Correlation of laboratory parameters and chest CT findings in young adults with COVID-19 and comparison of imaging findings with children

On October 15th 2020, the Emergency Radiology Journal published our article entitled “COVID-19 pneumonia in the emergency department: correlation of initial chest CT findings with short-term outcome”, that evaluated clinical, laboratorial and imaging findings of laboratory confirmed COVID-19 patients as predictors of severe disease. In this paper, we will explore the context and significance of the early recognition of the disease severity on patients’ management.

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Chest CT-based differential diagnosis of 28 patients with suspected corona virus disease 2019 (COVID-19)

British Journal of Radiology ◽

10.1259/bjr.20200243 ◽

2020 ◽

Vol 93 (1112) ◽

pp. 20200243 ◽

Cited By ~ 1

Author(s):

Sidong Xie ◽

Ziying Lei ◽

Xiuzhen Chen ◽

Weimin Liu ◽

Xiaohong Wang ◽

...

Keyword(s):

Virus Disease ◽

Laboratory Data ◽

Chest Ct ◽

Imaging Findings ◽

Negative Results ◽

Ct Findings ◽

Corona Virus ◽

Mixed Ground ◽

Bilateral Lung ◽

Interlobular Septal Thickening

Objectives: The chest CT findings that can distinguish patients with corona virus disease 2019 (COVID-19) from those with clinically suspected COVID-19 but subsequently found to be COVID-19 negative have not previously been described in detail. The purpose of this study was to determine the distinctions among patients with COVID-19 by comparing the imaging findings of patients with suspected confirmed COVID-19 and those of patients initially suspected to have COVID-19 who were ultimately negative for the disease. Methods: 28 isolated suspected in-patients with COVID-19 were enrolled in this retrospective study from January 22, 2020 to February 6, 2020. 12 patients were confirmed to have positive severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) RNA results, and 16 patients had negative results. The thin-section CT imaging findings and clinical and laboratory data of all the patients were evaluated. Results: There were no significant differences between the 12 confirmed COVID-19 (SARS-Cov-2-positive) patients and 16 SARS-CoV-2-negative patients in epidemiology and most of the clinical features or laboratory data. The CT images showed that the incidence of pure/mixed ground-glass opacities (GGOs) was not different between COVID-19 and SARS-CoV-2-negative patients [9/12 (75.0%) vs 10/16 (62.5%), p = 0.687], but pure/mixed GGOs in the peripheral were more common in patients with COVID-19 [11/12 (91.7%) vs 6/16 (37.5%), p = 0.006]. There were no significant differences in the number of lesions, bilateral lung involvement, large irregular/patchy opacities, rounded opacities, linear opacities, crazy-paving patterns, halo signs, interlobular septal thickening or air bronchograms. Conclusions: Although peripheral pure/mixed GGOs on CT may help distinguish patients with COVID-19 from clinically suspected but negative patients, CT cannot replace RT-PCR testing. Advances in knowledge: Peripheral pure/mixed GGOs on-chest CT findings can be helpful in distinguishing patients with COVID-19 from those with clinically suspected COVID-19 but subsequently found to be COVID-19 negative.

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The association between clinical laboratory data and chest CT findings explains disease severity in a large Italian cohort of COVID-19 patients

BMC Infectious Diseases ◽

10.1186/s12879-021-05855-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Simone Canovi ◽

◽

Giulia Besutti ◽

Efrem Bonelli ◽

Valentina Iotti ◽

...

Keyword(s):

