scholarly journals The mean severity score and its correlation with common computed tomography chest manifestations in Egyptian patients with COVID-2019 pneumonia

Author(s):  
Mona A. F. Hafez

Abstract Background Computed tomography (CT) is one of the main diagnostic tools for early detection and management of coronavirus disease 2019 (COVID-19) pneumonia. This study aims to highlight the commonly encountered CT findings in patients with COVID-19 pneumonia in Egypt and the mean severity score and its correlation with the imaging findings. This study involved 200 patients with pathologically confirmed COVID-19 infection; non-contrast CT chest was performed for all cases; in addition, CT findings and severity score (CT-SS) were then assessed using descriptive analysis, and the correlation between the CT findings and disease severity was assessed. Results The ground-glass densities and peripheral adhesions were the most typical CT findings. Prominent interlobular septations; bronchial thickening/dilatation; CT signs of crazy-paving, halo, and reversed halo; and reactive mediastinal lymphadenopathy were significantly correlated with disease severity. The mean CT-SS of Egyptian patients with COVID-19 pneumonia was 11.2 (mild to moderate severity). Conclusion Multislice CT played a vital role in the early identification of Egyptian patients with COVID-19 pneumonia. The assessment of the CT severity score of COVID-19 is essential for the extent of pneumonia involvement to help clinicians achieve the purpose of early diagnosis and accurate treatment.

2021 ◽  
pp. 028418512110063
Author(s):  
Okan Dilek ◽  
Emin Demirel ◽  
Hüseyin Akkaya ◽  
Mehmet Cenk Belibagli ◽  
Gokhan Soker ◽  
...  

Background Computed tomography (CT) gives an idea about the prognosis in patients with COVID-19 lung infiltration. Purpose To evaluate the success rates of various scoring methods utilized in order to predict survival periods, on the basis of the imaging findings of COVID-19. Another purpose, on the other hand, was to evaluate the agreements among the evaluating radiologists. Material and Methods A total of 100 cases of known COVID-19 pneumonia, of which 50 were deceased and 50 were living, were included in the study. Pre-existing scoring systems, which were the Total Severity Score (TSS), Chest Computed Tomography Severity Score (CT-SS), and Total CT Score, were utilized, together with the Early Decision Severity Score (ED-SS), which was developed by our team, to evaluate the initial lung CT scans of the patients obtained at their initial admission to the hospital. The scans were evaluated retrospectively by two radiologists. Area under the curve (AUC) values were acquired for each scoring system, according to their performances in predicting survival times. Results The mean age of the patients was 61 ± 14.85 years (age range = 18–87 years). There was no difference in co-morbidities between the living and deceased patients. The survival predicted AUC values of ED-SS, CT-SS, TSS, and Total CT Score systems were 0.876, 0.823, 0.753, and 0.744, respectively. Conclusion Algorithms based on lung infiltration patterns of COVID-19 may be utilized for both survival prediction and therapy planning.


2020 ◽  
Vol 14 (12) ◽  
pp. 1085-1090
Author(s):  
George A Alexiou ◽  
Georgios D Lianos ◽  
Aggeliki Tzima ◽  
Athanasios Sotiropoulos ◽  
Anastasios Nasios ◽  
...  

Aim: Traumatic brain injury (TBI) is a serious health concern. We set out to investigate the role of neutrophil-to-lymphocytes ratio (NLR) at admission for predicting the need for computed tomography (CT) in mild-TBI. Materials & methods: A retrospective study of adult patients who presented with mild-TBI Results: One hundred and thirty patients met the inclusion criteria. Seventy-four patients had positive CT-findings. The mean NLR-levels at presentations were 5.6 ± 4.8. Patients with positive CT-findings had significant higher NLR-levels. Receiver operating characteristic curve analysis was conducted and the threshold of NLR-levels for detecting the cases with positive CT-findings was 2.5, with 78.1% sensitivity and 63% specificity Conclusion: To the best of our knowledge no previous study has assessed the value of NLR-levels for predicting the need for CT in mild-TBI.


2011 ◽  
Vol 1 (1) ◽  
pp. 6
Author(s):  
Junichi Ochi ◽  
Minoru Ohkouchi ◽  
Yoshikazu Tsukada ◽  
Shinichiro Tominaga ◽  
Satoshi Takayama ◽  
...  

