scholarly journals Clinical characteristics and chest CT imaging features of critically ill COVID-19 patients

2020 ◽  
Vol 30 (11) ◽  
pp. 6151-6160 ◽  
Author(s):  
Nan Zhang ◽  
Xunhua Xu ◽  
Ling-Yan Zhou ◽  
Gang Chen ◽  
Yu Li ◽  
...  
Keyword(s):  
Critically Ill ◽  
Clinical Characteristics ◽  
Ct Imaging ◽  
Chest Ct ◽  
Imaging Features

scholarly journals Chest CT imaging features of critically ill COVID-19 patients

2020 ◽  
Author(s):  
Nan Zhang ◽  
Xunhua Xu ◽  
Ling-Yan Zhou ◽  
Gang Chen ◽  
Yu Li ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Ct Imaging ◽  
Chest Ct ◽  
Imaging Features ◽  
Reactive Protein ◽  
Disease Outcomes ◽  
Recovery Group ◽  
Death Group ◽  
Lung Lobes

Abstract Objectives To analyze the findings of computed tomography (CT) imaging in critically ill patients diagnosed with coronavirus disease 2019 (COVID-19).Methods This retrospective study reviewed 60 critically ill patients (43 males and 17 females, mean age 64.4±11.0 years) with COVID-19 pneumonia who were admitted to two different clinical centers. Their clinical and medical records were analyzed, and the chest CT images were assessed to determine the involvement of lobes and the distribution of lesions in the lungs between the patients who recovered from the illness and those who died.Results Patients were significantly older in the death group (10/60, 16.67%) than in the recovery group (50/60, 83.33%) (p=0.044). C-reactive protein (CRP) (67.9±50.5 mg/L) was significantly elevated in the death group as opposed to the recovery group (p<0.001). The neutrophil-to-lymphocyte ratio (NLR) was higher in the death group when compared with the recovery group (p=0.030). Involvement of five lung lobes was found in 98% of the patients, with medial or parahilar area involvement observed in all the death patients. Ground-glass opacities (97%), crazy-paving pattern (92%) and air bronchogram (93%) were the most common radiological findings. Presence of emphysema was more prevalent in the death group than in the recovery group (30% vs 2%, p=0.011).Conclusions The degree of lung involvement and lesion distribution with dominance in the medial and parahilar pulmonary areas were more severe in the death patients than in those who recovered. Patient’s age, emphysema, CRP and NLR could be combined with CT to predict the disease outcomes.

scholarly journals Prognostic effects of clinical and CT imaging features on critically ill patients with interstitial lung disease hospitalized in respiratory intensive care unit

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Shenyun Shi ◽  
Yonglong Xiao ◽  
Xiaohua Qiu ◽  
Yan Li ◽  
Yuying Qiu ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Chest Ct ◽  
Imaging Features ◽  
Significant Difference ◽  
Respiratory Intensive Care Unit

AbstractThe study aimed to evaluate the clinical and imaging features of critically ill patients with interstitial lung disease (ILD) treated in respiratory intensive care unit (RICU) and assess the prognostic effects of these factors. A total of 160 severe ILD patients admitted to the RICU were finally enrolled in this study. The clinical, imaging and follow-up data of them were studied retrospectively. The in-hospital mortality and total mortality were 43.1% and 63.8% respectively. By multivariate cox regression analysis, shock (OR = 2.39, P = 0.004), pulmonary fibrosis on CT (OR = 2.85, P = 0.002) and non-invasive ventilation (OR = 1.86, P = 0.037) were harmful factors to survivals of critically ill patients with ILD. In contrast, oxygenation index (OR = 0.99, P = 0.028), conventional oxygen therapy (OR = 0.59, P = 0.048) and β-lactam antibiotics use (OR = 0.51, P = 0.004) were protective factors. There is significant difference of survivals between patients with and without fibrosing ILD on CT (Log-rank, p = 0.001). The prognosis of critically ill patients with ILD was poor. Shock, respiratory failure and fibrosing signs on chest CT affected the prognosis. Chest CT was considered as a valuable tool to indicate the prognosis.

