A comparative multi-center study on the clinical and imaging features of confirmed and unconfirmed patients with COVID-19

AbstractBackgroundPrevious studies had described the differences in clinical characteristics between ICU and non-ICU patients. However, seldom study focused on confirmed and unconfirmed groups. Our aim was to compare clinical and imaging characteristics of COVID-19 patients outside Hubei province between confirmed and unconfirmed group.MethodsWe retrospectively enrolled 163 consecutive adult patients with suspected COVID-19 from three tertiary hospitals in two provinces outside Hubei province from January 12, 2020 to February 13, 2020 and the differences in epidemiological, clinical, laboratory and imaging characteristics between the two groups were compared.ResultsThis study enrolled 163 patients with 62 confirmed cases and 101 unconfirmed cases. Most confirmed patients were clustered (31, 50.0%) and with definite epidemiological exposure. Symptoms of COVID-19 were nonspecific, largely fever and dry cough. Laboratory findings in confirmed group were characterized by normal or reduced white blood cell count, reduced the absolute value of lymphocytes, and elevated levels of C-reactive protein (CRP) and accelerated Erythrocyte sedimentation rate (ESR). The typical chest CT imaging features of patients with confirmed COVID-19 were peripherally distributed multifocal GGO with predominance in the lower lung lobe. Compared with unconfirmed patients, confirmed patients had significantly higher proportion of dry cough, leucopenia, lymphopenia and accelerated ESR (P<0.05); but not with alanine aminotransferase, aspartate aminotransferase, D-dimer, lactic dehydrogenase, and myoglobin (P>0.05). Proportion of peripheral, bilateral or lower lung distribution and multi-lobe involvement, GGO, crazy-paving pattern, air bronchogram and pleural thickening in the confirmed group were also higher (P<0.05).ConclusionsSymptoms of COVID-19 were nonspecific. Leukopenia, lymphopenia and ESR, as well as chest CT could be used as a clue for clinical diagnosis of COVID-19.

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Chest CT imaging characteristics of COVID-19 pneumonia in preschool children: a retrospective study

10.21203/rs.3.rs-21851/v1 ◽

2020 ◽

Author(s):

Yang Li ◽

Jianghui Cao ◽

Xiaolong Zhang ◽

Guangzhi Liu ◽

Xiaxia Wu ◽

...

Keyword(s):

Preschool Children ◽

Clinical Laboratory ◽

Ct Imaging ◽

Chest Ct ◽

World Health ◽

Imaging Data ◽

Pleural Thickening ◽

Ct Findings ◽

Imaging Characteristics ◽

The Right

Abstract Background : Recently, the World Health Organization (WHO) has declared the coronavirus disease 2019 (COVID-19) outbreak a public health emergency of international concern. So far, however, limited data are available for children. Therefore, we aimed to investigate the clinical and chest CT imaging characteristics of COVID-19 in preschool children. Methods: From January 26, 2020 to February 20, 2020, the clinical and initial chest CT imaging data of eight preschool children with laboratory-confirmed COVID-19 from two hospitals were retrospectively collected. The chest CT imaging characteristics, including the distribution, shape, and density of lesions, and the pleural effusion, pleural changes, and enlarged lymph nodes were evaluated. Results: Two cases (25%) were classified as mild type, and they showed no obvious abnormal CT findings or minimal pleural thickening on the right side. Five cases (62.5%) were classified as moderate type. Among these patients, one case showed consolidation located in the subpleural region of the right upper lobe, with thickening in the adjacent pleura; one case showed multiple consolidation and ground-glass opacities (GGO) with blurry margins; one case displayed bronchial pneumonia-like changes in the left upper lobe; and two cases displayed asthmatic bronchitis-like changes. One case (12.5%) was classified as critical type and showed bronchial pneumonia-like changes in the bilateral lungs, presenting blurred and messy bilateral lung markings and multiple patchy shadows scattered along the lung markings with blurry margins. Conclusions: The chest CT findings of COVID-19 in preschool children are atypical and various. Accurate diagnosis requires a comprehensive evaluation of epidemiological, clinical, laboratory and CT imaging data.

