-id institution-id-type="ISNI">0000 0004 1767 0473</institution-id><institution>Infection Prevention and Control Department,</institution><institution>Yokohama City University Hospital,</institution></institution-wrap>Yokohama, Japan</nlm:aff></affiliation></author><author><name sortKey="Yamashiro, Tsuneo" sort="Yamashiro, Tsuneo" uniqKey="Yamashiro T" first="Tsuneo" last="Yamashiro">Tsuneo Yamashiro</name><affiliation><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="GRID">grid.470126.6</institution-id><institution-id institution-id-type="ISNI">0000 0004 1767 0473</institution-id><institution>Diagnostic Radiology,</institution><institution>Yokohama City University Hospital,</institution></institution-wrap>3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004 Japan</nlm:aff></affiliation><affiliation><nlm:aff id="Aff6"><institution-wrap><institution-id institution-id-type="GRID">grid.267625.2</institution-id><institution-id institution-id-type="ISNI">0000 0001 0685 5104</institution-id><institution>Department of Radiology, Graduate School of Medical Science,</institution><institution>University of the Ryukyus,</institution></institution-wrap>Nishihara, Japan</nlm:aff></affiliation></author><author><name sortKey="Izumi, Toshiharu" sort="Izumi, Toshiharu" uniqKey="Izumi T" first="Toshiharu" last="Izumi">Toshiharu Izumi</name><affiliation><nlm:aff id="Aff4"><institution-wrap><institution-id institution-id-type="GRID">grid.470126.6</institution-id><institution-id institution-id-type="ISNI">0000 0004 1767 0473</institution-id><institution>Central Radiology,</institution><institution>Yokohama City University Hospital,</institution></institution-wrap>Yokohama, Japan</nlm:aff></affiliation></author><author><name sortKey="Takeuchi, Ichiro" sort="Takeuchi, Ichiro" uniqKey="Takeuchi I" first="Ichiro" last="Takeuchi">Ichiro Takeuchi</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.470126.6</institution-id><institution-id institution-id-type="ISNI">0000 0004 1767 0473</institution-id><institution>Advanced Critical Care Medicine,</institution><institution>Yokohama City University Hospital,</institution></institution-wrap>Yokohama, Japan</nlm:aff></affiliation></author><author><name sortKey="Nakajima, Hideaki" sort="Nakajima, Hideaki" uniqKey="Nakajima H" first="Hideaki" last="Nakajima">Hideaki Nakajima</name><affiliation><nlm:aff id="Aff5"><institution-wrap><institution-id institution-id-type="GRID">grid.470126.6</institution-id><institution-id institution-id-type="ISNI">0000 0004 1767 0473</institution-id><institution>Hematology and Clinical Immunology,</institution><institution>Yokohama City University Hospital,</institution></institution-wrap>Yokohama, Japan</nlm:aff></affiliation></author><author><name sortKey="Utsunomiya, Daisuke" sort="Utsunomiya, Daisuke" uniqKey="Utsunomiya D" first="Daisuke" last="Utsunomiya">Daisuke Utsunomiya</name><affiliation><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="GRID">grid.470126.6</institution-id><institution-id institution-id-type="ISNI">0000 0004 1767 0473</institution-id><institution>Diagnostic Radiology,</institution><institution>Yokohama City University Hospital,</institution></institution-wrap>3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004 Japan</nlm:aff></affiliation><affiliation><nlm:aff id="Aff4"><institution-wrap><institution-id institution-id-type="GRID">grid.470126.6</institution-id><institution-id institution-id-type="ISNI">0000 0004 1767 0473</institution-id><institution>Central Radiology,</institution><institution>Yokohama City University Hospital,</institution></institution-wrap>Yokohama, Japan</nlm:aff></affiliation></author></analytic><series><title level="j">Japanese Journal of Radiology</title><idno type="ISSN">1867-1071</idno><idno type="eISSN">1867-108X</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>A novel coronavirus (severe acute respiratory syndrome coronavirus 2) causes a cluster of pneumonia cases in Wuhan, China. It spread rapidly and globally. CT imaging is helpful for the evaluation of the novel coronavirus disease 2019 (COVID-19) pneumonia. Infection control inside the CT suites is also important to prevent hospital-related transmission of COVID-19. We present our experience with infection control protocol for COVID-19 inside the CT suites.