Medium-term chest computed tomography (CT) follow-up of COVID-19 pneumonia patients after recovery to assess the rate of resolution and determine the potential predictors of persistent lung changes

Abstract Background The data on medium-term follow-up of coronavirus disease-19 (COVID-19) pneumonia survivors is scarce. Medium-term follow-up will generate knowledge and help in devising a structured follow-up plan and to facilitate enrolment in clinical trials assessing the role of antifibrotic drugs in modifying the course of disease in order to avert long-term pulmonary sequelae of disease. The study was aimed to evaluate the lung findings on a medium-term follow-up (3 months or more) chest computed tomography (CT) in COVID-19 pneumonia survivors, assess the rate of resolution or persistence of lung abnormalities and to identify the initial demographic, clinical, and imaging characteristics that could potentially predict the persistence of lung abnormalities on follow-up. Results Out of the total study cohort of 81 patients, 46 (56.8%) demonstrated complete resolution of lung findings and the remaining 35 (43.2%) had residual lung opacities on follow-up CT. The most common type of residual abnormality was ground glass opacity (GGO) (16/35; 45.7%), followed by parenchymal bands (9/35; 25.7%), mixed pattern of GGO and parenchymal bands (6/35; 17.2%), bronchiectasis (6/35; 17.2%), and interlobular septal thickening (4/35; 11.4%). Patients with residual abnormalities were older, had higher BMI, more comorbidities, lower SpO2, longer hospital stay, higher rate of intensive care unit (ICU) admission, higher WBC count, a higher CT severity score, and lower rate of steroid administration with all p values < 0.05. Conclusion Nearly half of post-COVID-19 survivors had residual lung abnormalities after ≥ 3 months of follow-up. Certain clinico-radiological characteristics have the potential to identify the individuals at risk of having residual lung abnormalities on medium-term follow-up.

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Efficacy of chest X-ray in the diagnosis of COVID-19 pneumonia: comparison with computed tomography through a simplified scoring system designed for triage

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-021-00541-x ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Akın Çinkooğlu ◽

Selen Bayraktaroğlu ◽

Naim Ceylan ◽

Recep Savaş

Keyword(s):

Computed Tomography ◽

Intensive Care ◽

Intensive Care Units ◽

Scoring System ◽

Imaging Modality ◽

Ground Glass Opacity ◽

Initial Presentation ◽

X Ray ◽

Chest X Ray

Abstract Background There is no consensus on the imaging modality to be used in the diagnosis and management of Coronavirus disease 2019 (COVID-19) pneumonia. The purpose of this study was to make a comparison between computed tomography (CT) and chest X-ray (CXR) through a scoring system that can be beneficial to the clinicians in making the triage of patients diagnosed with COVID-19 pneumonia at their initial presentation to the hospital. Results Patients with a negative CXR (30.1%) had significantly lower computed tomography score (CTS) (p < 0.001). Among the lung zones where the only infiltration pattern was ground glass opacity (GGO) on CT images, the ratio of abnormality seen on CXRs was 21.6%. The cut-off value of X-ray score (XRS) to distinguish the patients who needed intensive care at follow-up (n = 12) was 6 (AUC = 0.933, 95% CI = 0.886–0.979, 100% sensitivity, 81% specificity). Conclusions Computed tomography is more effective in the diagnosis of COVID-19 pneumonia at the initial presentation due to the ease detection of GGOs. However, a baseline CXR taken after admission to the hospital can be valuable in predicting patients to be monitored in the intensive care units.

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Serial computed tomography findings of Coronavirus disease 2019 (COVID-19) pneumonia treated with favipiravir and steroid therapy: report of 11 cases

Bulletin of the National Research Centre ◽

10.1186/s42269-021-00553-7 ◽

2021 ◽

Vol 45 (1) ◽

Author(s):

Naoki Irizato ◽

Hiroshi Matsuura ◽

Atsuya Okada ◽

Ken Ueda ◽

Hitoshi Yamamura

Keyword(s):

Computed Tomography ◽

Mechanical Ventilation ◽

Steroid Therapy ◽

Time Course ◽

Ground Glass ◽

Time Points ◽

Ct Findings ◽

Mixed Pattern ◽

Bronchial Dilatation

Abstract Background This study evaluated the time course of computed tomography (CT) findings of patients with COVID-19 pneumonia who required mechanical ventilation and were treated with favipiravir and steroid therapy. Results Eleven patients with severe COVID-19 pneumonia were included. CT findings assessed at the three time points showed that all patients had ground-glass opacities (GGO) and consolidation and mixed pattern at intubation. Consolidation and mixed pattern disappeared in most of the patients whereas GGO persisted in all patients at 1-month follow-up. In addition to GGO, a subpleural line and bronchus distortion and bronchial dilatation were frequent findings. The degree of resolution of GGO varied depending on each patient. The GGO score correlated significantly with the time from symptoms onset to initiation of steroid therapy (ρ = 0.707, p = 0.015). Conclusions At 1-month follow-up after discharge, non-GGO lesions were absorbed almost completely, and GGO were a predominant CT manifestation. Starting steroid therapy earlier after onset of symptoms in severe COVID-19 pneumonia may reduce the extent of GGO at 1-month follow-up.

