CT imaging of two cases of one family cluster 2019 novel  coronavirus (2019-nCoV) pneumonia: inconsistency between  clinical symptoms amelioration and imaging sign progression

Background: During the COVID-19 pandemic, many patients admitted to hospital for treatment have recovered and been discharged; however, in some instances, these same patients are re-admitted due to a second fever or a positive COVID-19 PCR test result. To ascertain whether it is necessary to treat these patients in hospitals, especially in asymptomatic cases, we summarize and analyze the clinical and treatment characteristics of patients re-admitted to hospital with a second COVID-19 infection.Methods: Of the 141 COVID-19 cases admitted to the Wenzhou Central Hospital between January 17, 2020, to March 5, 2020, which were followed until March 30, 2020, 12 patients were re-admitted with a second COVID-19 infection. Data was collected and analyzed from their clinical records, lab indexes, commuted tomography (CT), and treatment strategies.Results: Most of the 141 patients had positive outcomes from treatment, with only 12 (8.5%) being re-admitted. In this sub-group: one (8.3%) had a fever, a high white blood cell count (WBC), and progressive CT changes; and one (8.3%) had increased transaminase. The PCR tests of these two patients returned negative results. Another 10 patients were admitted due to a positive PCR test result, seven of which were clinically asymptomatic. Compared to the CT imaging following their initial discharge, the CT imaging of all patients was significantly improved, and none required additional oxygen or mechanical ventilation during their second course of treatment.Conclusions: The prognoses of the re-admitted patients were good with no serious cases. We conclude that home treatment with concentrated medical observation is a safe and feasible course of treatment if the patient returns a positive PCR test result but does not display serious clinical symptoms. During medical observation, patients with underlying conditions should remain a primary focus, but most do not need to be re-admitted to the hospital.

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A false alarm of COVID-19 pneumonia in lung cancer: a case report of anti-PD-1 related pneumonitis and literature review

10.21203/rs.3.rs-41095/v1 ◽

2020 ◽

Author(s):

Ying Dai ◽

Sha Liu ◽

Zhiyan Zhao ◽

...

Keyword(s):

Lung Cancer ◽

Clinical Symptoms ◽

Close Contact ◽

Ct Imaging ◽

Chest Ct ◽

Radiographic Feature ◽

Rt Pcr ◽

Lung Lobe ◽

History Of ◽

Novel Coronavirus

Abstract Background: The fatal toxicity of anti-PD-1/PD-L1 agents is pneumonitis. The diagnosis consists of the history of immunotherapy, clinical symptoms and presentation of computed tomography (CT) imaging. The typical CT findings include ground-glass opacities. Based on the similar radiographic feature with 2019 Novel Coronavirus (COVID-19) pneumonia, clinicians are cautious to evaluate diagnosis especially in COVID-19 epidemic areas. Case presentation: Herein we report a 67-year-old male patient with advanced non-small cell lung cancer developed pneumonitis post Sintilimab injection. The dyspnea appeared at the 15th day of close contact with his son who returned from Wuhan, but not accompanied with fever. The chest CT indicated peripherally subpleural lattice opacities at the inferior right lung lobe and bilateral thoracic infusion. The real-time reverse-transcription polymerase-chain-reaction (RT-PCR) from double swab samples within 72 hours remained negative. The patient was thereafter treated with prednisolone and antibiotics for over two weeks. Thereafter the chest CT demonstrated the former lesion almost absorbed, in line with prominently falling CRP level. The anti-PD-1 related pneumonitis with bacterial infection was diagnosed finally based on the clinical evidence and good response to the prednisolone and antibiotics. Conclusion: Both ani-PD-1 related pneumonitis and COVID-19 pneumonia harbor the common clinical symptom and the varied features of CT imaging. Differential diagnosis was based on the epidemiological and immunotherapy histories, RT-PCR tests. The response to glucocorticoid can indirectly help the diagnosis.

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FaNet: fast assessment network for the novel coronavirus (COVID-19) pneumonia based on 3D CT imaging and clinical symptoms

Applied Intelligence ◽

10.1007/s10489-020-01965-0 ◽

2020 ◽

Author(s):

Zhenxing Huang ◽

Xinfeng Liu ◽

Rongpin Wang ◽

Mudan Zhang ◽

Xianchun Zeng ◽

...

