Comparison of X-ray and CT Images of COVID-19 Caused by the Wild-Type and Alpha-Variant SARS-CoV-2

Introduction This study aimed to determine the characteristics of coronavirus disease 2019 (COVID-19) pneumonia caused by the wild type and the alpha variant in patients. This study included patients with COVID-19 admitted to Fukui General Hospital between October 31, 2020, and April 30, 2021. Methods Pneumonia occurrence rate, chest X-ray, and computed tomography (CT) findings were evaluated by two radiologists. The time since the onset and presence of pneumonia were also investigated. Results Out of 128 patients, 43 had pneumonia. The pneumonia detection rates using chest radiography were 15.6% (20/128) and 33.6% (43/128) using CT (p = 0.0008). Of the pneumonia cases detected by CT, 32.0% (8/25) of the wild type and 66.7% (12/18) of the alpha variant were detected by X-rays (p = 0.0246). The main finding of pneumonia was a higher percentage of ground-glass opacities than consolidation in both the wild type and alpha variant. In the alpha variant, multiple signs of air bubbles were observed in four patients on chest CT; however, these were not observed in the wild type (p = 0.014). Conclusion The imaging features of pneumonia may be different in variants of COVID-19 compared to those in the wild type. CT helps to detect pneumonia and identify features in patients with COVID-19 because it is difficult to detect COVID-19 pneumonia using plain chest radiographs.