scholarly journals Chest CT in COVID-19 pneumonia: correlations of imaging findings in clinically suspected but repeatedly RT-PCR test-negative patients

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Inan Korkmaz ◽  
Nursel Dikmen ◽  
Fatma Oztürk Keleş ◽  
Tayibe Bal
Keyword(s):  
False Negative ◽  
False Negative Rate ◽  
Lower Lobe ◽  
Ground Glass Opacity ◽  
Distribution Patterns ◽  
Clinical Suspicion ◽  
Ground Glass ◽  
Rt Pcr ◽  
Ct Findings

Abstract Background To emphasize the importance of CT in the diagnosis of COVID-19 disease by comparing the thoracic CT findings of COVID-19 patients with positive RT-PCR results and patients with clinical suspicion of COVID-19 but with negative RT-PCR results. Results In our study, COVID-19 patients with positive RT-PCR results (RT-PCR (+) group) and patients with clinical suspicion of COVID-19 but negative RT-PCR results (RT-PCR (−) group) were compared in terms of CT findings. In CT images, ground-glass opacity and ground-glass opacity + patchy consolidation were the most common lesion patterns in both groups. No statistically significant differences in the rates and types of lesion patterns were observed between the two groups. In both groups, lesion distributions and distribution patterns were similarly frequent in the bilateral, peripheral, and lower lobe distributions. Among the 39 patients who underwent follow-up CT imaging in the first or second month, a regression in lesion number and density was detected in 18 patients from both groups. Consolidations were completely resorbed in 16 of these patients, and five patients had newly developed fibrotic changes. The follow-up CT examination of 16 patients was normal. Conclusions Due to the false-negative rate of RT-PCR tests caused by various reasons, clinically suspected COVID-19 patients with a contact history should be examined with CT scans, even if RT-PCR tests are negative. If the CT findings are positive, these patients should not be removed from isolation.

scholarly journals Incidence and clinical profiles of COVID-19 in patients with gynecological surgery: A single center descriptive study from Spain.

2020 ◽  
Author(s):  
Reyes Oliver ◽  
Gregorio Lopez-Gonzalez ◽  
Alberto Galindo ◽  
Carmen Alvarez-Conejo ◽  
Sofia Aragon-Sanchez ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
False Negative ◽  
False Negative Rate ◽  
Second Phase ◽  
Gynecological Surgery ◽  
Rt Pcr ◽  
Third Phase ◽  
Surgical Complexity ◽  
Clinical Records

Abstract Background: The inflammatory reaction after a surgical intervention could exacerbate the course of the COVID-19. We aim to determine the rate of COVID-19 and its complications among gynecological surgeries in the context of different measures taken during the pandemic period in our department. Methods: A retrospective longitudinal observational study was conducted. Clinical records of patients who underwent gynecological surgery from March 1 st to April 10 th , 2020 were reviewed. During this period, three different approachs were made: first phase, without any screening or surgical restrictions; second phase, with presurgical epidemiological screening using a specific questionnaire; and third phase, also with presurgical SARS-COV-19 RT-PCR. During the second and third phases the surgical activity and complexity were restricted, and different workflows were established for patient with suspected/confirmed infection. After hospital discharge, telephone follow-up was performed and screening for COVID-19 was carried out. Complications from the disease were analyzed. Results : Of the 118 patients that underwent gynecological surgeries, 10 (8.5%) were perioperatively diagnosed with COVID-19. Of these patients, 8 (80%) were not pre-surgical screened for SARS-CoV-2 infection, neither clinical nor with RT-PCR. The other 2 (20%) were preoperative screened with RT-PCR, one of them with a positive test result. Screening false negative rate was 0.8%. No postoperative complications derived from COVID-19 were observed. Conclusions: The establishment of different surgical workflows, the reduction of surgical complexity, and the use of a pre-surgical screening to detect patient at SARS-CoV-2 infection risk, could reduce the postoperative complications derived from that infection and improve surgical outcomes.