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Fibrotic progression and radiologic correlation in matched lung samples from COVID-19 post-mortems

Virchows Archiv ◽

10.1007/s00428-020-02934-1 ◽

2020 ◽

Cited By ~ 3

Author(s):

Emanuela Barisione ◽

Federica Grillo ◽

Lorenzo Ball ◽

Rita Bianchi ◽

Marco Grosso ◽

...

Keyword(s):

Computed Tomography ◽

Diffuse Alveolar Damage ◽

Ground Glass Opacity ◽

Post Mortem ◽

Mechanically Ventilated ◽

Illness Duration ◽

Transbronchial Lung Cryobiopsy ◽

Histopathologic Analysis ◽

Lung Lobes

Abstract Data on the pathology of COVID-19 are scarce; available studies show diffuse alveolar damage; however, there is scarce information on the chronologic evolution of COVID-19 lung lesions. The primary aim of the study is to describe the chronology of lung pathologic changes in COVID-19 by using a post-mortem transbronchial lung cryobiopsy approach. Our secondary aim is to correlate the histologic findings with computed tomography patterns. SARS-CoV-2-positive patients, who died while intubated and mechanically ventilated, were enrolled. The procedure was performed 30 min after death, and all lung lobes sampled. Histopathologic analysis was performed on thirty-nine adequate samples from eight patients: two patients (illness duration < 14 days) showed early/exudative phase diffuse alveolar damage, while the remaining 6 patients (median illness duration—32 days) showed progressive histologic patterns (3 with mid/proliferative phase; 3 with late/fibrotic phase diffuse alveolar damage, one of which with honeycombing). Immunohistochemistry for SARS-CoV-2 nucleocapsid protein was positive predominantly in early-phase lesions. Histologic patterns and tomography categories were correlated: early/exudative phase was associated with ground-glass opacity, mid/proliferative lesions with crazy paving, while late/fibrous phase correlated with the consolidation pattern, more frequently seen in the lower/middle lobes. This study uses an innovative cryobiopsy approach for the post-mortem sampling of lung tissues from COVID-19 patients demonstrating the progression of fibrosis in time and correlation with computed tomography features. These findings may prove to be useful in the correct staging of disease, and this could have implications for treatment and patient follow-up.

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Overuse of follow-up chest computed tomography in patients with incidentally identified nodules suspicious for lung cancer

Journal of Cancer Research and Clinical Oncology ◽

10.1007/s00432-021-03692-6 ◽

2021 ◽

Author(s):

Ran Guo ◽

Yang Zhang ◽

Zelin Ma ◽

Chaoqiang Deng ◽

Fangqiu Fu ◽

...

Keyword(s):

Computed Tomography ◽

Lung Cancer ◽

Chest Computed Tomography

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Pure ground-glass opacity on chest computed tomography: predictive factors for invasive adenocarcinoma

Journal of Thoracic Disease ◽

10.21037/jtd.2016.06.34 ◽

2016 ◽

Vol 8 (7) ◽

pp. 1561-1570 ◽

Cited By ~ 24

Author(s):

Youngkyu Moon ◽

Sook Whan Sung ◽

Kyo Young Lee ◽

Sung Bo Sim ◽

Jae Kil Park

Keyword(s):

Computed Tomography ◽

Predictive Factors ◽

Ground Glass Opacity ◽

Ground Glass ◽

Invasive Adenocarcinoma ◽

Chest Computed Tomography

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Pulmonary Mucosa-Associated Lymphoid Tissue Lymphoma: A Report of 2 Cases and Literature Review

Diseases & Research ◽

10.54457/dr.202101007 ◽

2021 ◽

Vol 1 (1) ◽

pp. 36-40

Author(s):

Xiangting Xie ◽

◽

Ying Zhang ◽

Xiaoyan Tan ◽

Yun Luo ◽

...

Keyword(s):

Computed Tomography ◽

Malt Lymphoma ◽

Lymphoid Tissue ◽

Relevant Literature ◽

Complete Resection ◽

The Other ◽

Malignant Lymphomas ◽

Chest Computed Tomography ◽

Pulmonary Malt Lymphoma

Pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma is indolent and progresses more slowly than other malignant lymphomas. The clinical features are not specific and the diagnosis can often be difficult. Here, we present two rare cases of pulmonary MALT lymphoma. Both patients were incidentally found lesions in the lungs with chest computed tomography during physical examination. They were finally diagnosed by pathological biopsy. One received complete resection, the other was treated with chemotherapy. There were no recurrence in the two patients during follow-up. We also review relevant literature to provide a better recognition of this disease.

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Successive follow-up of chest computed tomography in patients with Mycobacterium avium-intracellulare complex

Respiratory Medicine ◽

10.1016/s0954-6111(99)90070-7 ◽

1999 ◽

Vol 93 (1) ◽

pp. 11-15 ◽

Cited By ~ 30

Author(s):

Y. Obayashi ◽

J. Fujita ◽

I. Suemitsu ◽

T. Kamei ◽

M. Nii ◽

...

