scholarly journals Imaging of COVID-19 simulators

Author(s):  
Abdelghany Mohammed Motawea ◽  
Suzan Omar ◽  
Rabab Yasin

Abstract Background Coronavirus (COVID-19) pneumonia emerged in Wuhan, China, in December 2019. It was highly contagious spreading all over the world, with a rapid increase in the number of deaths. The reported cases have reached more than 14 million with more than 600,000 deaths around the world. So, the pandemic of COVID-19 became a surpassing healthcare crisis with an intensive load on the healthcare resources. In this study, the aim was to differentiate COVID-19 pneumonia from its mimickers as atypical infection, interstitial lung diseases, and eosinophilic lung diseases based on CT, clinical, and laboratory findings. Results This retrospective study included 260 patients, of which 220 were confirmed as COVID-19 positive by two repeated RT-PCR test and 40 were classified as non-COVID by two repeated negative RT-PCR test or identification of other pathogens, other relevant histories, or clinical findings. In this study, 158 patients were male (60.7 %) and 102 patients were female (39.3%). There was 60.9% of the COVID-19 group were male and 39.1% were female. Patients in the non-COVID group were significantly older (the mean age was 46.4) than those in the confirmed COVID-19 group (35.2y). In the COVID-19 group, there was exposure history to positive cases in 84.1% while positive exposure history was 20% in the non-COVID group. Conclusion The spectrum of CT imaging findings in COVID-19 pneumonia is wide that could be contributed by many other diseases making the interpretation of chest CTs nowadays challenging to differentiate between different diseases having the same signs and act as deceiving simulators in the era of COVID-19.

2020 ◽  
Vol 26 (3) ◽  
pp. 143-148
Author(s):  
Gordana Todorović ◽  
Aleksandar Joldžić ◽  
Slađana Anđelić ◽  
Darko Nedeljković

Introduction/Objective Severe acute respiratory distress syndrome caused by coronavirus 2 (SARS-COV-2) is a new respiratory disease -COVID-19. A virus from the Coronaviridae family, highly contagious and virulent took over the world in a very short time causing the 2019/2020 pandemic. We are presenting the case of COVID-19 transmission among family members, patients of various ages, sex, clinical presentation and findings, who have been infected in different ways. Case reports Three patients are described, all with different coronavirus-specific symptomatology. Symptoms ranged from fatigue and loss of appetite with no other, more prominent symptoms in the youngest patient, to fever, high temperature, diarrhoea, muscle ache and chest pain during inspiration in the oldest patient. The third patient's dominant symptoms were dry, non-productive cough, lack of oxygen, shortness of breath and perspiration on exertion, headache and normal temperature, with radiographically confirmed bilateral pneumonia. Laboratory findings (leukopenia, lymphocytopenia with elevated C-reactive protein levels, high erythrocyte sedimentation rate and lactate dehydrogenase levels) were consistent with a viral infection, highly suspicious of SARS-COV-2, which was confirmed with a real-time RT-PCR test in all three patients. After being hospitalized in the Clinical Hospital Center "Zemun" Department of Pulmonology and treated with symptomatic, antiviral and antibiotic therapy, the disease regressed and the RT-PCR tests became negative. Conclusion SARS-COV-2 is a very aggressive and potent cause of the coronavirus disease. The presented cases confirm the possibility of quick transmission within a family through direct and indirect contact, as well as the diversity of symptoms, laboratory and clinical findings. Our clinical examples are similar in symptomatology and available results to cases from other parts of the world hit with the pandemic.


2020 ◽  
Vol 25 (4) ◽  
pp. 499-505
Author(s):  
Onur Ural ◽  
Şua Sümer ◽  
Nazlım Aktuğ Demir ◽  
Emine Yalçınkaya ◽  
Elif Uçan ◽  
...  

Introduction: The COVID-19 pandemic continues to affect the world with serious number of cases and deaths. For this reason, knowing the clinical findings and course of the disease is important for early diagnosis and treatment. In this article, COVID-19 cases followed up after quarantine were discussed. Materials and Methods: In this study, the data of 99 patients who were followed up during travel and post-Umrah quarantine between 31 March and 15 April 2020 were retrospectively reviewed. Results: Of the 99 patients included in the study, 66 (66.7%) were females, 33 (33.3%) were males, and mean age was 59.8 ± 11.4 years. SARS-CoV-2 RT-PCR test was positive at the time of admission in 97 (98.0%) of the 99 patients. Thirty-nine (39.4%) of the patients were symptomatic and 25.3% of the patients had cough, 8.1% had fever, and 7.1% had shortness of breath. While SARSCoV-2 RT-PCR test was negative in 2 (3.3%) of the 60 patients without complaints, 58 (96.7%) of them were positive for SARS-CoV-2 RT-PCR test. Leukopenia was detected as 3%, lymphopenia 66.7%, D-dimer height 47.5%, LDH elevation 38.4%, CRP elevation 45.5%. Ground glass opacities were present in 81 (81.8%) of the patients with lung involvement, and consolidation areas were present in 40 patients (40.4%). Underlying disease was present in 38 (38.4%) of the patients. Hypertension and diabetes mellitus were the most common underlying diseases. It was observed that 89 (89.4%) of our cases had negative SARS-CoV-2 RT-PCR test on the 5th day. Conclusion: COVID-19 infection is an infectious disease that can present with many different clinics. In asymptomatic COVID-19 cases, lung involvement findings and disorders in laboratory parameters may be observed. It should be kept in mind that asymptomatic cases pose a risk in terms of transmission.