scholarly journals Acute Pulmonary Embolism Mimicking Covid-19 Pneumonia

2020 ◽  
Vol 2 (6) ◽  
pp. 1-2
Author(s):  
Benslima N ◽  
◽  
Kacimi M ◽  
Berrada S ◽  
◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Ground Glass Opacity ◽  
Ground Glass ◽  
Rt Pcr ◽  
Severe Respiratory Distress ◽  
Thoracic Ct ◽  
History Of ◽  
The Right ◽  
Contrast Ct

We report the case of a 21 years old male patient, with a history of asthma since the age of 8 months, without follow-up, presenting a severe respiratory distress appeared suddenly, associated with a right basithoracic pain, and moderate hemoptysis. The non-contrast CT-chest scan showed a basal ground-glass opacity of the right lung leading to suspicion of Covid 19s’ pneumonia. Laboratory tests reveal an elevated levels of D-dimers (D-D), a thrombocytopenia, a neutrophilic leukocytosis and a hyper eosinophilia. The molecular test RT-PCR is negative. With the persistence of the right-side basithoracic pain and the presence of a hyper eosinophilia and increased levels of D-Dimers. A thoracic CT angiography was indicated that shows a bilateral distal pulmonary embolism with a right-sided basal sub segmental ischemia. We discuss a fortuitous discovery of an idiopathic pulmonary embolism associated to peripheral basal ground-glass opacities similar to the radiological findings found in the case of a SARS-Cov-2 pneumonia.

scholarly journals Diagnosis of Coronavirus Disease 2019 (COVID-19): Neither Chest CT nor RT-PCR Fits All

2020 ◽  
Author(s):  
Yue Teng ◽  
Hui Dai ◽  
Yalei Shang ◽  
Jianguo Xia ◽  
Yuehua Chen ◽  
...  
Keyword(s):  
False Negative ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Ct Scans ◽  
Imaging Features ◽  
Rt Pcr ◽  
Negative Results ◽  
Halo Sign ◽  
Solid Nodule ◽  
Ct Findings

Abstract BackgroundComputed tomography (CT) and reverse-transcription polymerase chain reaction (RT-PCR) are the recommended tools for the diagnosis of coronavirus disease 2019 (COVID-19). The present study aimed to investigate the correlation between chest CT and RT-PCR while describing the atypical CT imaging features of COVID-19.MethodsIn this study, 418 patients in Jiangsu, China, clinically diagnosed with COVID-19 from January 10 to February 17, 2020, were included. Patients who fulfilled the following conditions were evaluated further: (1) Patients had positive RT-PCR and negative CT; (2) Patients had initial negative RT-PCR and positive CT, and follow-up PT-PCR tests were positive; (3) Patients had atypical CT findings.ResultsOf the 418 initial chest CT scans, 30 (7.2%) patients had normal CT presentation, and 6 (1.4%) patients had initial negative RT-PCR results and positive CT scans. Next, 10 (2.4%) cases of patients showed atypical CT findings, including 2 case of solid nodule, 4 cases of halo sign (solid nodule or mass surrounded by ground glass opacity), and 4 cases of predominant fibrous stripes.ConclusionsFalse-negative results can be found on both chest CT and RT-PCR; hence, the diagnosis of COVID-19 should consider both CT and RT-PCR. CT manifestations, such as solitary nodule, halo sign, and pulmonary fibrous stripes, might indicate the possibility of COVID-19 to the radiologists.

scholarly journals HRCT Chest Evaluation of COVID-19 Patients: Experience in Combined Military Hospital Dhaka, Bangladesh

2020 ◽  
pp. 21-28
Author(s):  
Syed Zoherul Alam ◽  
SMA Al Muid ◽  
Afroza Akhter ◽  
AKM Sharifur Rahman ◽  
Md Al Emran ◽  
...  
Keyword(s):  
Lower Lobe ◽  
Ground Glass Opacity ◽  
Ground Glass ◽  
Military Hospital ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Pulmonary Lesions ◽  
Halo Sign ◽  
Polymerase Chain ◽  
Patients Experience