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Wang, D" uniqKey="Wang D">D Wang</name></author><author><name sortKey="Hu, B" uniqKey="Hu B">B Hu</name></author><author><name sortKey="Hu, C" uniqKey="Hu C">C Hu</name></author><author><name sortKey="Zhu, F" uniqKey="Zhu F">F Zhu</name></author><author><name sortKey="Liu, X" uniqKey="Liu X">X Liu</name></author><author><name sortKey="Zhang, J" uniqKey="Zhang J">J Zhang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pan, Y" uniqKey="Pan Y">Y Pan</name></author><author><name sortKey="Guan, H" uniqKey="Guan H">H Guan</name></author><author><name sortKey="Zhou, S" uniqKey="Zhou S">S Zhou</name></author><author><name sortKey="Wang, Y" uniqKey="Wang Y">Y Wang</name></author><author><name sortKey="Li, Q" uniqKey="Li Q">Q Li</name></author><author><name sortKey="Zhu, T" uniqKey="Zhu T">T Zhu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pan, F" uniqKey="Pan F">F Pan</name></author><author><name sortKey="Ye, T" uniqKey="Ye T">T Ye</name></author><author><name sortKey="Sun, P" uniqKey="Sun P">P Sun</name></author><author><name sortKey="Gui, S" uniqKey="Gui S">S Gui</name></author><author><name sortKey="Liang, B" uniqKey="Liang B">B Liang</name></author><author><name sortKey="Li, L" uniqKey="Li L">L Li</name></author></analytic></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Jpn J Radiol</journal-id><journal-id journal-id-type="iso-abbrev">Jpn J Radiol</journal-id><journal-title-group><journal-title>Japanese Journal of Radiology</journal-title></journal-title-group><issn pub-type="ppub">1867-1071</issn><issn pub-type="epub">1867-108X</issn><publisher><publisher-name>Springer Japan</publisher-name><publisher-loc>Tokyo</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmc">7089199</article-id><article-id pub-id-type="publisher-id">948</article-id><article-id pub-id-type="doi">10.1007/s11604-020-00948-y</article-id><article-categories><subj-group subj-group-type="heading"><subject>Special Report</subject></subj-group></article-categories><title-group><article-title>COVID-19 pneumonia: infection control protocol inside computed tomography suites</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Nakajima</surname><given-names>Kento</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Kato</surname><given-names>Hideaki</given-names></name><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Yamashiro</surname><given-names>Tsuneo</given-names></name><xref ref-type="aff" rid="Aff3">3</xref><xref ref-type="aff" rid="Aff6">6</xref></contrib><contrib contrib-type="author"><name><surname>Izumi</surname><given-names>Toshiharu</given-names></name><xref ref-type="aff" rid="Aff4">4</xref></contrib><contrib contrib-type="author"><name><surname>Takeuchi</surname><given-names>Ichiro</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Nakajima</surname><given-names>Hideaki</given-names></name><xref ref-type="aff" rid="Aff5">5</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Utsunomiya</surname><given-names>Daisuke</given-names></name><address><email>d.utsunomiya@gmail.com</email></address><xref ref-type="aff" rid="Aff3">3</xref><xref ref-type="aff" rid="Aff4">4</xref></contrib><aff id="Aff1"><label>1</label><institution-wrap><institution-id institution-id-type="GRID">grid.470126.6</institution-id><institution-id institution-id-type="ISNI">0000 0004 1767 0473</institution-id><institution>Advanced Critical Care Medicine,</institution><institution>Yokohama City University Hospital,</institution></institution-wrap>Yokohama, Japan</aff><aff id="Aff2"><label>2</label><institution-wrap><institution-id institution-id-type="GRID">grid.470126.6</institution-id><institution-id institution-id-type="ISNI">0000 0004 1767 0473</institution-id><institution>Infection Prevention and Control Department,</institution><institution>Yokohama City University Hospital,</institution></institution-wrap>Yokohama, Japan</aff><aff id="Aff3"><label>3</label><institution-wrap><institution-id institution-id-type="GRID">grid.470126.6</institution-id><institution-id institution-id-type="ISNI">0000 0004 1767 0473</institution-id><institution>Diagnostic Radiology,</institution><institution>Yokohama City University Hospital,</institution></institution-wrap>3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004 Japan</aff><aff id="Aff4"><label>4</label><institution-wrap><institution-id institution-id-type="GRID">grid.470126.6</institution-id><institution-id institution-id-type="ISNI">0000 0004 1767 0473</institution-id><institution>Central Radiology,</institution><institution>Yokohama City University Hospital,</institution></institution-wrap>Yokohama, Japan</aff><aff id="Aff5"><label>5</label><institution-wrap><institution-id