A spectrum of HRCT chest findings in RT-PCR positive asymptomatic COVID-19 patients at a COVID designated hospital in Nepal

Introduction: COVID-19 pandemic is grappling the world with the surge of infection time and again. Clinicians are trying to justify the ethics of public health care. Asymptomatic COVID-19 cases are going undocumented and most of them practice self-isolation. Studies have revealed significant radiological changes among RT-PCR positive asymptomatic COVID-19 cases. Objective: The aim of this cross-sectional study is to characterized chest CT findings of asymptomatic RT-PCR-positive patients in one of the COVID designated hospitals in Nepal. Results: Out of 43, 26 (60.5%) participants had positive Chest CT scan findings consistent with COVID pneumonia. 65% had bilateral and 77% had multifocal lesions. The ground-glass opacities (92%), mixed (ground-glass opacities and consolidation) pattern (30.7%), and consolidation only (34.6%) were common chest CT findings. The median CT score was 3.5 (Interquartile range; 2-6). Conclusion: The majority of the RT-PCR positive asymptomatic patient present with CT scan changes of lungs which are important to determine clinical status, prognosis, and long-term sequel in those cohorts.

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Spectrum of Ground Glass Opacities in Chest CT of COVID-19 Patients in Karbala, Iraq

Journal of Contemporary Medical Sciences ◽

10.22317/jcms.v6i3.769 ◽

2020 ◽

Vol 6 (3) ◽

Author(s):

Dhia Mahdey Alghazali ◽

Maytham A Maamera ◽

Haider Fadel Alkazraji ◽

Ali A Abutiheen

Keyword(s):

Ct Scan ◽

Cross Sectional Study ◽

Chest Ct ◽

Ground Glass ◽

P Value ◽

Late Time ◽

Chi Square ◽

Cross Sectional ◽

Male Predominance ◽

Chest Ct Scan

Objective: To describe the ground-glass opacities (GGO) seen in chest CT scans of COVID-19 patients and to estimate the association between these opacities and the time of clinical presentation. Patients and methods: A cross-sectional study involving 81 COVID-19 confirmed patients in Imam Al-Hussein Medical city in Karbala-Iraq during the period from March 1st to April 20, 2020. Chest CT scan findings were evaluated by 2 radiologists and categorized accordingly. Chi-square test was used for statistical analysis and a P value of less than 0.05 was considered statistically significant. Results: The mean age ± standard deviation of patients was 53.5 ± 17.1 years, with male predominance as 63 (77.8%) of cases were males. Nearly half of the patients were presented within the second week of starting the sign and symptoms. GGO was present in 79 scans (97.5%), followed by consolidation opacity in 29 patients (35.8%). Four types of GGO were described. Bilateral multiple subpleural GGO was the most prevalent type. There was a significant association between late time of patient presentation and more extensive GGO type. Conclusion: Chest CT scan is valuable in the diagnosis and management of COVID-19 cases. The presence of GGO in CT scan of a patient that previously had no chest illness is highly suggestive of COVID-19 disease, different types of GGO were seen. Bilateral confluent type of GGO is associated with more serious and delayed status and warns the need for intensive care unit admission.

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Descriptive Analysis of Chest Computed Tomography Scan in Coronavirus Disease 2019 Pneumonia: Correlation with Reverse Transcription-polymerase Chain Reaction and Clinical Features

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.6224 ◽

2021 ◽

Vol 9 (B) ◽

pp. 865-871

Author(s):

Rusli Muljadi ◽

Mira Yuniarti ◽

Ricardo Tan ◽

Teodorus Alfons Pratama ◽

Ignatius Bima Prasetya ◽

...

Keyword(s):

Social Sciences ◽

Ct Scan ◽

Cross Sectional Study ◽

Chest Ct ◽

Rt Pcr ◽

Chain Reaction ◽

Cross Sectional ◽

The Social ◽

Polymerase Chain ◽

Chest Ct Scan

BACKGROUND: Reverse transcriptase-polymerase chain reaction (RT-PCR) is the primary diagnostic tool to confirm coronavirus disease 2019 (COVID-2019) due to its high specificity. However, it has relatively low sensitivity and time consuming. In contrast, chest computed tomography (CT) has high sensitivity and achieves quick results. It may, therefore, play a critical role in screening and diagnosing COVID-19. A cross-sectional study was done in 212 patients with confirmed cases and patients under surveillance for COVID-19 tested for RT-PCR and chest CT scan. Statistical analysis was performed using SPSS Version 23 (Statistical Package for the Social Sciences, IBM Corp., Armonk, NY, USA). AIM: We aim to investigate the diagnostic value of chest CT in correlation to RT-PCR in Indonesia. METHODS: A cross-sectional study was done in 212 patients with confirmed cases and patients under surveillance for COVID-19 tested for RT-PCR and chest CT scan. Statistical analysis was performed using SPSS Version 23 (Statistical Package for the Social Sciences, IBM Corp., Armonk, NY, USA). RESULTS: From a total of 212 patients, 92% of them were diagnosed as confirmed cases of COVID-19. It was found that the sensitivity of CT scan for COVID-19 patients was 72.3% (65.5% and 78.5%) with positive predictive value (PPV) of 93.9% (90.9% and 96.0%) and the sensitivity and PPV improve in symptomatic patients. Typical chest CT scan lesions were 8.0 times which were more likely (3.9–16.4; p <0.001) to be detected in symptomatic patients while patients with severe CT scan findings were 4.4 times more likely (3.0–6.5; p <0.001) to be admitted to the intensive care unit. CONCLUSION: A high PPV suggests that a chest CT scan can detect COVID-19 lesions, but the absence of the lesions would not exclude the disease’s presence.