Background: HRCT Chest is an important tool in both diagnosis and management of COVID-19 patient, as well as it is an important complement to the reverse-transcription polymerase chain reaction (RT-PCR) tests. Purpose: The purpose of this study is to assess different patterns of manifestation in HRCT chest in COVID-19 infection & to grade the severity by observing a sample of 128 after the symptoms began. Method: From 11 April 2020 to 27 May 2020, 128 patients who were admitted in Combined Military Hospital Dhaka and underwent both HRCT chest and RT-PCR for COVID- 19 were included. Distribution and patterns of pulmonary lesions like ground glass opacity (GGO), consolidation, reverse halo sign, crazy paving, thickened vascular marking, lymphadenopathy and pleural effusion were evaluated. Result: Total 128 patients diagnosed (RT-PCR Positive) with COVID-19 were included. Among them, 112(87.5%) patients had fever, and 58(45.31%) patients had fatigability. The most frequent CT abnormality was ground glass opacity in 123(96.09%) cases. Amongst them 81(63.28%) cases had GGO plus consolidation and ground glass opacity alone were 42(32.81%) cases. Crazy-paving pattern was in 65(50.78%) cases. Most patients had multiple lesions and involved all the 5 lobes in 96(75.00%) cases. The lesions were mostly peripheral (123,96.09%) and posterior (103,80.47%) and in 65(50.78%) cases the distribution were diffuse but predominantly peripheral. Most commonly involved lobe is right lower lobe (120,93.75%) and left lower lobe(117,91.41%). Conclusion: HRCT chest can play an important role in the early diagnosis and prompt management of this global health emergency. J Bangladesh Coll Phys Surg 2020; 38(0): 21-28

scholarly journals Spectrum of Chest Computerised Tomography (CT) findings of Covid 19 in Indian Population

2021 ◽  
Vol 9 (1) ◽  
pp. 43-49
Author(s):  
Shravya Boini ◽  
Vikas Chennamaneni ◽  
Vamshi Kiran Diddy ◽  
Momin Sayed Kashif
Keyword(s):  
Lower Lobe ◽  
Ground Glass Opacity ◽  
Ct Images ◽  
Chest Ct ◽  
Ct Scans ◽  
Ground Glass ◽  
Study Cohort ◽  
Study Population ◽  
Ct Features

Background: To analyze the chest computed tomography (CT) features in patients with coronavirus disease 2019 (COVID-19) pneumonia. Methods: This was a prospective descriptive study comprising 202 consecutive reverse transcriptase polymerase chain reaction (RT-PCR) positive patients who underwent CT chest. For 25 patients, follow-up CT scans were obtained. The CT images were evaluated for the number, type and distribution of the opacity, and CT severity scoring was done Results: Among the total study cohort of 202 patients, 152 were males and 50 were females .From July 07, 2020, to september07, 2020, totally 202 laboratory-confirmed patients with COVID-19 underwent chest CT. For 25 patients, follow-up CT scans were obtained. The CT images were evaluated for the number, type and distribution of the opacity, and the affected lung lobes. Furthermore, the initial CT scan and the follow-up CT scans were compared. Results were patients (98.5%) had two or more opacities in the lung and 3 (1.5%) patients has negative chest CT. 183 (90.6%) patients had only ground-glass opacities; 13 patients (6.4%) had ground-glass and consolidative opacities; and 3 patients (1.5%) had only consolidation. A total 192 of patients (96.5%) showed two or more lobes involved. The opacities tended to be both in peripheral and central 7 (3.5%) or purely peripheral distribution 192 (96.5%). 177 patients (88.9%) had the lower lobe involved.8 patients showed complete resolution of lung findings. Conclusion: In this study population, the typical CT features of COVID 19 pneumonia are ground glass opacity with or without consolidation, which is patchy and peripheral, predominantly in lower lobes.

scholarly journals Correlation between CT findings and outcomes in 46 Patients with Coronavirus Disease-19

2020 ◽  
Author(s):  
Qiang Lei ◽  
Guangming Li ◽  
Xiaofen Ma ◽  
Junzhang Tian ◽  
Yunfan Wu ◽  
...  
Keyword(s):  
Lower Lobe ◽  
Ground Glass Opacity ◽  
Ground Glass ◽  
C Reactive Protein ◽  
Lung Lobe ◽  
Reactive Protein ◽  
Ct Findings ◽  
Short Term Mortality ◽  
Recovery Group ◽  
Early Fibrosis