scholarly journals Semi-quantitative analysis for the dynamic chest CT imaging features from onset to recovery in severe and critical COVID-19

2020 ◽  
Vol 7 (3) ◽  
pp. 114-122
Author(s):  
Ruxiu Liu ◽  
Chaoqi Lei ◽  
Xiang Liao ◽  
Shan Shi ◽  
Jun Li ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Ct Imaging ◽  
Chest Ct ◽  
Imaging Features

scholarly journals Computed Tomography Features of COVID-19 in Children: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Ji-Gan Wang ◽  
Yu-Fang Mo ◽  
Yu-heng Su ◽  
Li-chuang Wang ◽  
Guang-bing Liu ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Ct Imaging ◽  
Chest Ct ◽  
Ground Glass ◽  
Imaging Features ◽  
Lung Lesions ◽  
Lung Lobe ◽  
Lung Ct

Objectives: To systematically analyze the chest CT imaging features of children with COVID-19 and provide references for clinical practice. Methods: We searched PubMed, Web of Science, and Embase; data published by Johns Hopkins University; and Chinese databases CNKI, Wanfang, and Chongqing Weipu. Reports on chest CT imaging features of children with COVID-19 from January 1, 2020, to August 10, 2020, were analyzed retrospectively and a meta-analysis carried out using Stata12.0 software. Results: Thirty-seven articles (1747 children) were included in this study. The overall rate of abnormal lung CT findings was 63.2% (95% confidence interval [CI]: 55.8-70.6%), with a rate of 61.0% (95% CI: 50.8-71.2%) in China and 67.8% (95% CI: 57.1-78.4%) in the rest of the world in the subgroup analysis. The incidence of ground-glass opacities was 39.5% (95% CI: 30.7-48.3%), multiple lung lobe lesions 65.1% (95% CI: 55.1-67.9%), and bilateral lung lesions 61.5% (95% CI: 58.8-72.2%). Other imaging features included nodules (25.7%), patchy shadows (36.8%), halo sign (24.8%), consolidation (24.1%), air bronchogram signs (11.2%), cord-like shadows (9.7%), crazy-paving pattern (6.1%), and pleural effusion (9.1%). Two articles reported three cases of white lung, another reported two cases of pneumothorax, and another one case of bullae. CONCLUSION: The lung CT results of children with COVID-19 are usually normal or slightly atypica, with a low sensitivity and specificity compared with that in adults. The lung lesions of COVID-19 pediatric patients mostly involve both lungs or multiple lobes, and the common manifestations are patchy shadows, ground-glass opacities, consolidation, partial air bronchogram signs, nodules, and halo signs; white lung, pleural effusion, and paving stone signs are rare. CLINICAL IMPACT: Therefore, chest CT has limited value as a screening tool for children with COVID-19 and can only be used as an auxiliary assessment tool.

scholarly journals Clinical characteristics of coronavirus disease 2019 (COVID-19) in patients out of Wuhan from China: a case control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hua Zhang ◽  
Feng Du ◽  
Xiao-jun Cao ◽  
Xia-long Feng ◽  
He-ping Zhang ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Large Scale ◽  
Time Course ◽  
Second Generation ◽  
Oxygenation Index ◽  
Ct Imaging ◽  
Moderate Degree ◽  
Imaging Features ◽  
Oxyhemoglobin Saturation ◽  
Amyloid A