institution-id-type="GRID">grid.470126.6</institution-id><institution-id institution-id-type="ISNI">0000 0004 1767 0473</institution-id><institution>Hematology and Clinical Immunology,</institution><institution>Yokohama City University Hospital,</institution></institution-wrap>Yokohama, Japan</aff><aff id="Aff6"><label>6</label><institution-wrap><institution-id institution-id-type="GRID">grid.267625.2</institution-id><institution-id institution-id-type="ISNI">0000 0001 0685 5104</institution-id><institution>Department of Radiology, Graduate School of Medical Science,</institution><institution>University of the Ryukyus,</institution></institution-wrap>Nishihara, Japan</aff></contrib-group><pub-date pub-type="epub"><day>17</day><month>3</month><year>2020</year></pub-date><fpage>1</fpage><lpage>3</lpage><history><date date-type="received"><day>28</day><month>2</month><year>2020</year></date><date date-type="accepted"><day>5</day><month>3</month><year>2020</year></date></history><permissions><copyright-statement>© Japan Radiological Society 2020</copyright-statement><license><license-p>This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.</license-p></license></permissions><abstract id="Abs1"><p>A novel coronavirus (severe acute respiratory syndrome coronavirus 2) causes a cluster of pneumonia cases in Wuhan, China. It spread rapidly and globally. CT imaging is helpful for the evaluation of the novel coronavirus disease 2019 (COVID-19) pneumonia. Infection control inside the CT suites is also important to prevent hospital-related transmission of COVID-19. We present our experience with infection control protocol for COVID-19 inside the CT suites.</p></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>COVID-19</kwd><kwd>Pneumonia</kwd><kwd>Computed tomography</kwd><kwd>Infection</kwd></kwd-group></article-meta></front><body><p id="Par1">A novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified as the etiology for a cluster of pneumonia cases in Wuhan, a city in the Hubei Province of China [<xref ref-type="bibr" rid="CR1">1</xref>]. It spread rapidly throughout China, resulting in a nation-wide epidemic; moreover, there were reports of sporadic cases globally. Previously published reports describe the imaging features of patients with the novel coronavirus disease 2019 (COVID-19) pneumonia [<xref ref-type="bibr" rid="CR2">2</xref>, <xref ref-type="bibr" rid="CR3">3</xref>]. These reports have highlighted the clinical importance of chest computed tomography (CT) for the detection and management of patients infected with SARS-CoV-2. On the other hand, the infection control in the CT suite is also critically important because high rate of presumed hospital-related transmission of COVID-19 (41.3%) was reported [<xref ref-type="bibr" rid="CR1">1</xref>, <xref ref-type="bibr" rid="CR4">4</xref>]. Radiologists should not only be aware of the CT features of patients with COVID-19 pneumonia but they must also be well informed of the infection control protocols to be followed inside the CT suite to prevent the spread of infection. Herein, we present our experience with infection control protocol for COVID-19 inside the CT suite.</p><sec id="Sec2"><title>Personal protective equipment (PPE)</title><p id="Par2">Two radiologic technologists (RTs) are desirable for the CT scanning of patients for the assessment of COVID-19 pneumonia. One RT uses PPE to set up the patient on the CT imaging table, while the other RT operates the CT console. The PPE includes eye protection (goggles), a filtering facepiece respirator (N95), a surgical cap, gloves, a fluid-resistant gown, and shoe covers (Fig. <xref rid="Fig1" ref-type="fig">1</xref>).<fig id="Fig1"><label>Fig. 1</label><caption><p>Personal protective equipment (a radiologic technologist)</p></caption><graphic xlink:href="11604_2020_948_Fig1_HTML" id="MO1"></graphic></fig></p></sec><sec id="Sec3"><title>Protocol for chest CT imaging at CT suite</title><p id="Par3">In principle, CT examinations for patients suspected of or confirmed with SARS-CoV-2 infection are performed last in the daily CT schedule. The schematic of our CT suite is shown in Fig. <xref rid="Fig2" ref-type="fig">2</xref>. The CT examination is performed as follows (Fig. <xref rid="Fig3" ref-type="fig">3</xref>): (1) RT-1 with PPE is on stand-by; (2) the patient and the attending medical doctor (MD) arrive inside the CT scanner room; (3) RT-1 and MD set up the patient on the CT imaging table; (4) RT-1 and