2021 ◽  
Vol 5 (1) ◽  
pp. 019-026
Author(s):  
Perincek Gokhan ◽  
Onal Canver ◽  
Avci Sema

Introduction: COVID-19 is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 and it was first reported in China. The aim of this study was to compare clinical features, chest CT findings and laboratory examinations of suspected COVID-19 inpatients according to RT-PCR analysis. Methods: Demographics, comorbidites, symptoms and signs, laboratory results and chest CT findings were compared between positive and negative groups. The study included 292 patients (134 females, 158 males) suspected of COVID-19. All statistical calculations were performed with SPSS 23.0. Results: 158 (54.1%) of the cases were male and 134 (45.9%) were female. Their ages ranged from 17 to 95 years, with an average of 50.46 ± 20.87. A symptom or sign was detected in 86.3% of all patients. The chest CT images of 278 patients were analyzed. Chest CT was negative in 59.2% of patients with positive RT-PCR and 43.9% of patients with negative RT-PCR results. Chest CT findings were atypical or indeterminate in 22.4% of patients with positive RT-PCR results and 20% of patients with negative RT-PCR analysis. ALP, bilirubine, CRP, eosinophil count, glucose, CK-MB mass and lactate were significantly lower in patients with positive RT-PCR test. LDH, lipase, MCV, monocyte, neutrophil count, NLR, platelet, pO2, pro-BNP, procalcitonin, INR, prothrombin time, sodium, troponin T, urea, WBC were significantly lower in patients with positive RT-PCR test results. Conclusion: The diagnosis of COVID-19 is based on history of patient, typical symptoms or clinical findings. Chest CT, RT-PCR and laboratory abnormalities make the diagnosis of disease stronger.


2021 ◽  
Vol 10 (13) ◽  
pp. 2953
Author(s):  
Tzu-Chen Lo ◽  
Yu-Yen Chen

This study aimed to achieve a better understanding of the epidemiological and clinical characteristics of multisystem inflammatory syndrome in children (MIS-C) following coronavirus disease 2019 (COVID-19). We searched PubMed and Embase between December 2019 and March 2021 and included only peer-reviewed clinical studies or case series. The proportions of patients who had conjunctivitis, systemic symptoms/signs (s/s), Kawasaki disease (KD), and exposure history to suspected/confirmed COVID-19 cases were obtained. Moreover, positive rates of the nasopharyngeal real-time reverse transcriptase polymerase chain reaction (RT-PCR) and serum antibody for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were recorded. Overall, 32 studies with 1458 patients were included in the pooled analysis. Around half of the patients had conjunctivitis. The five most common systemic manifestations were fever (96.4%), gastrointestinal s/s (76.7%), shock (61.5%), rash (57.1%), and neurological s/s (36.8%). Almost one-third presented complete KD and about half had exposure history to COVID-19 cases. The positivity of the serology (82.2%) was higher than that of the nasopharyngeal RT-PCR (37.0%). MIS-C associated with COVID-19 leads to several features similar to KD. Epidemiological and laboratory findings suggest that post-infective immune dysregulation may play a predominant role. Further studies are crucial to elucidate the underlying pathogenesis.


Author(s):  
Muhammet Asena ◽  
ilyas yolbaş ◽  
murat Kanğın

Background: The pandemic of the new coronavirus disease (COVID-19) continues to be a major health problem globally. In this study, clinical findings, radiological findings, laboratory findings and polymerase chain reaction (PCR) test results were evaluated according to age groups in pediatric patients with COVID-19. Methods: In this study, PCR (+) and PCR (-) 278 cases diagnosed with COVID-19 between March 15, 2020 and September 30, 2020 were assessed considering clinical symptoms, radiological and laboratory findings and RT-PCR test results. Results: 43.9% of the cases consisted of RT-PCR (+) and 56.1% of RT-PCR (-) cases. Fever was observed at the rate of 64.7%, cough 53.2%, respiratory distress 12.2%, myalgia 24.5%, diarrhea 12.9%, chest X-ray findings 48.2% and computed tomography findings 43.6%. Diarrhea and cough, alanine aminotransferase, aspartate aminotransferase, leukocyte and lymphocyte elevation were determined as significantly higher in younger age group cases, while high myalgia and neutrophilia was observed in older age group children (p <0.05). Fever, high CRP, leukocytosis frequency, high neutrophil, were significantly higher in PCR(-) cases and the frequency of respiratory distress, high lymphocyte and chest computed tomography findings in PCR(+) cases (p <0.05). Conclusion: COVID-19 infection may indicate different nonspecific clinical, laboratory and radiological findings in children according to both adults and pediatric age groups. In addition, the results of the PCR test may give erroneous results in cases due to conditions such as fever, respiratory distress, high CRP, leukocytosis, high neutrophil and CT finding. Keywords: pediatric, COVID-19, RT-PCR


Author(s):  
James T Lee ◽  
Elisabeth M Hesse ◽  
Heather N Paulin ◽  
Deblina Datta ◽  
Lee S Katz ◽  
...  

