scholarly journals Chest CT-based differential diagnosis of 28 patients with suspected corona virus disease 2019 (COVID-19)

2020 ◽  
Vol 93 (1112) ◽  
pp. 20200243 ◽  
Author(s):  
Sidong Xie ◽  
Ziying Lei ◽  
Xiuzhen Chen ◽  
Weimin Liu ◽  
Xiaohong Wang ◽  
...  
Keyword(s):  
Virus Disease ◽  
Laboratory Data ◽  
Chest Ct ◽  
Imaging Findings ◽  
Negative Results ◽  
Ct Findings ◽  
Corona Virus ◽  
Mixed Ground ◽  
Bilateral Lung ◽  
Interlobular Septal Thickening

Objectives: The chest CT findings that can distinguish patients with corona virus disease 2019 (COVID-19) from those with clinically suspected COVID-19 but subsequently found to be COVID-19 negative have not previously been described in detail. The purpose of this study was to determine the distinctions among patients with COVID-19 by comparing the imaging findings of patients with suspected confirmed COVID-19 and those of patients initially suspected to have COVID-19 who were ultimately negative for the disease. Methods: 28 isolated suspected in-patients with COVID-19 were enrolled in this retrospective study from January 22, 2020 to February 6, 2020. 12 patients were confirmed to have positive severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) RNA results, and 16 patients had negative results. The thin-section CT imaging findings and clinical and laboratory data of all the patients were evaluated. Results: There were no significant differences between the 12 confirmed COVID-19 (SARS-Cov-2-positive) patients and 16 SARS-CoV-2-negative patients in epidemiology and most of the clinical features or laboratory data. The CT images showed that the incidence of pure/mixed ground-glass opacities (GGOs) was not different between COVID-19 and SARS-CoV-2-negative patients [9/12 (75.0%) vs 10/16 (62.5%), p = 0.687], but pure/mixed GGOs in the peripheral were more common in patients with COVID-19 [11/12 (91.7%) vs 6/16 (37.5%), p = 0.006]. There were no significant differences in the number of lesions, bilateral lung involvement, large irregular/patchy opacities, rounded opacities, linear opacities, crazy-paving patterns, halo signs, interlobular septal thickening or air bronchograms. Conclusions: Although peripheral pure/mixed GGOs on CT may help distinguish patients with COVID-19 from clinically suspected but negative patients, CT cannot replace RT-PCR testing. Advances in knowledge: Peripheral pure/mixed GGOs on-chest CT findings can be helpful in distinguishing patients with COVID-19 from those with clinically suspected COVID-19 but subsequently found to be COVID-19 negative.

scholarly journals COVID-19 pneumonia: The first two chest CTs in the Bamrasnaradura Infectious Disease Institute

2020 ◽  
pp. 69-81
Author(s):  
Panyaros Kongpanya ◽  
Parichut Vongthawatchai ◽  
Priyanut Atiburanakul ◽  
Nayot Panitanum ◽  
Patama Suttha
Keyword(s):  
Infectious Disease ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Lung Involvement ◽  
Chest Computed Tomography ◽  
Ct Findings ◽  
Infectious Disease Institute ◽  
The World ◽  
Bilateral Lung ◽  
Interlobular Septal Thickening

Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to spread rapidly around the world. We reported the first two cases of COVID-19 pneumonia who had the chest computed tomography (CT) performed at the Bamrasnaradura Infectious Disease Institute (BIDI). The chest CT findings in the two patients with COVID-19 pneumonia showed bilateral lung involvement, multifocal involvement, peripheral distribution, ground glass opacity (GGO), consolidation and GGO with interlobular septal thickening (“crazy-paving” pattern). The chest CT findings in these patients are nonspecific and overlapped with other diseases.

scholarly journals COVID-19 pneumonia: The first two chest CTs in the Bamrasnaradura Infectious Disease Institute

2020 ◽  
Vol 21 (2) ◽  
pp. 69-81
Author(s):  
Panyaros Kongpanya ◽  
Parichut Vongthawatchai ◽  
Priyanut Atiburanakul ◽  
Nayot Panitanum ◽  
Patama Suttha
Keyword(s):  
Infectious Disease ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Lung Involvement ◽  
Chest Computed Tomography ◽  
Ct Findings ◽  
Infectious Disease Institute ◽  
The World ◽  
Bilateral Lung ◽  
Interlobular Septal Thickening

Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to spread rapidly around the world. We reported the first two cases of COVID-19 pneumonia who had the chest computed tomography (CT) performed at the Bamrasnaradura Infectious Disease Institute (BIDI). The chest CT findings in the two patients with COVID-19 pneumonia showed bilateral lung involvement, multifocal involvement, peripheral distribution, ground glass opacity (GGO), consolidation and GGOwith interlobular septal thickening (“crazy-paving” pattern). The chest CT findings in these patients are nonspecific and overlapped with other diseases.

scholarly journals The association between clinical laboratory data and chest CT findings explains disease severity in a large Italian cohort of COVID-19 patients

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.

scholarly journals CT findings of 795 COVID-19 positive cases: a multicenter study in Egypt

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Youssriah Yahia Sabri ◽  
Mohamed Mohsen Tolba Fawzi ◽  
Eman Zaki Nossair ◽  
Safaa Mohamed El-Mandooh ◽  
Amira Aly Hegazy ◽  
...  
Keyword(s):  
Virus Disease ◽  
Chest Ct ◽  
Imaging Features ◽  
Rt Pcr ◽  
Relevant Research ◽  
Non Invasive ◽  
Ct Findings ◽  
Global Pandemic ◽  
Polymerase Chain ◽  
Ct Studies

Abstract Background Corona Virus Disease 2019 (COVID-19) outbreak was officially announced as a global pandemic by the WHO on March 11th 2020. Thorough understanding of CT imaging features of COVID-19 is essential for effective patient management; rationalizing the need for relevant research. The aim of this study was to analyze the chest CT findings of patients with real-time polymerase chain reaction (RT-PCR) proved COVID-19 admitted to four Egyptian hospitals. The recently published RSNA expert consensus statement on reporting COVID-19 chest CT findings was taken into consideration. Results Normal CT “negative for COVID-19” was reported in 26.1% of our RT-PCR proved COVID-19 cases. In descending order of prevalence, imaging findings of the positive CT studies (73.9%) included GGO (69%), consolidation (49.7%), crazy paving (15.4%), and peri-lobular fibrosis (40.6%). These showed a dominantly bilateral (68.2%), peripheral (72.4%), and patchy (64.7%) distribution. Remarkably, thymic hyperplasia was identified in 14.3% of studies. According to the RSNA consensus, CT findings were classified as typical in 68.9%, indeterminate in 3.6%, and atypical in 1.4% of the evaluated CT studies. Conclusion Although COVID-19 cannot be entirely excluded by chest CT, it can be distinguished in more than two-thirds of cases; making CT a widely available, non-invasive, and rapid diagnostic tool.

Study on the Dynamic Changes in Chest CT Findings of COVID-19 Rehabilitated Patients

2020 ◽  
pp. 1-7
Keyword(s):  
Disease Progression ◽  
Onset Time ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Ground Glass ◽  
Dynamic Changes ◽  
Course Of Disease ◽  
Pleural Thickening ◽  
Ct Findings ◽  
Interlobular Septal Thickening

Objective: To study the dynamic changes in CT findings in COVID-19 (coronavirus disease-19, COVID-19) rehabilitated patients. Methods: A total of 148 chest CT images of 37 patients with COVID-19 were collected. In the first 21 days of the course of disease, 7 stages were performed every 3 days, and the eighth stage was performed after 21 days. Results: In the first chest CT examination, 19 cases were ground glass opacity, and 18 cases were high-density shadows with consolidation. The lesion shape was flaky and patchy in 33 cases. The percentage of consolidation, air bronchogram, fiber cord, interlobular septal thickening, subpleural line and pleural thickening were the highest on days 4-6, 7-9, 7-9, 10-12, 19-21 and 19-21, respectively. The highest percentage of disease progression was 80.00% on days 4-6, and then the percentage of disease progression gradually decreased with the extension of the onset time. The percentage of patients with improvement gradually increased from days 4-6, reaching 83.33% on days 16-18 and 100.00% on day 21. The percentage of lesion range enlargement and density increase was the highest on days 4-6, both of which were 60.00%，Then the percentage of both decreased gradually. The percentage of patients with lesion range reduction and density absorption dilution increased gradually with the onset time. There was no obvious regularity in the number of lesions. Conclusion: Patients with COVID-19 have regular changes in their lung conditions.