Keyword(s):

Computed Tomography ◽

Mycobacterium Avium ◽

Chest Computed Tomography ◽

Mycobacterium Avium Intracellulare

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Clinical outcomes of hemodialysis patients infected with severe acute respiratory syndrome coronavirus 2 and impact of proactive chest computed tomography scans

Clinical Kidney Journal ◽

10.1093/ckj/sfaa086 ◽

2020 ◽

Vol 13 (3) ◽

pp. 328-333 ◽

Cited By ~ 3

Author(s):

Rui Wang ◽

Hong He ◽

Cong Liao ◽

Hongtao Hu ◽

Chun Hu ◽

...

Keyword(s):

Computed Tomography ◽

Invasive Mechanical Ventilation ◽

Case Series ◽

Ground Glass Opacity ◽

High Sensitivity ◽

Chest Ct ◽

Maintenance Hemodialysis ◽

Rt Pcr ◽

Chest Computed Tomography ◽

Reactive Protein

Abstract Background Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that first manifested in humans in Wuhan, Hubei Province, China, in December 2019, and has subsequently spread worldwide. Methods We conducted a retrospective, single-center case series of the seven maintenance hemodialysis (HD) patients infected with COVID-19 at Zhongnan Hospital of Wuhan University from 13 January to 7 April 2020 and a proactive search of potential cases by chest computed tomography (CT) scans. Results Of 202 HD patients, 7 (3.5%) were diagnosed with COVID-19. Five were diagnosed by reverse transcription polymerase chain reaction (RT-PCR) because of compatible symptoms, while two were diagnosed by RT-PCR as a result of screening 197 HD patients without respiratory symptoms by chest CT. Thirteen of 197 patients had positive chest CT features and, of these, 2 (15%) were confirmed to have COVID-19. In COVID-19 patients, the most common features at admission were fatigue, fever and diarrhea [5/7 (71%) had all these]. Common laboratory features included lymphocytopenia [6/7 (86%)], elevated lactate dehydrogenase [3/4 (75%)], D-dimer [5/6 (83%)], high-sensitivity C-reactive protein [4/4 (100%)] and procalcitonin [5/5 (100%)]. Chest CT showed bilateral patchy shadows or ground-glass opacity in the lungs of all patients. Four of seven (57%) received oxygen therapy, one (14%) received noninvasive and invasive mechanical ventilation, five (71%) received antiviral and antibacterial drugs, three (43%) recieved glucocorticoid therapy and one (14%) received continuous renal replacement therapy. As the last follow-up, four of the seven patients (57%) had been discharged and three patients were dead. Conclusions Chest CT may identify COVID-19 patients without clear symptoms, but the specificity is low. The mortality of COVID-19 patients on HD was high.

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The utility of chest computed tomography (CT) and RT-PCR screening of asymptomatic patients for SARS-CoV-2 prior to semiurgent or urgent hospital procedures

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.331 ◽

2020 ◽

Vol 41 (12) ◽

pp. 1375-1377 ◽

Cited By ~ 1

Author(s):

Aditya S. Shah ◽

Lara A. Walkoff ◽

Ronald S. Kuzo ◽

Matthew R. Callstrom ◽

Michael J. Brown ◽

...

Keyword(s):

Computed Tomography ◽

Ct Scan ◽

Tertiary Care ◽

Case Series ◽

Chest Ct ◽

Study Cohort ◽

Rt Pcr ◽

Chest Computed Tomography ◽

Tertiary Care Medical Center ◽

Asymptomatic Patients

AbstractObjective:Presently, evidence guiding clinicians on the optimal approach to safely screen patients for coronavirus disease 2019 (COVID-19) to a nonemergent hospital procedure is scarce. In this report, we describe our experience in screening for SARS-CoV-2 prior to semiurgent and urgent hospital procedures.Design:Retrospective case series.Setting:A single tertiary-care medical center.Participants:Our study cohort included patients ≥18 years of age who had semiurgent or urgent hospital procedures or surgeries.Methods:Overall, 625 patients were screened for SARS-CoV-2 using a combination of phone questionnaire (7 days prior to the anticipated procedure), RT-PCR and chest computed tomography (CT) between March 1, 2020, and April 30, 2020.Results:Of the 625 patients, 520 scans (83.2%) were interpreted as normal; 1 (0.16%) had typical features of COVID-19; 18 scans (2.88%) had indeterminate features of COVID-19; and 86 (13.76%) had atypical features of COVID-19. In total, 640 RT-PCRs were performed, with 1 positive result (0.15%) in a patient with a CT scan that yielded an atypical finding. Of the 18 patients with chest CTs categorized as indeterminate, 5 underwent repeat negative RT-PCR nasopharyngeal swab 1 week after their initial swab. Also, 1 patient with a chest CT categorized as typical had a follow-up repeat negative RT-PCR, indicating that the chest CT was likely a false positive. After surgery, none of the patients developed signs or symptoms suspicious of COVID-19 that would indicate the need for a repeated RT-PCR or CT scan.Conclusion:In our experience, chest CT scanning did not prove provide valuable information in detecting asymptomatic cases of SARS-CoV-2 (COVID-19) in our low-prevalence population.

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