Amiodarone-induced pulmonary toxicity is a critical and potentially fatal side effect of amiodarone. Our study was designed to reveal its clinical features, including KL-6, as an interstitial marker. The medical records of eight patients (five men and three women) with amiodarone-induced pulmonary toxicity, who had been referred to our hospital, were examined. The mean age at the initiation of amiodarone was 48 years (range, 54-87 years) and mean duration of medication prior to the development of pulmonary toxicity was 18 months (range, 7-33 months). Serum KL-6 was elevated in six of the eight patients with a range of 525-2915 U/mL. Chest computed tomography (CT) findings showed non-segmental consolidation and/or ground glass opacity. Foamy macrophages were found in bronchoalveolar lavage (BAL) fluids of all examined patients and in transbronchial lung biopsy (TBLB) specimens in half of the examined patients. We concluded that serum KL-6, chest CT findings, and foamy macrophages in BAL fluids and TBLB specimens will be helpful for the diagnosis of amiodarone-induced pulmonary toxicity.


2020 ◽  
Vol 9 (4) ◽  
pp. 1164 ◽  
Author(s):  
Vicente Faus-Matoses ◽  
Cristina Pasarín-Linares ◽  
Ignacio Faus-Matoses ◽  
Federico Foschi ◽  
Salvatore Sauro ◽  
...  

Background: The objective was to evaluate the efficiency of ProTaper Gold (PTG) and Reciproc Blue (RB) NiTi files in obturation material removal from straight root canals assessed by micro-computed tomography. Methods: Fifty-two anterior human teeth were shaped with a PTG rotary system until F2 (25/.08). Specimens were obturated with a continuous wave of condensation technique. For retreatment, specimens were randomly distributed in two experimental groups: PTG group (F4 file) and RB (R40 file). Micro-CT scans were performed before and after retreatment procedures. The percentage of the remaining obturation material compared to the original volume was calculated, as well as the retreatment time. The presence of separated files was recorded. A descriptive analysis was carried out, and nonparametric tests were employed. Results: The mean percentages of remaining obturation material in the PTG group and the RB group were 4.14 ± 4.30% and 4.18 ± 4.29%, respectively. The mean retreatment times for the PTG and RB groups were 144 ± 51 and 163 ± 88 s, respectively. There were no statistically significant differences, neither in removal efficiency (p > 0.05) nor in retreatment time (p > 0.05), between the two groups. The coronal and middle thirds presented significantly more remaining obturation material than the apical third (p < 0.05). No file separation occurred. Conclusions: ProTaper Gold and Reciproc Blue present with comparable efficiency in removing the obturation material, with a similar mean retreatment time.


2020 ◽  
Author(s):  
Jung Youn Kim ◽  
Yong Girl Rhee ◽  
Young Wan Ko ◽  
Sung Min Rhee

Abstract Background: This study was to analyze the clinical results of locking hook plate fixation for acute acromioclavicular joint (ACJ) injury and to find out the incidence of subacromial erosion, carry out quantitative analysis and identify risk factors. Methods: The study was conducted on 35 patients who underwent the locking hook plate fixation for acute ACJ joint injury. The clinical outcomes were evaluated measuring the visual analog scale (VAS) for pain, and the University of California at Los Angeles (UCLA) score. The computed tomography (CT) was conducted to measure the subacromial erosion. The acromioclavicular slope (AC slope) of the unaffected side, the acromion-hook angle (AH angle), the acromioclavicular anteroposterior distance (AC-AP distance), and the preoperative acromioclavicular interval (ACI) of the affected side were analyzed to identify the risk factors of subacromial erosion. Results: The mean preoperative VAS score was 7.6 points, which improved by a significant level of 0.3 at the final follow-up (P <0.001). The UCLA score at the last follow-up was 32.3 points, which was higher than the preoperative average of 15.2 points (P = 0.003). According to the computed tomography (CT) findings, subacromial erosion was found in all cases, and the mean value was 5.0mm, which is 53% of the entire acromion thickness. The AC slope (B=-0.159, P<0.001) and AC-AP distance (B=0.233, P=0.004) were found to have a significant influence on postoperative subacromial erosion. The AC slope showed a negative correlation with the amount of erosion, while the AC-AP distance showed a positive correlation with erosion. onclusion: The study was able to obtain satisfactory clinical and radiological results after locking hook plate fixation for acute ACJ injury. The CT findings revealed that subacromial erosion occurred in all cases, and the mean erosion depth was about 50% of the acromial thickness. If the preoperative AC slope of the unaffected side was more acute and the AC-AP distance was larger, the incidence of subacromial erosion was higher. Level of evidence: Therapeutic Level IV Retrospectively registered study: This study was retrospective in nature, and final approval of informed consent exemption by the institutional review board was obtained (KHUH IRB 2019-04-079)


2021 ◽  
Vol 02 ◽  
Author(s):  
Abeer A. Al Helali ◽  
Mohamed A. Kukkady ◽  
Ghufran A. Saeed ◽  
Tamer I. Elholiby ◽  
Rabab A. Al Mansoori ◽  
...  