scholarly journals COVID-19 pneumonia: a pictorial review of CT findings and differential diagnosis

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Fattane Shirani ◽  
Azin Shayganfar ◽  
Somayeh Hajiahmadi
Keyword(s):  
Differential Diagnosis ◽  
Ct Scan ◽  
Screening Tool ◽  
False Negative ◽  
Imaging Findings ◽  
Rt Pcr ◽  
Negative Results ◽  
Ct Findings ◽  
Pictorial Review ◽  
False Negative Results

Abstract Background The gold standard for verifying COVID-19 mostly depends on microbiological tests like real-time polymerase chain reaction (RT-PCR). However, the availability of RT-PCR kits can be known as a problem and false negative results may be encountered. Although CT scan is not a screening tool for the diagnosis of COVID-19 pneumonia, given the widespread acquisition of it in the pandemic state, familiarity with different CT findings and possible differential diagnosis is essential in this regard. Main text In this review, we introduced the typical and atypical CT features of COVID-19 pneumonia, and discussed the main differential diagnosis of COVID-19 pneumonia. Conclusions The imaging findings in this viral pneumonia showed a broad spectrum, and there are no pathognomonic imaging findings for COVID-19 pneumonia. Although CT scan is not a diagnostic and screening tool, familiarity with different imaging findings and their differential diagnosis can be helpful in a rapid and accurate decision-making.

scholarly journals A multicentric observational study of imaging findings in COVID-19-related rhino-orbito-cerebral mucormycosis: a new Pandora’s box

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Annu Singhal ◽  
Shikha Jain ◽  
Swati Sharma ◽  
Vivek Cherumanalil Kottiyath ◽  
Girish Khandelwal
Keyword(s):  
Fungal Infection ◽  
Virus Disease ◽  
Infratemporal Fossa ◽  
Common Finding ◽  
High Morbidity ◽  
Imaging Findings ◽  
Oxygen Inhalation ◽  
Corona Virus ◽  
Sinus Wall ◽  
Mucosal Thickening

Abstract Background There is a sudden rise of fungal infection with corona virus disease. This is attributed to the immunomodulation by the disease and the drugs used, diabetes mellitus, steroid use, oxygen inhalation using dirty water, use of zinc and iron supplements, etc. Early diagnosis and prompt medical and surgical intervention is the mainstay of treatment. This can greatly reduce the high morbidity and mortality associated with this disease. The objective of the study is to describe the imaging findings of acute invasive rhino-orbito-cerebral mucormycosis (ROCM) in 25 patients with severe acute respiratory syndrome corona virus 2, from three different centers with proven mucormycosis. Special emphasis is placed on the signal enhancement patterns of sinonasal mucosa, the earliest and most common findings. Statistical analysis was performed using descriptive statistics. Results Computed tomography (CT) and magnetic resonance imaging (MRI) of 25 patients showed most commonly involved sinuses as maxillary and ethmoid sinuses (19, 76%) together. Sino-nasal mucosal thickening was the most common finding (24, 96%). Periantral infiltration (18, 72%) preceded before orbital (15, 60%), cerebral (5, 20%) and vascular (2, 8%) complications, with grossly intact bones. Sinus wall erosions were seen in only 2 patients (8%). Palatal (22%) and maxillary alveolar arch erosion (39%) were frequent findings. CT showed minimally enhancing hypodense soft tissue thickening as the predominant finding in involved areas, while MRI showed T1 and T2 iso- to hypointense mucosal thickening (62%) and intense (43%) and no (33%) contrast enhancement as the main finding. Conclusions Contrast enhanced MRI is better at demonstrating early mucosal abnormalities, turbinate necrosis, non-enhancing devitalized tissues, orbital apex involvement and intra-cerebral extension. Imaging findings of inflammatory tissue infiltration adjacent to the paranasal sinuses in premaxillary, retroantral fat, facial muscles, pterygopalatine fossa, temporal, infratemporal fossa and extraconal orbital fat along with typical patterns of sinonasal mucosal enhancement should raise the suspicion of acute invasive fungal etiology given the short duration of history and immunocompromised status. High incidence of periantral and orbital extension of the disease is suggestive of acute invasive form of fungal infection. Also the rapidly progressive inflammatory changes without much bone involvement should suggest the suspicion of ROCM. Bony, cerebral and vascular involvements are relatively late complications.