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Chest CT imaging characteristics of COVID-19 pneumonia in preschool children: a retrospective study

10.21203/rs.3.rs-21851/v2 ◽

2020 ◽

Author(s):

Yang Li ◽

Jianghui Cao ◽

Xiaolong Zhang ◽

Guangzhi Liu ◽

Xiaxia Wu ◽

...

Keyword(s):

Preschool Children ◽

Clinical Laboratory ◽

Ct Imaging ◽

Chest Ct ◽

World Health ◽

Imaging Data ◽

Pleural Thickening ◽

Ct Findings ◽

Imaging Characteristics ◽

The Right

Abstract Background: Recently, the World Health Organization has declared the coronavirus disease 2019 (COVID-19) outbreak a public health emergency of international concern. So far, however, limited data are available for children. Therefore, we aimed to investigate the clinical and chest CT imaging characteristics of COVID-19 in preschool children.Methods: From January 26, 2020 to February 20, 2020, the clinical and initial chest CT imaging data of eight preschool children with laboratory-confirmed COVID-19 from two hospitals were retrospectively collected. The chest CT imaging characteristics, including the distribution, shape, and density of lesions, and the pleural effusion, pleural changes, and enlarged lymph nodes were evaluated. Results: Two cases (25%) were classified as mild type, and they showed no obvious abnormal CT findings or minimal pleural thickening on the right side. Five cases (62.5%) were classified as moderate type. Among these patients, one case showed consolidation located in the subpleural region of the right upper lobe, with thickening in the adjacent pleura; one case showed multiple consolidation and ground-glass opacities with blurry margins; one case displayed bronchial pneumonia-like changes in the left upper lobe; and two cases displayed asthmatic bronchitis-like changes. One case (12.5%) was classified as critical type and showed bronchial pneumonia-like changes in the bilateral lungs, presenting blurred and messy bilateral lung markings and multiple patchy shadows scattered along the lung markings with blurry margins.Conclusions: The chest CT findings of COVID-19 in preschool children are atypical and various. Accurate diagnosis requires a comprehensive evaluation of epidemiological, clinical, laboratory and CT imaging data.

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Clinical and Imaging Features of Patients With Encephalitic Symptoms and Myelin Oligodendrocyte Glycoprotein Antibodies

Frontiers in Immunology ◽

10.3389/fimmu.2021.722404 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jingsi Wang ◽

Zhandong Qiu ◽

Dawei Li ◽

Xixi Yang ◽

Yan Ding ◽

...

Keyword(s):