Keyword(s):

Clinical Symptoms ◽

Ct Imaging ◽

The Novel ◽

3D Ct ◽

Novel Coronavirus ◽

3D Ct Imaging

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CT imaging research progress in 2019 novel coronavirus pneumonia

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405617666210816091217 ◽

2021 ◽

Vol 17 ◽

Author(s):

Zhi Yong Shen ◽

Xun Cheng Yan ◽

Xiao Dong You ◽

Xue Wen Zhang

Keyword(s):

Clinical Symptoms ◽

Disease Recurrence ◽

Ct Imaging ◽

Research Progress ◽

Imaging Examination ◽

The World ◽

Imaging Research ◽

Asymptomatic Infections ◽

One Year ◽

Novel Coronavirus

: The highly contagious novel coronavirus disease 2019 (COVID-19) broke out at the end of 2019 and has lasted for nearly one year, and the pandemic is still rampant around the world. The diagnosis of COVID-19 is on the basis of the combination of epidemiological history, clinical symptoms, and laboratory and imaging examinations. Among them, imaging examination is of importance in the diagnosis of patients with suspected clinical cases, the investigation of asymptomatic infections and family clustering, the judgment of patient recovery, rediagnosis after disease recurrence, and prognosis prediction. This article reviews the research progress of CT imaging examination in the COVID-19 pandemic.

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A false alarm of COVID-19 pneumonia in lung cancer with anti-PD-1 related pneumonitis: a case report and review of the literature

Journal of Medical Case Reports ◽

10.1186/s13256-020-02619-y ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Ying Dai ◽

Sha Liu ◽

Yiruo Zhang ◽

Xiaoqiu Li ◽

Zhiyan Zhao ◽

...

Keyword(s):

Lung Cancer ◽

Differential Diagnosis ◽

Clinical Symptoms ◽

Close Contact ◽

Ct Imaging ◽

Imaging Features ◽

Rt Pcr ◽

Lung Lobe ◽

Clinical Presentations ◽

Novel Coronavirus

Abstract Background Pneumonitis belongs to the fatal toxicities of anti-PD-1/PD-L1 treatments. Its diagnosis is based on immunotherapeutic histories, clinical symptoms, and the computed tomography (CT) imaging. The radiological features were typically ground-glass opacities, similar to CT presentation of 2019 Novel Coronavirus (COVID-19) pneumonia. Thus, clinicians are cautious in differential diagnosis especially in COVID-19 epidemic areas. Case presentation Herein, we report a 67-year-old Han Chinese male patient presenting with dyspnea and normal body temperature on the 15th day of close contact with his son, who returned from Wuhan. He was diagnosed as advanced non-small cell lung cancer and developed pneumonitis post Sintilimab injection during COIVD-19 pandemic period. The chest CT indicated peripherally subpleural lattice opacities at the inferior right lung lobe and bilateral thoracic effusion. The swab samples were taken twice within 72 hours and real-time reverse-transcription polymerase-chain-reaction (RT-PCR) results were COVID-19 negative. The patient was thereafter treated with prednisolone and antibiotics for over 2 weeks. The suspicious lesion has almost absorbed according to CT imaging, consistent with prominently falling CRP level. The anti-PD-1 related pneumonitis mixed with bacterial infection was clinically diagnosed based on the laboratory and radiological evidences and good response to the prednisolone and antibiotics. Conclusion The anti-PD-1 related pneumonitis and COVID-19 pneumonia possess similar clinical presentations and CT imaging features. Therefore, differential diagnosis depends on the epidemiological and immunotherapy histories, RT-PCR tests. The response to glucocorticoid is still controversial but helpful for the diagnosis.

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A Family Cluster of Severe Acute Respiratory Syndrome Coronavirus 2 Infections

10.21203/rs.3.rs-16921/v1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Xuesong Gao ◽

Zheng Yuan ◽

Di Yang ◽

Hongjie Li ◽

Yijin Zhang ◽

...

Keyword(s):

Severe Acute Respiratory Syndrome ◽

Clinical Symptoms ◽

Close Contact ◽

Hubei Province ◽

Adverse Outcomes ◽

Family Cluster ◽

High Flow Oxygen ◽

Novel Coronavirus ◽

Epidemiological Characteristics ◽

Beijing China

Abstract Background In December 2019, the outbreak of 2019 novel coronavirus disease (COVID-19) began in Wuhan, Hubei Province, China. The disease has rapidly spread from Wuhan to other provinces and other countries. Clinical and epidemiological knowledge is limited. We aimed to describe the clinical and epidemiological characteristics of a family cluster of COVID-19 in Beijing.Methods We reported a family cluster of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases in Beijing, China. We obtained and analyzed clinical and epidemiologic data from these patients. Throat swab samples were tested for SARS-CoV-2 using real-time reverse transcriptase-polymerase chain reaction assays.Results This family comprised three laboratory confirmed cases with clinical symptoms. All three patients had close contact with a relative from Wuhan, Hubei Province. Chest computerized tomography revealed ground-glass opacities and consolidation. Patient 1 was finally intubated and mechanical ventilated. Patient 2 received high-flow oxygen therapy. The clinical condition of Patient 3 has resolved.Conclusion SARS-CoV-2 infections tend to clusters. Advanced age and comorbidities are associated with adverse outcomes. Physicians should be aware of contact history so that infected patients can be identified promptly and further spreading prevented.