Abstract Purpose: The aim of this study was to retrospectively analyze chest Computed Tomography (CT) findings in COVID-19 pneumonia and identify features associated with poor prognosis.Methods: This retrospective review included 46 patients with RT-PCR confirmed COVID-19 infection. Basic clinical characteristics and detailed CT features were evaluated and compared between patients who recovered (n = 40) from coronavirus and those who expired (n = 6). Chest CT examinations for ground-glass opacity, crazy-paving pattern, consolidation, and fibrosis were scored by two reviewers. The total CT score comprised the sum of lung involvement (5 lobes, scores 1-5 for each lobe, range; 0, none; 25, maximum) was determined.Results: We analyzed clinical data from 46 patients (26 males and 20 females; age 9-82 years) with confirmed COVID-19 pneumonia were evaluated. The chest CTs showed 27 (58.7%) patients had ground-glass opacity, 19 (41.3%) had ground glass and consolidation, and 35 (76.1%) patients had crazy-paving pattern. None of the patients who expired had fibrosis, in contrast to six (15%) patients who recovered from coronavirus. Most patients had subpleural lesions (89.0%), bilateral (87.0%) and lower (93.0%) lung lobe involvement. Diffuse lesions were present in four (67%) patients who succumbed to coronavirus, but only one (2.5%) patient who recovered (p = 0.000). CT identified a greater area of lung lobe involvement in patients who died (p = 0.000). In the group of patients who expired, the total CT score was higher than that of the recovery group (17.2 ± 7.8 vs. 7.1 ± 4.3, p = 0.005). Patients in the death group had lower lymphocyte count and higher C-reactive protein than those in the recovery group (p = 0.011 and p = 0.041, respectively).Conclusion: The CT of patients with COVID-19 mainly showed ground-glass opacity and ground-glass opacity plus consolidation, with a peripheral lower lobe preference. Early fibrosis may correlate with well prognosis. Lymphopenia, elevated C-reactive protein, and high CT score in conjunction with diffuse distribution of lung lesions are indicative of disease severity and short- term mortality.

scholarly journals 74 Days Dynamic Changes of Chest CT Images of Coronavirus Disease 2019 (COVID-19) in Hebei Province, China

2020 ◽  
Author(s):  
jianqin Liang ◽  
Guizeng Liu ◽  
Shuzhuang Yu ◽  
Yang Yang ◽  
Yanchun Li ◽  
...  
Keyword(s):  
False Negative ◽  
False Negative Rate ◽  
Ct Imaging ◽  
Chest Ct ◽  
Hebei Province ◽  
Ground Glass ◽  
Initial Symptom ◽  
Fine Mesh ◽  
Halo Sign

Abstract Background Since December 2019, the COVID-19 infection broke out in many parts of the world with confirmed and death cases rapidly increasing, which posed a great threat to human life and health. Current nucleic acid detection and antibody testing for the SARS-CoV-2 were the main methods for diagnosis of COVID-19, but not so sensitive, with high false negative rate and missed diagnosis rate. Imaging changes of COVID-19 not only precede symptomatic changes, but also have different imaging characteristics in different periods. We conducted 74 days of dynamic chest CT imaging observation on COVID-19 patients in Hebei province, aiming to understand the dynamic characteristics of the chest CT changes of COVID-19, so as to find the source of infection early, take early intervention measures, and judge the prognosis. Methods Chest CT examinations at intervals 1 to 4 days were conducted for 11 patients with a diagnosis of COVID-19. On the 74th day after onset, chest CT was reexamined to analyze the characteristics of chest CT in each stage. Results Of the 11 cases, 1 case was imported from Wuhan, 10 cases were infected for family clustering after close contact with confirmed COVID-19 cases. There were 3 ordinary cases, 3 severe cases and 5 critical cases. Among them, 2 critical cases died for old age and complications of underlying diseases, while 9 cases were cured by April 7, 2020. The changes of chest CT imaging in 1 child appeared prior to the clinical symptoms. 1–4 days after onset of the initial symptom were the early stages: Chest CT was mainly characterized by single lung quasi-circular ground glass shadow and fine mesh shadow. 5–10 days were the progressive stages: The lesion spread along the axial interstitium of the bronchi and gradually diffused to the whole lung, and reach the peak on day 6 to 9, which was characterized by consolidation, paving stone sign, halo sign, reversed halo sign, and even ‘white lung’ for the critical patients. The recovery stages began on day 11 after onset: The fiber cord, ground glass and consolidation shadow were gradually absorbed. After 74 days of follow-up, no serious permanent lung injury was found. Conclusion Chest CT could determine the different stages of COVID-19. Dynamic follow-up chest CT showed a good prognosis of COVID-19 in Hebei Province, China