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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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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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Evaluation of chest computed tomography features in COVID-19: a single-center retrospective study

Journal of Ideas in Health ◽

10.47108/jidhealth.vol4.iss4.172 ◽

2021 ◽

Vol 4 (4) ◽

pp. 588-594

Author(s):

Akshat Sanjay Shukla ◽

Sanjay Rajendraprasad Shukla ◽

Feral Ravi Daruwala

Keyword(s):

Computed Tomography ◽

Ct Scan ◽

False Negative ◽

Chest Ct ◽

Single Center ◽

Rt Pcr ◽

Pulmonary Vessel ◽

Ct Findings ◽

Diagnostic Center ◽

Second Wave

Background: Even though Real-Time Polymerase Chain Reaction (RT-PCR) is a gold standard for confirming COVID-19, it continues to be plagued by a lack of RT-PCR kits and the potential of false-negative results. Hence, during the second wave of COVID-19 in India, Computed Tomography (CT) scan is an emerging diagnostic tool in evaluating the severity of illness in COVID-19 pneumonia. The present study endeavored to assess chest CT features of COVID-19 pneumonia in Indian population. Methods: This was a single-center, retrospective, observational study conducted in 300 consecutive adults RT-PCR confirmed COVID-19 patients from 1, Jan 2021 to 31, March 2021 at a private radio diagnostic center. Data regarding baseline demographics, clinical and laboratory characteristics, extent, pattern, and type of abnormal CT findings were noted. Results: The study population (204 males and 108 females) had mean age of 43.18 ± 8.27 years. Our study's most common clinical presentation was cough (48.1%) and fever (47.1%), respectively. Lung parenchymal abnormalities were found in 294 (94.2%) patients. Abnormal CT findings revealed the involvement of bilateral (45.6%) and multilobar (42.9%) with a predominant peripheral (92.3%) and posterior (80.8%) distribution. According to the type of opacity, Ground Glass Opacity (GGO) was the dominant abnormality found in 270 (91.8%) patients, in which pure GGO (36.7%), GGO with crazy paving pattern (39.8%), and GGO mixed with consolidation (52.0 %) were noted. Peri-lesional or intralesional segmental or subsegmental pulmonary vessel enlargement was found in 192 (65.3 %) patients. Conclusion: During the second wave of COVID-19, a chest CT scan is a modality of choice in diagnosing COVID-19 pneumonia and related lung parenchymal changes.

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Association of Lung CT Findings in Coronavirus Disease 2019 (COVID-19) With Patients' Age, Body Weight, Vital Sings and Medical Regimen

10.21203/rs.3.rs-233329/v1 ◽

2021 ◽

Author(s):

Abdel-Ellah Al-Shudifat ◽

Ali Al-Radaideh ◽

Shatha Hammad ◽

Nawal Hijjawi ◽

Shaden Abu- Baker ◽

...

Keyword(s):

Body Weight ◽

Ct Scan ◽

Demographic Data ◽

Cross Sectional Study ◽

Cross Sectional ◽

Medical Regimen ◽

Ct Findings ◽

Present Cross Sectional Study ◽

Lung Ct ◽

Lung Ct Scan

Abstract COVID-19 spread quickly in Jordan in the past few months. Many changes have been observed in lungs of COVID-19 patients which required their hospitalization. So far, many studies have been conducted on the epidemiological features of COVID-19 illness; however, the evidence regarding the pathological influence on lungs is still lacking. Therefore, the main aim of the present study was to detect the possible association between lung computed tomography (CT) findings in COVID-19 and patients' age, body weight, vital sings, and medical regimen. The present cross-sectional study enrolled 230 COVID-19 patients in Prince Hamza Hospital in Jordan. Demographic data as well as major lung CT scan changes were obtained from the hospital records of the COVID-19 patients. The main observed major lung changes among the enrolled COVID-19 patients included ground glass opacification in 47(15.2%) patients and consolidation in 22(7.1%) patients. The higher percentage of patients with major lung changes (24%) was observed among patients above 60 years old, while (50%) of patients with no changes in their lung’s findings in the age group of 18-29 years old. Results obtained from the present study showed that only patients with major CT lung changes (9.7%) were prescribed more than three antibiotics. Additionally, 41.6 % patients with major lung CT scan changes had either dry (31.0%) or productive (10.6%) cough at the admission. Several predictors of lung CT scan changes have been detected in this study including age, BMI, medications, severity of symptoms, and cough at admission.

