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Objective To observe the evolution of chest high-resolution computed tomography (HRCT) manifestations in 105 patients with coronavirus disease 2019 (COVID-19). Methods One hundred five patients with confirmed COVID-19 were enrolled from 11 January to 9 February 2020. Sequential chest HRCT examinations were performed. Five stages were identified from the onset of initial symptoms: 0–3, 4–7, 8–14, 15–21, and >21 days (Stages A–E, respectively). A semi-quantitative CT scoring system was used to estimate the sum of lung abnormalities in each stage. Results In total, 393 CT scans were collected. The patients underwent 3.8 ± 1.5 CT examinations. Multiple lobes were involved in most cases. The proportion of consolidation and the total CT score gradually increased from Stage A to C and gradually decreased from Stage C to E. The total CT score of lung involvement was significantly higher in Stage C than in Stages B and D. The CT score of the lower lobe was significantly higher than the corresponding upper and middle lobes in Stages A to D. Conclusions Most patients with COVID-19 had a disease course of >14 days, and the lung lesions in most patients improved after 14 days since initial symptom onset.