Abstract Background We investigated patients with potential SARS-CoV-2 reinfection in the United States during May–July 2020. Methods We conducted case finding for patients with potential SARS-CoV-2 reinfection through the Emerging Infections Network. Cases reported were screened for laboratory and clinical findings of potential reinfection followed by requests for medical records and laboratory specimens. Available medical records were abstracted to characterize patient demographics, comorbidities, clinical course, and laboratory test results. Submitted specimens underwent further testing, including RT-PCR, viral culture, whole genome sequencing, subgenomic RNA PCR, and testing for anti-SARS-CoV-2 total antibody. Results Among 73 potential reinfection patients with available records, 30 patients had recurrent COVID-19 symptoms explained by alternative diagnoses with concurrent SARS-CoV-2 positive RT-PCR, 24 patients remained asymptomatic after recovery but had recurrent or persistent RT-PCR, and 19 patients had recurrent COVID-19 symptoms with concurrent SARS-CoV-2 positive RT-PCR but no alternative diagnoses. These 19 patients had symptom recurrence a median of 57 days after initial symptom onset (interquartile range: 47 – 76). Six of these patients had paired specimens available for further testing, but none had laboratory findings confirming reinfections. Testing of an additional three patients with recurrent symptoms and alternative diagnoses also did not confirm reinfection. Conclusions We did not confirm SARS-CoV-2 reinfection within 90 days of the initial infection based on the clinical and laboratory characteristics of cases in this investigation. Our findings support current CDC guidance around quarantine and testing for patients who have recovered from COVID-19.


2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Niloufar Bineshfar ◽  
Alireza Mirahmadi ◽  
Fereshteh Karbasian ◽  
Elham Pourbakhtyaran ◽  
Abdollah Karimi ◽  
...  

Coronavirus disease-2019 (COVID-19) which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has spread throughout the world causing problems for millions of people. Symptoms of COVID-19 in pediatric patients include both respiratory and gastrointestinal symptoms. The most common symptoms are fever, cough, and fatigue. In this report, we describe a case of a previously well 14-year-old boy, who presented to our emergency department with a complaint of abdominal pain, nausea, and vomiting without fever or respiratory symptoms. He was diagnosed with acute pancreatitis based on an abnormal amylase level and abdomen computed tomography (CT) and later found to be infected by SARS-CoV-2, by a positive reverse transcriptase-polymerase chain reaction (RT-PCR) test.


2020 ◽  
Vol 8 (3) ◽  
pp. 131-133 ◽  
Author(s):  
Shahin Jafarpoor ◽  
Masoumeh Abedini ◽  
Fatemeh Eghbal ◽  
Amin Saburi

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or COVID-19, is a pandemic infectious disease involved all over the world. Its mortality, especially in cases with additional co-morbidities, is so high that is has attracted the attention of the world. Diabetes mellitus is known as one of its risk factors for mortality. Case Presentation: A unique case of pediatrics COVID-19 who presented with diabetic ketoacidosis (DKA) is reported in this manuscript as the first presentation. He presented with abdominal pain, nausea, and vomiting. RT-PCR test for COVID-19 via nasal swab was performed, and a positive diagnosis was obtained. Chest CT scan confirmed the diagnosis with multifocal bilateral patchy consolidation. Case was discharged after usual treatment of COVID-19. Conclusion: In pediatrics, this disease can be subtle and have a confusion presentation, but it should be controlled to avoid spread of the disease. During epidemic status, suspicious cases specially children with nonspecific symptoms and other underlying diseases should be considered as at risk or potentially asymptomatic COVID-19 cases.


Author(s):  
Terry Robinson ◽  
Jane Scullion

The interstitial lung diseases (ILDs), are an extensive range of lung diseases, rather than a single disease entity. These diseases are often grouped together because they have similarities in clinical presentation, radiographic changes, physiological features, and symptoms. Despite their similarities, these diseases have a variety of aetiologies, treatments, and prognoses. The rate of onset of symptoms is very variable. Some patients present with long-standing radiological symptoms, often found opportunistically. Other patients present with acute onset symptoms, rapidly developing respiratory failure and ultimately progressing to death. This chapter covers the presentation, clinical findings, diagnosis, common causes, and associated investigations. Common ILDs are also described.


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