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Cross-sectional study of chest CT-scan findings in patients affected by SARS-CoV-2 in a tertiary care health centre in Guntur Andhra Pradesh

IP Indian Journal of Immunology and Respiratory Medicine ◽

10.18231/j.ijirm.2021.012 ◽

2021 ◽

Vol 6 (1) ◽

pp. 54-57

Author(s):

P V Kalyan Kumar ◽

Y Vivekanand

Keyword(s):

Ct Scan ◽

Andhra Pradesh ◽

Health Centre ◽

Tertiary Care ◽

Cross Sectional Study ◽

Chest Ct ◽

Sectional Study ◽

Cross Sectional ◽

Care Health ◽

Chest Ct Scan

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Comparison between CT and RT-PCR in a cohort of symptomatic patients with suspected COVID-19 pneumonia during the outbreak peak in Italy

10.21203/rs.3.rs-26275/v1 ◽

2020 ◽

Author(s):

Giulia Besutti ◽

Paolo Giorgi Rossi ◽

Valentina Iotti ◽

Lucia Spaggiari ◽

Riccardo Bonacini ◽

...

Keyword(s):

Cross Sectional Study ◽

Ground Glass ◽

Reference Standard ◽

Sectional Study ◽

Rt Pcr ◽

Cross Sectional ◽

Oxygen Saturation Level ◽

Blood Tests ◽

Cell Counts ◽

Italian Cohort

Abstract Objective: To assess sensitivity and specificity of CT vs RT-PCR for the diagnosis of COVID-19 pneumonia in a prospective Italian cohort of symptomatic patients during the outbreak peak.Methods: In this cross-sectional study we included all consecutive patients who presented to the ER between March 13th and 23rd for suspected COVID-19 and underwent both CT and RT-PCR within 3 days. Using a structured report, radiologists prospectively classified CTs in highly suggestive, suggestive, and non-suggestive of COVID-19 pneumonia. Ground-glass, consolidation, and visual extension of parenchymal changes were collected. Three different RT-PCR-based reference standard definitions were used. Oxygen saturation level, CRP, LDH, and blood cell counts were collected and compared between CT/RT-PCR classes.Results: The study included 696 patients (41.4% women; age 59±15.8 years): 423/454 (93%) patients with highly suggestive CT, 97/127 (76%) with suggestive CT, and 31/115 (27%) with non-suggestive CT had positive RT-PCR. CT sensitivity ranged from 73% to 77% and from 90% to 94% for high and low positivity threshold, respectively. Specificity ranged from 79% to 84% for high positivity threshold and was about 58% for low positivity threshold. PPV remained ≥90% in all cases. Ground-glass was more frequent in patients with positive RT-PCR in all CT classes. Blood tests were significantly associated with RT-PCR and CT classes. Leukocytes, lymphocytes, neutrophils, and platelets decreased, CRP and LDH increased from non-suggestive to suggestive CT classes.Conclusions: During the outbreak peak, CT presented high PPV and may be considered a good reference to recognize COVID-19 patients while waiting for RT-PCR confirmation.

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Evaluation of Chest CT Scan as a Screening and Diagnostic Tool in Trauma Patients with Coronavirus Disease 2019 (COVID-19): A Cross-Sectional Study

Emergency Medicine International ◽

10.1155/2021/4188178 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Hossein Abdolrahimzadeh Fard ◽

Salahaddin Mahmudi-Azer ◽

Sepideh Sefidbakht ◽

Pooya Iranpour ◽

Shahram Bolandparvaz ◽

...

Keyword(s):

Ct Scan ◽

Negative Predictive Value ◽

Predictive Value ◽

Cross Sectional Study ◽

Chest Ct ◽

Trauma Patients ◽

Ct Scanner ◽

Sectional Study ◽

Cross Sectional ◽

Chest Ct Scan

Background. The lack of enough medical evidence about COVID-19 regarding optimal prevention, diagnosis, and treatment contributes negatively to the rapid increase in the number of cases globally. A chest computerized tomography (CT) scan has been introduced as the most sensitive diagnostic method. Therefore, this research aimed to examine and evaluate the chest CT scan as a screening measure of COVID-19 in trauma patients. Methods. This cross-sectional study was conducted in Rajaee Hospital in Shiraz from February to May 2020. All patients underwent unenhanced CT with a 16-slice CT scanner. The CT scans were evaluated in a blinded manner, and the main CT scan features were described and classified into four groups according to RSNA recommendation. Subsequently, the first two Radiological Society of North America (RSNA) categories with the highest probability of COVID-19 pneumonia (i.e., typical and indeterminate) were merged into the “positive CT scan group” and those with radiologic features with the least probability of COVID-19 pneumonia into “negative CT scan group.” Results. Chest CT scan had a sensitivity of 68%, specificity of 56%, positive predictive value of 34.8%, negative predictive value of 83.7%, and accuracy of 59.3% in detecting COVID-19 among trauma patients. Moreover, for the diagnosis of COVID-19 by CT scan in asymptomatic individuals, a sensitivity of 100%, specificity of 66.7%, and negative predictive value of 100% were obtained ( p value: 0.05). Conclusion. Findings of the study indicated that the CT scan’s sensitivity and specificity is less effective in diagnosing trauma patients with COVID-19 compared with nontraumatic people.

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