Clinical Laboratory ◽

Laboratory Data ◽

Organ Damage ◽

Cross Sectional Study ◽

Chest Ct ◽

Arterial Oxygen ◽

Emergency Rooms ◽

Cross Sectional ◽

Ct Findings ◽

Patient Prognosis

Abstract Background Laboratory data and computed tomography (CT) have been used during the COVID-19 pandemic, mainly to determine patient prognosis and guide clinical management. The aim of this study was to evaluate the association between CT findings and laboratory data in a cohort of COVID-19 patients. Methods This was an observational cross-sectional study including consecutive patients presenting to the Reggio Emilia (Italy) province emergency rooms for suspected COVID-19 for one month during the outbreak peak, who underwent chest CT scan and laboratory testing at presentation and resulted positive for SARS-CoV-2. Results Included were 866 patients. Total leukocytes, neutrophils, C-reactive protein (CRP), creatinine, AST, ALT and LDH increase with worsening parenchymal involvement; an increase in platelets was appreciable with the highest burden of lung involvement. A decrease in lymphocyte counts paralleled worsening parenchymal extension, along with reduced arterial oxygen partial pressure and saturation. After correcting for parenchymal extension, ground-glass opacities were associated with reduced platelets and increased procalcitonin, consolidation with increased CRP and reduced oxygen saturation. Conclusions Pulmonary lesions induced by SARS-CoV-2 infection were associated with raised inflammatory response, impaired gas exchange and end-organ damage. These data suggest that lung lesions probably exert a central role in COVID-19 pathogenesis and clinical presentation.

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Initial Thin-Section Chest CT Findings in Patients With Inhalation Injury

CHEST Journal ◽

10.1378/chest.1822192 ◽

2014 ◽

Vol 145 (3) ◽

pp. 250A

Author(s):

In-Gyu Hyun ◽

Cheol-Hong Kim

Keyword(s):

Thin Section ◽

Inhalation Injury ◽

Chest Ct ◽

Ct Findings

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CT findings of 795 COVID-19 positive cases: a multicenter study in Egypt

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-020-00351-7 ◽

2020 ◽

Vol 51 (1) ◽

Author(s):

Youssriah Yahia Sabri ◽

Mohamed Mohsen Tolba Fawzi ◽

Eman Zaki Nossair ◽

Safaa Mohamed El-Mandooh ◽

Amira Aly Hegazy ◽

...

Keyword(s):

Virus Disease ◽

Chest Ct ◽

Imaging Features ◽

Rt Pcr ◽

Relevant Research ◽

Non Invasive ◽

Ct Findings ◽

Global Pandemic ◽

Polymerase Chain ◽

Ct Studies

Abstract Background Corona Virus Disease 2019 (COVID-19) outbreak was officially announced as a global pandemic by the WHO on March 11th 2020. Thorough understanding of CT imaging features of COVID-19 is essential for effective patient management; rationalizing the need for relevant research. The aim of this study was to analyze the chest CT findings of patients with real-time polymerase chain reaction (RT-PCR) proved COVID-19 admitted to four Egyptian hospitals. The recently published RSNA expert consensus statement on reporting COVID-19 chest CT findings was taken into consideration. Results Normal CT “negative for COVID-19” was reported in 26.1% of our RT-PCR proved COVID-19 cases. In descending order of prevalence, imaging findings of the positive CT studies (73.9%) included GGO (69%), consolidation (49.7%), crazy paving (15.4%), and peri-lobular fibrosis (40.6%). These showed a dominantly bilateral (68.2%), peripheral (72.4%), and patchy (64.7%) distribution. Remarkably, thymic hyperplasia was identified in 14.3% of studies. According to the RSNA consensus, CT findings were classified as typical in 68.9%, indeterminate in 3.6%, and atypical in 1.4% of the evaluated CT studies. Conclusion Although COVID-19 cannot be entirely excluded by chest CT, it can be distinguished in more than two-thirds of cases; making CT a widely available, non-invasive, and rapid diagnostic tool.

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The role of CT imaging for management of COVID-19 in epidemic area: early experience from a University Hospital

Insights into Imaging ◽

10.1186/s13244-020-00957-5 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Vikram rao Bollineni ◽

Koenraad Hans Nieboer ◽

Seema Döring ◽

Nico Buls ◽

Johan de Mey

Keyword(s):