scholarly journals CT features and artificial intelligence quantitative analysis of recovered COVID-19 patients with negative RT-PCR and clinical symptoms

2020 ◽  
Author(s):  
Siyao Du ◽  
Si Gao ◽  
Guoliang Huang ◽  
Shu Li ◽  
Wei Chong ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Quantitative Analysis ◽  
Clinical Symptoms ◽  
Lower Lobe ◽  
Ground Glass Opacity ◽  
Imaging Features ◽  
Rt Pcr ◽  
Ct Value ◽  
Novel Coronavirus

Abstract Objectives: To evaluate imaging features and performed quantitative analysis for mild novel coronavirus pneumonia (COVID-19) cases ready for discharge.Methods: CT images of 125 patients (16-67 years, 63 males) recovering from COVID-19 were examined. We defined the double-negative period (DNp) as the period between the sampling days of two consecutive negative RT-PCR and three days thereafter. Lesion demonstrations and distributions on CT in DNp (CTDN) were evaluated by radiologists and artificial intelligence (AI) software. Major lesion transformations and the involvement range for patients with follow-up CT were analyzed.Results: Twenty (16.0%) patients exhibited normal CTDN; abnormal CTDN for 105 indicated ground-glass opacity (GGO) (99/125, 79.2%) and fibrosis (56/125, 44.8%) as the most frequent CT findings. Bilateral-lung involvement with mixed or random distribution was most common for GGO on CTDN. Fibrous lesions often affected both lungs, tending to distribute on the subpleura. Follow-up CT showed lesion improvement manifesting as GGO thinning (40/40, 100%), fibrosis reduction (17/26, 65.4%), and consolidation fading (9/11, 81.8%), with or without range reduction. AI analysis showed the highest proportions for right lower lobe involvement (volume, 12.01±35.87cm3; percentage; 1.45±4.58%) and CT-value ranging –570 to –470 HU (volume, 2.93±7.04cm3; percentage, 5.28±6.47%). Among cases with follow-up CT, most of lung lobes and CT-value ranges displayed a significant reduction after DNp.Conclusions: The main CT imaging manifestations were GGO and fibrosis in DNp, which weakened with or without volume reduction. AI analysis results were consistent with imaging features and changes, possibly serving as an objective indicator for disease monitoring and discharge.

Role of CT Chest in the Diagnosis and Management of SARS-Cov-2 Pneumonia Patients - Hospital Based Descriptive Study, Hyderabad

2021 ◽  
Vol 8 (19) ◽  
pp. 1446-1452
Author(s):  
P.M.T. Mahidhar ◽  
Gayathri Gadiyaram ◽  
Rakhee Kumar Paruchuri
Keyword(s):  
Lower Lobe ◽  
Ground Glass Opacity ◽  
Descriptive Study ◽  
Middle Lobe ◽  
Chest Ct ◽  
Response To Treatment ◽  
Ground Glass ◽  
Ct System ◽  
The Right