Purpose: This study aimed at evaluating the diagnostic performance of standard greyscale and inverted greyscale Chest X-ray (CXR) using Computed Tomography (CT) scan as a gold standard. Methods: In this retrospective study, electronic medical records of 120 patients who had valid CXR and High-resolution CT (HRCT) within less than 24 hours after having a positive COVID-19 RT-PCR test during the period from May 19th to May 23rd, 2020, in a single tertiary care center were reviewed. PA chest radiographs were presented on 2 occasions to 5 radiologists to evaluate the role and appropriateness of standard greyscale and inverted greyscale chest radiographs (CXR) when images are viewed on high-specification viewing systems using a primary display monitor and compared to computed tomography (CT) findings for screening and management of suspected or confirmed COVID-19 patients. Results: Ninety-six (80%) patients had positive CT findings, 81 (67.5%) had positive grey scale CXR lesions, and 25 (20.8%) had better detection in the inverted grey scale CXR. The CXR sensitivity for COVID-19 pneumonia was 93.8% (95% CI (86.2% - 98.0%) and the specificity was 48.7% (95% CI (32.4% - 65.2%). The CXR sensitivity of detecting lung lesions was slightly higher in male (95.1% (95% CI (86.3% - 99.0%)) than female (90.0% (95% CI (68.3% - 98.8%)), while the specificity was 48.0% (95% CI (27.8% - 68.7%) and 50.0% (95% CI (23.0% - 77.0%) in males and females, respectively. However, no significant difference was detected in ROC area between men and women. Conclusion: The sensitivity of detecting lung lesions of CXR was relatively high, particularly in men. The results of the study support the idea of considering conventional radiographs as an important diagnostic tool in suspected COVID-19 patients, especially in healthcare facilities where there is no access to HRCT scans. CXR shows high sensitivity for detecting lung lesions in HRCT confirmed COVID-19 patients. Better detection of lesions was noted in the inverted greyscale CXR in 20.8% of cases, with positive findings in standard greyscale CXR. Conventional radiographs can be used as diagnostic tools in suspected COVID-19 patients, especially in healthcare facilities where there is no access to HRCT scans.


Author(s):  
Mohamed G. Mansour ◽  
Ahmed S. Abdelrahman ◽  
Emad H. Abdeldayem

Abstract Background The 2019 coronavirus disease (COVID-19) has become a global health crisis. CT chest is considered as an important investigation for early diagnosis as well as assessment of severity of COVID-19 pneumonia. Several articles reported that there is a correlation between ABO blood group system and susceptibility as well as prognosis of the disease. In our study we correlated the CT severity score (CT-SS) and the ABO blood group in patients with COVID-19 infection. This study involved 547 symptomatic patients with pathologically proven COVID-19 infection (positive PCR); non contrast CT chest was done for all cases and CT severity score (CT-SS) was calculated followed by its correlation with the patients’ ABO blood group. Aim of the work was to evaluate the relation between CT-SS and the ABO blood groups in Egyptian patients with COVID-19 infection. Results The mean CT-SS in patients with blood group A patients (n = 153; 28%) was 13.7 (moderate severity), while in patients with blood group O (n = 227; 41.5%) the mean CT-SS was 6.7 (mild severity). In blood group B patients (n = 139; 25.4%) the mean CT-SS was 9.1 (mild to moderate severity) and in blood group AB patients (n = 28; 5.1%) the mean CT-SS was 9.7 (mild to moderate severity). Conclusion COVID-19 patients with blood group A are more prone to aggressive CT findings (higher CT-SS) and consequently may be susceptible to increased risk of mortality compared to the patients with other blood groups; however, patients with blood group O are suggested to have the least CT-SS and appear to be relatively protected.


Author(s):  
Deepak Kumar A. ◽  
Sachin N. Solanke

Background: An unknown pneumonia broke out in Wuhan City in December 2019 and it was confirmed as an acute respiratory infectious disease caused by Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2, formerly known as 2019-nCoV). Consumption coagulopathy, which should be obviated in order to decrease mortality, arises in disseminated intravascular coagulation with a decrease in fibrinogen and an increase in D-dimer levels. However, studies on the predictive and prognostic values of coagulation parameters in the setting of patients with COVID-19 are still limited. The objective of this retrospective study was to investigate the correlation of D-dimer and computed tomography severity score in patients with COVID-19 pneumonia.Methods: The present retrospective study was conducted among 108 subjects reported COVID RT-PCR positive admitted during the study period i.e.; January-August 2021 in the department of medicine of Rural Medical College, Loni. Pneumonia was confirmed by Computed tomography (CT) examination and coagulation test completed within 12 hr after admission were enrolled. Coagulation tests, which Fibrinogen (Fib) and D-dimer were performed. CT score was categorized into mild (0-7), moderate (8-16) and advanced grade (17-25 points).Results: The mean age of male and female was 38.52±5.34 and 35.67±3.22 years respectively, with an overall age of 37.79±4.58 years. Mean D-dimer level was 0.54±0.09, 0.91±0.22 and 1.96±0.47 mcg/ml among subjects having mild, moderate and severe CT score respectively. According to multivariate analysis, higher D-dimer (OR:3.61, p<0.01) was significantly associated with CT severity score.Conclusions: Study concluded that the D-dimer level's time point was matched to the time of CT scan, we have reasons to correlate that the D-dimer level may predict the severity of inflammation prior to coagulopathy/thrombosis.