scholarly journals Analysis of SARS-CoV-2 PCR and Chest CT Findings at a Single Facility in Tokyo (Machida Municipal Hospital)

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Taisuke Kazuyori ◽  
Akihito Sato ◽  
Yasuhiro Morimoto ◽  
Kazuyoshi Kuwano
Keyword(s):  
Chest Ct ◽  
Background Characteristics ◽  
Rt Pcr ◽  
Important Indicator ◽  
Negative Results ◽  
Ct Findings ◽  
Positive Rate ◽  
Polymerase Chain ◽  
The City ◽  
Positive Results

Introduction. The SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) test is useful for diagnosing COVID-19, and the RT-PCR positive rate is an important indicator for estimating the incidence rate and number of infections. COVID-19 pneumonia is also associated with characteristic findings on chest CT, which can aid in diagnosis. Methods. We retrospectively evaluated patient background characteristics, the number of cases, the positivity rate, and chest CT findings for positive and negative cases in 672 patients who underwent RT-PCR for suspected COVID-19 at our hospital between April 3 and August 28, 2020. In addition, we compared trends in the positive rates at approximately weekly intervals with trends in the number of new infections in Machida City, Tokyo. Results. The study included 323 men and 349 women, with a median age of 46 years (range: 1 month–100 years). RT-PCR findings were positive in 37 cases, and the positive rate was 5.51%. Trends in the positive rate at our hospital and the number of new COVID-19 cases in the city were similar during the study period. Among patients with positive results, 15 (40.5%) had chest CT findings, and 14 had bilateral homogeneous GGOs. Among patients with negative results, 190 had chest CT findings at the time of examination, and 150 were diagnosed with bacterial pneumonia or bronchitis, with main findings consisting of consolidations and centrilobular opacities. Only 11 of these patients exhibited bilateral homogeneous GGOs. Conclusion. Bilateral homogeneous GGOs are characteristic of COVID-19 pneumonia and may aid in the diagnosis of COVID-19.

scholarly journals Clinical course and characteristics of Corona Virus Disease 2019 in Xiaoshan, Hangzhou: A Retrospective study

2020 ◽  
Author(s):  
Fenhua Lai ◽  
Yongtao Zheng ◽  
Hexiang Jia ◽  
Fuliang Wang ◽  
Xiangjue Sun ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Virus Disease ◽  
Descriptive Analysis ◽  
Laboratory Data ◽  
Scientific Basis ◽  
World Health ◽  
P Value ◽  
Chi Square ◽  
Course Of Disease ◽  
Corona Virus

Abstract Background: The World Health Organization declared the outbreak a public health emergency of international concern (Corona Virus Disease 2019) on January 30th, this study aimed to investigate the epidemiological and clinical characteristics of Corona Virus Disease 2019 in Xiaoshan, Hangzhou, and evaluate scientific basis for disease control and prevention. Methods: A total of 30 patients had been admitted to hospital from Jan 22 to Feb 22, 2020, all of them were laboratory confirmed SARS-Cov-2. Demographic, epidemiological, clinical, laboratory data were collected from Hospital information system and Epidemiological investigation reports. All data was performed by descriptive analysis, Chi-square test or non-parametric Mann-Whitney U test, as appropriate. Two sided p value less than 0.05 was considered statistically significant.Results: 30 patients were enrolled, the median age was 44.5 years (IQR 33.8-52.3) and 17 (56.7%) patients were female, 14 (46.7%) patients were native and had no exposure to Hubei Province. At the time of study submission, only one patient had not been discharged and no patients died during the study. The median hospital stay was 16.0 days (IQR 12.5-20.5) and the median course of disease was 20.5 days (IQR 17.0-23.3). The most common symptoms were fever (66.7%), dry cough (26.7%), and pharyngalgia (23.3%) on first admission. Most patients were generally illness or more mild, but 10 (33.3%) patients received oxygen therapy and 14 (46.7%) patients received hormone therapy during their hospitalization. Almost half of patients showed mild lymphocytopenia and 40% patients had elevated concentrations of CRP in the early stages of COVID-19.Conclusions: Among the 30 patients were confirmed with SARA-Cov-2 infection in Xiaoshan, Hangzhou, most of them had clinical presentation of respiratory tract infection, but the median course of disease was more than 2 weeks. Further systematic prospective studies about COVID-19 should be urgently needed.

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