Clinical Laboratory ◽

Brain Mri ◽

Age At Onset ◽

Myelin Oligodendrocyte Glycoprotein ◽

Outcome Data ◽

Periventricular White Matter ◽

Imaging Features ◽

Progressive Dementia ◽

Imaging Characteristics ◽

Progressive Course

BackgroundMyelin oligodendrocyte glycoprotein-antibody (MOG-ab)-associated disease (MOGAD) has highly heterogenous clinical and imaging presentations, in which encephalitis is an important phenotype. In recent years, some atypical presentations in MOG-ab-associated encephalitis (MOG-E) have been increasingly reported but have not yet been described well. The aim of the study was to describe the clinical and imaging features of patients with MOG-E in our center. Atypical phenotypes would be reported, which is expected to expand the spectrum of MOGAD.MethodsWe reviewed medical records of 59 patients with MOGAD diagnosed in our center and identified cases who had ever experienced encephalitic symptoms. Three hundred ten patients with autoimmune encephalitis (AE) were also reviewed, and cases with positive MOG-ab were identified. Besides, patients with chronically progressive encephalitis were identified from 13 MOG-E and 310 AE patients. We collected demographic, clinical, laboratory, radiological, and outcome data to explore clinical and imaging characteristics in MOG-E, especially in the atypical phenotype of chronically progressive encephalitis.ResultsWe identified 13 patients (7 males, 6 females) with MOG-E. The median age at onset was 33 years (range 13~62 years). Most (9/13, 69.2%) of patients showed acute or subacute onset of encephalitic symptoms. Brain MRI abnormalities were observed in all patients. The most common lesion locations on MRI were cortical/subcortical (11/13, 84.6%), deep/periventricular white matter (10/13, 76.9%) and corpus callosum (4/13, 30.8%). Brain MRI patterns were categorized into four phenotypes. The most common pattern was cortical encephalitis with leptomeningeal enhancement/brain atrophy (10/13, 76.9%). Eight (8/13, 61.5%) patients had a good response to immunotherapy. Four (4/13, 30.8%) patients with chronically progressive course were identified from MOG-E cohort. They showed leukodystrophy-like pattern, multifocal hazy lesions, or cortical encephalitis on MRI. With immunotherapy, they only showed mild or no improvement. We also identified four (4/310, 1.3%) patients with chronically progressive course from AE cohort. They had better outcomes than counterparts in MOG-E.ConclusionsThis study demonstrates that encephalitic presentations in MOGAD had complex clinical patterns. Chronically progressive encephalitis may be a new phenotype of MOGAD. We recommend to test MOG-ab in subacute and chronic progressive dementia with leukodystrophy-like MRI lesions.

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The Novel Coronavirus Disease (COVID-19): A PRISMA Systematic Review and Meta-Analysis of Clinical and Paraclinical Characteristics

BioMed Research International ◽

10.1155/2020/3149020 ◽

2020 ◽

Vol 2020 ◽

pp. 1-16 ◽

Cited By ~ 3

Author(s):

Hamidreza Hasani ◽

Shayan Mardi ◽

Sareh Shakerian ◽

Nooshin Taherzadeh-Ghahfarokhi ◽

Parham Mardi

Keyword(s):

Systematic Review ◽

Observational Studies ◽

Clinical Laboratory ◽

Meta Analysis ◽

Ct Scanning ◽

Imaging Features ◽

The Novel ◽

Laboratory Findings ◽

Global Concern ◽

Novel Coronavirus

An outbreak of pneumonia, caused by a novel coronavirus (SARS-CoV-2), was identified in China in December 2019. This virus expanded worldwide, causing global concern. Although clinical, laboratory, and imaging features of COVID-19 are characterized in some observational studies, we undertook a systematic review and meta-analysis to assess the frequency of these features. We did a systematic review and meta-analysis using three databases to identify clinical, laboratory, and computerized tomography (CT) scanning features of rRT-PCR confirmed cases of COVID-19. Data for 3420 patients from 30 observational studies were included. Overall, the results showed that fever (84.2%, 95% CI 82.6-85.7), cough (62%, 95% CI 60-64), and fatigue (39.4%, 95% CI 37.2-41.6%) are the most prevalent symptoms in COVID-19 patients. Increased CRP level, decreased lymphocyte count, and increased D-dimer level were the most common laboratory findings. Among COVID-19 patients, 92% had a positive CT finding, most prevalently ground-glass opacification (GGO) (60%, 95% CI 58-62) and peripheral distribution opacification (64%, 95% CI 60-69). These results demonstrate the clinical, paraclinical, and imaging features of COVID-19.

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

10.1101/2020.09.02.20187187 ◽

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.

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The multicenter study of Chest HRCT imaging characteristics of 2019 Novel Coronavirus (COVID-19) Pneumonia

10.21203/rs.3.rs-20837/v1 ◽

2020 ◽

Author(s):

Zhehao Lyu ◽

Meiji Ren ◽

Lian-Ming Wu ◽

Yuxin Yang ◽

Yi-Bo Lu ◽

...