BACKGROUND The computerised tomography (CT) characteristics of COVID-19 are reported and compared with the CT characteristics of other viruses to familiarise radiologists with potential CT trends and to determine the effectiveness of chest CT in the diagnosis and treatment of COVID-19. METHODS This was a hospital based descriptive study which involved the first 324 patients with a finding of severe acute respiratory syndrome (SARS-CoV-2) infection validated by real-time reverse transcription-polymerase chain reaction (RT – PCR). Monitoring patients (198 males, 126 females with a mean age of 46.50 years ± 8.96 [SD] and age range of 21 - 76 years) from April 2020 to July 2020. We correlated the image reports from the initial CT analysis with the findings of the laboratory studies and established possible CT patterns for viral infection. RESULTS The initial chest CT studies of the 324 SARS-CoV-2 patients showed that the disease affected all 'five lobes' in 248 (76.54 percent) patients, both 'lower lobes' in 49 (15.12 percent) patients, the right lower lobe in 23 patients (7.10 percent), and the left lower lobe and right middle lobe in 2 patients (0.62 percent). In 303 (93.52 percent) patients, the lesions were primarily peripheral and subpleural; and there were fewer lesions along the bronchovascular bundles. Two major patterns of SARS-CoV-2 lesions on CT images are GGO (ground - glass opacity) and consolidation. In 303 of the 324 patients (93.52 percent), CT showed single or multiple abnormal GGO or consolidation, or both. In the remaining 21 (6.48 percent) cases, neither GGO nor consolidation was observed on CT. Follow-up CT showed moderate or pronounced disease worsening in 12 out of 58 (20.69 percent) cases and follow-up CT showed improvement with the appearance of fibrosis and GGO resolution. CONCLUSIONS In conclusion, the use of a chest CT system in SARS-CoV-2 patients can accurately evaluate pneumonia. Most notably follow-up CT scans may help assess patients with SARS-CoV-2 pneumonia in their response to treatment. KEYWORDS SARS-CoV-2, Pneumonia, Chest Computed Tomography, Ground-Glass Opacities

scholarly journals Follow-up Chest CT findings from discharged patients with severe COVID-19: an 83-day observational study

2020 ◽  
Author(s):  
Tianhe Ye ◽  
Yanqing Fan ◽  
Jiacheng Liu ◽  
Chongtu Yang ◽  
Songjiang Huang ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Virus Disease ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Ct Scans ◽  
Ground Glass ◽  
Ct Findings ◽  
Lung Abnormalities ◽  
Discharged Patients

Abstract Background: Chest computed tomography (CT) has been used to be a monitoring measure to assess the severity of lung abnormalities in corona virus disease 19 (COVID-19). Up to date, there has been no reports about follow-up chest CT findings from discharge patients with severe COVID-19. This study aims to describe the change pattern of radiological abnormalities from admission, to discharge, and to the last chest CT follow-up through an 83-day retrospective observation, and focuses on follow-up chest CT findings in discharged patients with severe COVID-19.Methods: Twenty-nine discharged patients (17 males, 12 females; median age, 56 years, IQR, 47-67) confirmed with severe COVID-19 from 13 January to 15 February were enrolled in this study. A total of 80 chest CT scans was performed from admission to the last follow-up. Images were mainly evaluated for ground-glass opacity, consolidation, parenchymal bands, and crazy-paving pattern. A semi-quantitative CT scoring system was used for estimating lung abnormalities of each lobe.Results: All patients received nasal cannula or/and high-flow mask oxygen therapy. Admission occurred 9 days (IQR, 5-13) after symptom onset. The median in-hospital period was 18 days (IQR, 11-26). The last follow-up chest CT was performed 66 days (IQR, 61-77) after symptom onset. Total CT scores in follow-up decreased significantly compared to that of performed in-hospital ([3, IQR, 0-5] to [13, IQR, 10-16], P < 0.001). Predominant patterns on follow-up chest CT performed 64 days after symptom onset were subpleural parenchymal bands (47%, 9/19) and complete radiological resolution (37%, 7/19). Consolidation absorbed earlier than ground-glass opacity did, and subpleural parenchymal bands were the longest-lasting feature during radiological resolution.Conclusions: Radiological abnormalities in patients of severe COVID-19 could be completely absorbed with no residual lung injury in more than two months’ follow-up. Serial chest CT scans could be used as a monitoring modality to help clinician better understand the disease course.

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