2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Omair Shah ◽  
Shadab Maqsood ◽  
Tahleel Shera ◽  
Mudasir Bhat ◽  
Naseer Choh ◽  
...  

We evaluated the High Resolution Computed Tomography (HRCT) findings in young patients (< 40 years) infected with the COVID 19 virus and tried to find out any difference in the severity of lung involvement between the first and second wave of the pandemic and whether the notion of young population being more severely affected by the second wave holds true.Two-hundred (200) young patients (<40 years) with RT PCR documented COVID infections undergoing HRCT chest at our institute were included. Group A included young patients infected in the first wave (up to 28 February 2021) while Group B included patients beyond this date. Demographic and clinical data was obtained from the medical records department. HRCT scans were retrieved from the archive and were assessed by two radiologists or CT severity scoring. The mean severity scores were calculated and any statistical difference between Group A and B was sought. CT scans of four fully vaccinated patients were also evaluated.The age and gender distribution among the two groups was comparable. A greater number of patients in group B required hospital admission compared to group A (74% VS 53%). In group A, the mean severity score was 10.1±2.1 with 34 patients (34%) in mild category, 46 patients (46%) in moderate group and 20 patients (20%) in the severe group. In group B, the mean CT severity score was 12.6±2.3 with 20 patients (20%) in mild category, 42 patients (42%) in moderate group and 38 patients (38%) in the severe group.Lung involvement in young patients in the second wave is more severe requiring more hospital admissions. Vaccinated population may well have a milder form of the disease.


2021 ◽  
Author(s):  
Abeer Ahmed AlHelali ◽  
Mohamed Ashfaque Kukkady ◽  
Ghufran Aref Saeed ◽  
Tamer Ibrahim Elholiby ◽  
Rabab Abdulrahman Al Mansoori ◽  
...  

AbstractPurposeTo evaluate diagnostic performance of greyscale and inverted greyscale Chest X-ray (CXR) using Computed Tomography (CT) scan as a gold standard.MethodsIn this retrospective study, electronic medical records of 120 patients who had valid CXR and High-resolution CT (HRCT) within less than 24 hours after having a positive COVID-19 RT-PCR test during the period from May 19 th to May 23 rd 2020 in a single tertiary care center were reviewed.PA chest radiographs were presented on 2 occasions to 5 radiologists to evaluate the role and appropriateness of greyscale and inverted greyscale chest radiographs (CXR). The images were viewed on high-specification viewing systems using a primary display monitors and compared it to computed tomography (CT) findings for screening and management of suspected or confirmed COVID-19 patients.ResultsNinety-six (80%) patients had positive CT findings, 81 (67.5%) had positive grey scale CXR lesions, and 25 (20.8%) had better detection in the inverted grey scale CXR. The CXR sensitivity for COVID-19 pneumonia was 93.8% (95% CI (86.2% - 98.0%) and the specificity was 48.7% (95% CI (32.4% - 65.2%). The CXR sensitivity of detection of lung lesions was slightly higher in male (95.1% (95% CI (86.3% - 99.0%)) than female (90.0% (95% CI (68.3% - 98.8%)), while the specificity was 48.0% (95% CI (27.8% - 68.7%) and 50.0% (95% CI (23.0% - 77.0%) in males and females, respectively. However, no significant difference was detected in ROC area between men and women.ConclusionsThe sensitivity of detection of lung lesions of CXR was relatively high, particularly in men. The results of the study support the idea of considering conventional radiographs as an important diagnostic tool in suspected COVID-19 patients especially in healthcare facilities where there is no access to HRCT scans.HighlightsCXR shows high sensitivity for detecting lung lesions in HRCT confirmed COVID-19 patients.Better detection of lesions was noted in the inverted grey scale CXR in (20.8%) of cases with positive findings in standard greyscale CXR.Conventional radiographs can be used as diagnostic tools in suspected COVID-19 patients especially in healthcare facilities where there is no access to HRCT scans.


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