Keyword(s):

Computed Tomography ◽

Acute Respiratory Distress Syndrome ◽

Distress Syndrome ◽

Chest Ct ◽

Imaging Features ◽

Wholesale Market ◽

High Resolution Computed Tomography ◽

Imaging Characteristics ◽

History Of ◽

Novel Coronavirus

Abstract Background: In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A novel coronavirus was detected, capable of infecting humans, on 6 January 2020 and termed COVID-19. By 16 February 2020, there were 51857 confirmed cases with 2019-nCoV (COVID-19) pneumonia in 25 countries. COVID-19 can also lead to acute respiratory distress syndrome (ARDS).Methods: 149 patients with 2019 Novel Coronavirus (COVID-19)pneumonia(68 males, 81 females, ages 1-89)from 6 research centers in China were diagnosed with positive 2019 Novel Coronavirus(COVID-19)nucleic acids antibodies. And their high-resolution computed tomography(HRCT) imaging datas were evaluated.Results: 136/149(91.3%)patients had a clear history of exposure to Wuhan. Fever (122/149, 81.9%)and cough(83/149, 55.7%)were the most common symptoms. The main imaging characteristics within 4 days of onset included 30(20.13%) cases of pure ground glass opacities (P<0.05), 38(25.50%) cases of GGO with reticulation(P<0.01), 12(8.05%) cases of consolidation(P<0.01). In the 5-8 days group, the main imaging features included 71(47.65%) cases of pGGO(P<0.05), 69(46.31%) cases of GGO with reticulation(P<0.01). In the 9-12 days group, the main feature was 85(57.04%) cases with GGO with reticulation(P<0.01). In the group of 13-16 days group, the main imaging characteristics included 48(32.21%) cases of GGO with reticulation(P < 0.01), 34(22.82%) cases of consolidation(P<0.01).Conclusion: Patients infected with COVID-19 pneumonia show more chest CT characteristics within 5-8 days after the onset of disease. The main manifestations included pGGO, GGO with reticulation, consolidation and GGO with consolidation.

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Chest Computed Tomography Findings in COVID-19 and Influenza: A Narrative Review

BioMed Research International ◽

10.1155/2020/6928368 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8 ◽

Cited By ~ 4

Author(s):

Stephen O. Onigbinde ◽

Ademola S. Ojo ◽

Linwald Fleary ◽

Robert Hage

Keyword(s):

Influenza A ◽

Random Distribution ◽

Chest Ct ◽

Influenza Epidemic ◽

Laboratory Findings ◽

Pleural Thickening ◽

Ct Findings ◽

Full Text Review ◽

Chest Ct Scan ◽

Ct Features

Objective. The COVID-19 pandemic and annual influenza epidemic are responsible for thousands of deaths globally. With a similarity in clinical as well as laboratory findings, there is a need to differentiate these two conditions on chest CT scan. This paper attempts to use existing literature to draw out differences in chest CT findings in COVID-19 and influenza. Methods. A search was conducted using PubMed. 17 original studies on chest CT findings in COVID-19 and influenza were identified for full-text review and data analysis. Findings. COVID-19 and influenza share similar chest CT findings. The differences found show that COVID-19 ground-glass opacities are usually peripherally located with the lower lobes being commonly involved, while influenza has a central, peripheral, or random distribution usually affecting the five lobes. Vascular engorgement, pleural thickening, and subpleural lines were reported in COVID-19 patients. In contrast, pneumomediastinum and pneumothorax were reported only in studies on influenza. Conclusion and Relevance. COVID-19 and influenza have overlapping chest CT features with few differences which can assist in telling apart the two pathologies. Additional studies are needed to further define the differences and degree between COVID-19 and influenza.