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Novel Coronavirus Disease (COVID-19): A Narrative Review Based on Current Status

Anti-Infective Agents ◽

10.2174/2211352518999201020202540 ◽

2020 ◽

Vol 18 ◽

Author(s):

Rina Das ◽

Dinesh Kumar Mehta ◽

Meenakshi Dhanawat

Keyword(s):

Severe Acute Respiratory Syndrome ◽

Clinical Symptoms ◽

Virus Disease ◽

Relevant Literature ◽

World Health ◽

Current Status ◽

Future Research ◽

Treatment And Prevention ◽

First Case ◽

Novel Coronavirus

Abstract:: A novel virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), appeared and expanded globally by the end of year in 2019 from Wuhan, China, causing severe acute respiratory syndrome. During its initial stage, the disease was called the novel coronavirus (2019-nCoV). It was named COVID-19 by the World Health Organization (WHO) on 11 February 2020. The WHO declared worldwide the SARS-CoV-2 virus a pandemic on March 2020. On 30 January 2020 the first case of Corona Virus Disease 2019 (COVID-19) was reported in India. Now in current situation the virus is floating in almost every part of the province and rest of the globe. -: On the basis of novel published evidences, we efficiently summarized the reported work with reference to COVID-19 epidemiology, pathogen, clinical symptoms, treatment and prevention. Using several worldwide electronic scientific databases such as Pubmed, Medline, Embase, Science direct, Scopus, etc were utilized for extensive investigation of relevant literature. -: This review is written in the hope of encouraging the people successfully with the key learning points from the underway efforts to perceive and manage SARS-CoV-2, suggesting sailent points for expanding future research.

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Pediatric COVID-19 and the Factors That May Mitigate Its Clinical Course

Journal of Child Science ◽

10.1055/s-0040-1717077 ◽

2020 ◽

Vol 10 (01) ◽

pp. e137-e140

Author(s):

Mosaad Abdel-Aziz ◽

Nada M. Abdel-Aziz ◽

Dina M. Abdel-Aziz ◽

Noha Azab

Keyword(s):

Clinical Features ◽

Clinical Symptoms ◽

Clinical Course ◽

Clinical Manifestations ◽

Gastrointestinal Symptoms ◽

Angiotensin Converting Enzyme 2 ◽

Compulsory Vaccination ◽

Specific Factors ◽

Novel Coronavirus ◽

Radiographic Data

AbstractThe clinical manifestations of novel coronavirus disease 2019 (COVID-19) vary from mild flu-like symptoms to severe fatal pneumonia. However, children with COVID-19 may be asymptomatic or may have mild clinical symptoms. The aim of this study was to investigate clinical features of pediatric COVID-19 and to search for the factors that may mitigate the disease course. We reviewed the literature to realize the clinical features, laboratory, and radiographic data that may be diagnostic for COVID-19 among children. Also, we studied the factors that may affect the clinical course of the disease. Fever, dry cough, and fatigue are the main symptoms of pediatric COVID-19, sometimes flu-like symptoms and/or gastrointestinal symptoms may be present. Although some infected children may be asymptomatic, a recent unusual hyperinflammatory reaction with overlapping features of Kawasaki's disease and toxic shock syndrome in pediatric COVID-19 has been occasionally reported. Severe acute respiratory syndrome-coronvirus-2 (SARS-CoV-2) nucleic acid testing is the corner-stone method for the diagnosis of COVID-19. Lymphocyte count and other inflammatory markers are not essentially diagnostic; however, chest computed tomography is highly specific. Factors that may mitigate the severity of pediatric COVID-19 are home confinement with limited children activity, trained immunity caused by compulsory vaccination, the response of the angiotensin-converting enzyme 2 receptors in children is not the same as in adults, and that children are less likely to have comorbidities. As infected children may be asymptomatic or may have only mild respiratory and/or gastrointestinal symptoms that might be missed, all children for families who have a member diagnosed with COVID-19 should be investigated.