Ct Scan ◽

Predictive Value ◽

Ct Imaging ◽

Chest Ct ◽

University Hospital ◽

Rt Pcr ◽

Ct Findings ◽

Epidemic Area ◽

Chest Ct Scan ◽

Pcr Test

Abstract Background To evaluate the clinical value of the chest CT scan compared to the reference standard real-time polymerase chain reaction (RT-PCR) in COVID-19 patients. Methods From March 29th to April 15th of 2020, a total of 240 patients with respiratory distress underwent both a low-dose chest CT scan and RT-PCR tests. The performance of chest CT in diagnosing COVID-19 was assessed with reference to the RT-PCR result. Two board-certified radiologists (mean 24 years of experience chest CT), blinded for the RT-PCR result, reviewed all scans and decided positive or negative chest CT findings by consensus. Results Out of 240 patients, 60% (144/240) had positive RT-PCR results and 89% (213/240) had a positive chest CT scans. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of chest CT in suggesting COVID-19 were 100% (95% CI: 97–100%, 144/240), 28% (95% CI: 19–38%, 27/240), 68% (95% CI: 65–70%) and 100%, respectively. The diagnostic accuracy of the chest CT suggesting COVID-19 was 71% (95% CI: 65–77%). Thirty-three patients with positive chest CT scan and negative RT-PCR test at baseline underwent repeat RT-PCR assay. In this subgroup, 21.2% (7/33) cases became RT-PCR positive. Conclusion Chest CT imaging has high sensitivity and high NPV for diagnosing COVID-19 and can be considered as an alternative primary screening tool for COVID-19 in epidemic areas. In addition, a negative RT-PCR test, but positive CT findings can still be suggestive of COVID-19 infection.

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COVID-19 in pregnancy: a systematic review of chest CT findings and associated clinical features in 427 patients

Clinical Imaging ◽

10.1016/j.clinimag.2021.01.004 ◽

2021 ◽

Vol 75 ◽

pp. 75-82

Author(s):

Rachel R. Oshay ◽

Michael Y.C. Chen ◽

Brandon K.K. Fields ◽

Natalie L. Demirjian ◽

Ryan S. Lee ◽

...

Keyword(s):

Systematic Review ◽

Clinical Features ◽

Chest Ct ◽

Ct Findings ◽

In Pregnancy

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The Evolving Landscape of Lung Cancer Surgical Resection: An Update for Radiologists With Focus on Key Chest CT Findings

American Journal of Roentgenology ◽

10.2214/ajr.21.26408 ◽

2021 ◽

Author(s):

Konstantinos Stefanidis ◽

Elissavet Konstantelloy ◽

Gibran Yusuf ◽

Joanna Moser ◽

Carol Tan ◽

...

Keyword(s):

Lung Cancer ◽

Surgical Resection ◽

Chest Ct ◽

Ct Findings

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Study on the Dynamic Changes in Chest CT Findings of COVID-19 Rehabilitated Patients

Journal of Cardiology Research ◽

10.36879/jcr.20.000132 ◽

2020 ◽

pp. 1-7

Keyword(s):

Disease Progression ◽

Onset Time ◽

Ground Glass Opacity ◽

Chest Ct ◽

Ground Glass ◽

Dynamic Changes ◽

Course Of Disease ◽

Pleural Thickening ◽

Ct Findings ◽

Interlobular Septal Thickening

Objective: To study the dynamic changes in CT findings in COVID-19 (coronavirus disease-19, COVID-19) rehabilitated patients. Methods: A total of 148 chest CT images of 37 patients with COVID-19 were collected. In the first 21 days of the course of disease, 7 stages were performed every 3 days, and the eighth stage was performed after 21 days. Results: In the first chest CT examination, 19 cases were ground glass opacity, and 18 cases were high-density shadows with consolidation. The lesion shape was flaky and patchy in 33 cases. The percentage of consolidation, air bronchogram, fiber cord, interlobular septal thickening, subpleural line and pleural thickening were the highest on days 4-6, 7-9, 7-9, 10-12, 19-21 and 19-21, respectively. The highest percentage of disease progression was 80.00% on days 4-6, and then the percentage of disease progression gradually decreased with the extension of the onset time. The percentage of patients with improvement gradually increased from days 4-6, reaching 83.33% on days 16-18 and 100.00% on day 21. The percentage of lesion range enlargement and density increase was the highest on days 4-6, both of which were 60.00%，Then the percentage of both decreased gradually. The percentage of patients with lesion range reduction and density absorption dilution increased gradually with the onset time. There was no obvious regularity in the number of lesions. Conclusion: Patients with COVID-19 have regular changes in their lung conditions.

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