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Clinical presentation and CT features in pediatric patients with COVID‐19 infection

10.21203/rs.3.rs-595070/v1 ◽

2021 ◽

Author(s):

Huseyin Avni Solgun ◽

Isıl Yurdaısık

Keyword(s):

Pediatric Patients ◽

Clinical Laboratory ◽

Close Contact ◽

Laboratory Data ◽

Chest Ct ◽

Pharyngeal Swab ◽

Laboratory Findings ◽

Pulmonary Lesions ◽

Novel Coronavirus ◽

Ct Features

Abstract Background The aim of this study includes to discuss the clinical, laboratory, and chest computed tomography (CT) in pediatric patients with 2019 novel coronavirus (COVID-19) infection. Material and Methods The clinical, laboratory, and chest CT features of 17 pediatric inpatients with COVID-19 infection confirmed by pharyngeal swab COVID‐19 polymerase chain reaction(PCR). All clinical and laboratory data have been recorded and analyzed during march-february 2021. Chest CT have been performed to all Covid 19 PCR confirmed patients and radiologicall view have been noted. Results Seventeen pediatric patients with a history of close contact with COVID-19 diagnosed family members included to the study. Fever (10/17, 58%) and cough (13/17, 76%) were the most common symptoms. For laboratory findings, c reactive protein elevation (15/17, 88%) seem to be the most finding. A total of 4 patients presented with unilateral pulmonary lesions (4/17, 23%), 9 with bilateral pulmonary lesions (9/17, 52%) and 13 cases showed bilateral diffuse covid pattern on chest CT (13/17, 76%). Non-spesific consolidation with was observed in 8 patients (8/17, 47%), ground‐glass opacities were observed in 11 patients (11/17, 64%), nodules were observed in 7 patients (7/17, 41%), and tiny nodules were observed in 2 patients (2/17, 11%). Conclusion In pediatric patients with positive COVID-19 nucleic acid test from pharyngeal swab samples; the early detection of lesions by CT can be efficient; in management and early treatment for pediatric patients. However; early chest CT screening and COVİD-19 PCR testing together can be more efficent in diagnose.

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Association between clinical, laboratory findings and chest CT in COVID-19 in a secondary hospital in Jakarta, Indonesia

GERMS ◽

10.18683/germs.2021.1238 ◽

2021 ◽

Vol 11 (1) ◽

pp. 32-38

Author(s):

Muhammad Hafiz ◽

Aziza Ghanie Icksan ◽

Annisa Dian Harlivasari ◽

Sita Andarini ◽

Febrina Susanti ◽

...

Keyword(s):

Clinical Laboratory ◽

Chest Ct ◽

Laboratory Findings ◽

Secondary Hospital

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Clinical and Imaging features in COVID-19 Patients: Analysis of Data from Patients in Non-pandemic areas

10.21203/rs.3.rs-21373/v1 ◽

2020 ◽

Author(s):

Shengkun Peng ◽

Lingai Pan ◽

Shaojin Zhang ◽

Yalong Liu ◽

Hua Zhang ◽

...

Keyword(s):

Peripheral Zone ◽

Chest Ct ◽

Ct Scans ◽

Severe Illness ◽

Imaging Features ◽

Imaging Characteristics ◽

Number Of Patients ◽

Patient Will ◽

Acid Test

Abstract Purpose To describe the imaging characteristics in COVID-19 Patients from non-pandemic regions to improve understanding of the disease. Methods We reviewed chest CT scans of 30 COVID-19 patients from three hospitals in Sichuan province, China. Results Typical CT manifestations include the involvement of multiple lobes, mostly in the peripheral zone of the lungs, and subpleural distribution. GGO, crazy paving or mixed GGO and consolidation is the most common signs. Few patients can present small amount of pleural effusion. It is worth noting that none of the lung cavities, tree buds, and lymphadenopathy appeared. The follow-up imaging findings of some patients showed progress when the initial CT score reached 7. Conclusion The CT scan still play an important role in screening the COVID-19, most of the images present positive signs, mainly subpleural, multiple GGO. CT might can predict the severity or whether the patient will progress to severe illness. A small number of patients may be missed if they are based on CT findings alone, which should be closely combined with the patient's epidemiological history and nucleic acid test.

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