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Remdesivir Treatment for COVID 19 in Pregnant Patients with Moderate to Severe Symptoms: Serial Case Report

Infectious Disease Reports ◽

10.3390/idr13020042 ◽

2021 ◽

Vol 13 (2) ◽

pp. 437-443

Author(s):

Yudianto Budi Saroyo ◽

Amanda Rumondang ◽

Irene Sinta Febriana ◽

Achmad Kemal Harzif ◽

Rima Irwinda

Keyword(s):

Adverse Effects ◽

Adverse Events ◽

Pregnant Women ◽

Clinical Symptoms ◽

Recovery Period ◽

Rapid Improvement ◽

Major Health Problem ◽

Hospitalization Period ◽

Duration Of Hospitalization ◽

Novel Coronavirus

Introduction: Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) infection that causes novel Coronavirus Disease 2019 (COVID-19) has become a major health problem worldwide and been declared a pandemic since March 2020 by WHO. One special population that poses a challenge is pregnant women with COVID-19. There have not been many studies related to COVID-19 in pregnancy. In this study, we present five serial cases of Remdesivir treatment for COVID-19 in pregnant women with moderate to severe symptoms. Case Illustration: We briefly describe five serial cases being treated with Remdesivir therapy during hospitalization. Four cases were delivered by cesarean section, and one was delivered vaginally in gestation week 37. All cases showed a shortened duration of hospitalization, rapid improvement in clinical symptoms, and no adverse events were observed in mothers, fetuses, and neonates. Discussion: Remdesivir, an inhibitor RNA Polymerase, has been used in COVID-19 treatment and is known to shorten recovery time in nonpregnant women. Some studies have shown no adverse effects on Remdesivir for pregnant women. Based on randomized control trial (RCT) during the Ebola epidemic, Remdesivir was safe to use for pregnant women. All cases showed reduced hospitalization time and better clinical outcomes without maternal, fetal, or neonatal adverse events. Conclusion: Remdesivir protocol for pregnant women with moderate to severe symptoms of COVID-19 has resulted in better clinical improvement with a shorter recovery period and no adverse effects during the hospitalization period. Further studies and RCT are warranted to evaluate the biosafety and effects of Remdesivir in pregnant women.

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ESTIMATION OF SARS-COV-2 SPECIFIC ANTIBODIES SEROPREVALENCE IN HEALTHCARE WORKERS IN DISTRICT UDAIPUR, INDIA

10.36106/ijar/8102221 ◽

2021 ◽

pp. 61-63

Author(s):

Shelesh Kumar Swami ◽

Nitesh Kumar Chauhan ◽

Shuchi Goyal ◽

A.K. Verma ◽

Shweta Biyani

Keyword(s):

Healthcare Workers ◽

Clinical Symptoms ◽

Control Measures ◽

Rt Pcr ◽

High Seroprevalence ◽

Know How ◽

Novel Coronavirus ◽

And Control ◽

Infection Eradication ◽

Cumulative Prevalence

Background:Current pandemic caused by Novel coronavirus (COVID-19) causes clinical symptoms from fever to acute respiratory distress syndrome but may remain mild or asymptomatic. To evaluate the cumulative prevalence of SARSCoV-2 infection in a community and know how immune response develops in the population, reliable assay alongwith RT-PCR for detection of SARS-CoV 2 antibodies is needed. Healthcare workers (HCWs) represent a high-risk populat - ion for infection with SARS-CoV-2. Methods: We evaluated total antibodies recognizing the SARS CoV 2 receptor binding domain (S1-RBD) - - - or the Spike protein over a period of six months in a total of 310 healthcare workers engaged in hospital using SARS-CoV-2 Total antibody assay kit. Findings: The overall seroprevalence found in our analysis was 41.93%. In case of males the percentage positive was found to be signicantly higher at 43.91%, compared to females at 36.25%. Seroprevalence was signicantly higher in 50 years above age group in comparison to 20-50 years old aged healthcare workers. The seroprevalence was higher in doctors, nursing staff and lab technicians than other healthcare professionals as 44.6%. Conclusions: This study showed high seroprevalence of SARS-CoV-2 in healthcare workers which means remaining proportion of the healthcare workers are still susceptible to the infection. Good compliance to infection eradication and control measures, adequate PPEs, and early detection and isolation of healthcare workers infected with SARS-CoV-2 are mandatory to reduce the risk of SARS-CoV-2 infection.

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