MD remove and discard their contaminated PPE (RT-1 and MD) inside the CT suite and perform hand hygiene; (5) RT-1 and MD leave the CT scanner room; (6) RT-2 performs non-contrast chest CT scanning, while RT-1 and MD put on new PPE outside the CT scanner room; (7) after the CT scanning, RT-1 and MD transfer the patient from the CT imaging table; (8) the patient and MD leave the CT scanner room; (9) the CT scanner and console rooms are sanitized. After leaving the CT suite, the high-frequency contact surfaces (i.e., operating consoles, switches, handles, and door knobs) are wiped with a cloth soaked with alcohol-based disinfectants. The CT suite is tightly closed for 1 h to thoroughly ventilate and exchange the room air.<fig id="Fig2"><label>Fig. 2</label><caption><p>Schematic of CT suite in the setting of the patient infected with SARS-CoV-2. <italic>CT</italic> computed tomography, <italic>SARS-CoV-2</italic> severe acute respiratory syndrome coronavirus 2</p></caption><graphic xlink:href="11604_2020_948_Fig2_HTML" id="MO2"></graphic></fig><fig id="Fig3"><label>Fig. 3</label><caption><p>Process and staff distribution in the CT scanner and console rooms during CT examination of the patient infected with SARS-CoV-2. <italic>RT</italic> radiologic technologist, <italic>P</italic> patient, <italic>MD</italic> medical doctor, <italic>CT</italic> computed tomography, <italic>SARS-CoV-2</italic> severe acute respiratory syndrome coronavirus 2</p></caption><graphic xlink:href="11604_2020_948_Fig3_HTML" id="MO3"></graphic></fig></p><p id="Par4">We use a 64-detector CT (SOMATOM definition AS+, Siemens) with the following scanning parameters: collimation, 128 × 0.6 mm; gantry rotation speed, 0.5 s; X-ray tube voltage, 120 kV with automatic tube current modulation. The CT images are reconstructed with a slice thickness of 2 mm and increment of 2 mm. Coronal and sagittal multiplanar reconstruction images are also acquired.</p></sec></body><back><fn-group><fn><p><bold>Publisher's Note</bold></p><p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p></fn></fn-group><ref-list id="Bib1"><title>References</title><ref id="CR1"><label>1.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Wang</surname><given-names>D</given-names></name><name><surname>Hu</surname><given-names>B</given-names></name><name><surname>Hu</surname><given-names>C</given-names></name><name><surname>Zhu</surname><given-names>F</given-names></name><name><surname>Liu</surname><given-names>X</given-names></name><name><surname>Zhang</surname><given-names>J</given-names></name><etal></etal></person-group><article-title>Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China</article-title><source>JAMA</source><year>2020</year><pub-id pub-id-type="doi">10.1001/jama.2020.1585</pub-id><pub-id pub-id-type="pmid">32159775</pub-id></element-citation></ref><ref id="CR2"><label>2.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Pan</surname><given-names>Y</given-names></name><name><surname>Guan</surname><given-names>H</given-names></name><name><surname>Zhou</surname><given-names>S</given-names></name><name><surname>Wang</surname><given-names>Y</given-names></name><name><surname>Li</surname><given-names>Q</given-names></name><name><surname>Zhu</surname><given-names>T</given-names></name><etal></etal></person-group><article-title>Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China</article-title><source>Eur Radiol</source><year>2020</year><pub-id pub-id-type="doi">10.1007/s00330-020-06731-x</pub-id><pub-id pub-id-type="pmid">32162000</pub-id></element-citation></ref><ref id="CR3"><label>3.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Pan</surname><given-names>F</given-names></name><name><surname>Ye</surname><given-names>T</given-names></name><name><surname>Sun</surname><given-names>P</given-names></name><name><surname>Gui</surname><given-names>S</given-names></name><name><surname>Liang</surname><given-names>B</given-names></name><name><surname>Li</surname><given-names>L</given-names></name><etal></etal></person-group><article-title>Time course of lung changes on chest CT during recovery from 2019 novel coronavirus (COVID-19) pneumonia</article-title><source>Radiology</source><year>2020</year><pub-id pub-id-type="doi">10.1148/radiol.2020200370</pub-id><pub-id pub-id-type="pmid">32155105</pub-id></element-citation></ref><ref id="CR4"><label>4.</label><mixed-citation publication-type="other">Japanese College of Radiology. 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