Abstract Background A large-scale global outbreak of coronavirus disease-19 (COVID-19) out of Wuhan, from China, occurred in January 2020. To examine the clinical characteristics of COVID-19 in infected patients out of Wuhan, from China. Methods Thirteen patients were confirmed to be infected with novel coronavirus-2019 (2019-nCoV) between January 27 and February 8, 2020, in Baoji city, Shannxi, northwestern China. Epidemiological and clinical information, and computed to morphology imaging data from all COVID-19 patients were collected; cases were divided into two groups according to the severity of infection (mild or severe). Results Nine (9/13) COVID-19 patients exhibited mild disease severity, and defined as second-generation human-to-human transmission cases. Most patients (11/13) had a history of travel to or from Wuhan. There were no differences in sex and age between the mild and severe cases (all P > 0.05). A moderate degree of fever (11/13), cough (13/13), and fatigue (8/13) were common symptoms; however, there was no statistical difference between mild and severe cases in this regard (all P > 0.05). Oxyhemoglobin saturation and oxygenation index decreased, and C-reactive protein (CRP) and serum amyloid A (SAA) levels were elevated in all patients with COVID-19 infection, with statistically significant differences between those with severe disease and mild infection (all P < 0.05). Twelve of 13 COVID-19 patients exhibited changes in chest CT imaging features, and time course changes were different between mild and severe cases (all P < 0.05). Conclusion Most cases of COVID-19 infection were second-generation human-to-human transmissions from Wuhan and were mild in severity. The clinical characteristics of COVID-19 varied. Oxyhemoglobin saturation, oxygenation index, CRP and SAA levels, and CT features were reliable parameters to evaluate the severity of COVID-19 infection. However, a few patients with mild COVID-19 disease lacked typical characteristics such as fever and changes in CT imaging features.

scholarly journals Chest CT imaging features of COVID-19 and its correlation with the PaO2/FiO2 ratio: a multicenter study in Upper Egypt

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Noha M. Attia ◽  
Moustafa H. M. Othman
Keyword(s):  
Disease Severity ◽  
Negative Correlation ◽  
Severity Score ◽  
Ct Imaging ◽  
Chest Ct ◽  
Ground Glass ◽  
Arterial Oxygen ◽  
Imaging Features ◽  
Preliminary Assessment ◽  
Moderate Negative Correlation

Abstract Background The main challenge in managing COVID-19 pandemic is containment of the infection by early detection of the disease and wide dissemination of diagnostic tests with high sensitivity and specificity. Various imaging features were identified by chest CT with different patterns from early disease to diffuse disease with complications. However, CT cannot be performed for all patients. The arterial oxygen partial pressure/fraction of inspired oxygen (PaO2/FiO2) ratio is evaluated as a rapid and widely available test for the preliminary assessment of disease severity. This study aimed to evaluate the clinical and chest CT imaging features of COVID-19 in Egyptian patients as well as assess the correlation between the chest CT total severity score and the PaO2/FiO2 ratio to determine its value for preliminary assessment of disease severity. Results The most common symptoms were fever (83.2%), dry cough (77%), malaise (68.8%), prolonged headaches (48.5%), and dyspnea (37.6%). CT was positive in 79.2% of the patients. The CT features at presentation were ground-glass opacities only (40%), ground-glass opacities with consolidation (34.4%), and consolidation only (25.6%). Associated findings included crazy paving (17.5%), interlobular septal thickening (47.5%), air bronchogram (15%), bronchiectasis (12.8%), fibrous bands (8.1%), vascular enlargement within the lesion (45.6%), nodules (6.8%), pericardial thickening (5%), and pleural thickening (24.7%). The lesions were typically multilobar (50.5%), posterior (58.1%) with peripheral and central distribution (41.9%). Moderate negative correlation was observed between the CT total lung severity score and PaO2/FiO2 ratio with r = − 0.42 and P < 0.001. Conclusion The most common pattern of COVID-19 pneumonia in multiple quarantine hospitals was peripheral and central ground-glass opacities with bilateral multilobe posterior involvement and fever was the most common symptom. PaO2/FiO2 ratio has a moderate negative correlation with the CT total severity score and thus can be used in the preliminary assessment of disease severity.

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