CT Imaging Changes of Corona Virus Disease 2019 (COVID-19): A multi-center study in Southwest China

Abstract Background: Since the first case of a coronavirus disease 2019 (COVID-19) infection pneumonia was detected in Wuhan, China, a series of confirmed cases of the COVID-19 were found in Southwest China. The aim of this study was to describe the imaging manifestations of hospitalized patients with confirmed COVID-19 infection in southwest China. Methods: In this retrospective study, data were collected from 131 patients with confirmed coronavirus disease 2019 (COVID-19) from 3 Chinese hospitals. Their common clinical manifestations, as well as characteristics and evolvement features of chest CT images, were analyzed. Results: A total of 100 (76%) patients had a history of close contact with people living in Wuhan , Hubei. The clinical manifestations of COVID-19 included cough, fever. Most of the lesions identified in chest CT images were multiple lesions of bilateral lungs, lesions were more localized in the peripheral lung, 109 (83%) patients had more than two lobes involved, 20 (15%) patients presented with patchy ground glass opacities, patchy ground glass opacities and consolidation of lesions co-existing in 61 (47%) cases. Complications such as pleural thickening, hydrothorax, pericardial effusion, and enlarged mediastinal lymph nodes were detected but only in rare cases. For the follow-up chest CT examinations (91 cases), We found 66 (73%) cases changed very quickly, with an average of 3.5 days, 25 cases (27%) presented absorbed lesions, progression was observed in 41 cases (46%), 25 (27%) cases showed no significant changes. Conclusion: Chest CT plays an important role in diagnosing COVID-19. The imaging pattern of multifocal peripheral ground glass or mixed consolidation is highly suspicious of COVID-19, that can quickly change over a short period of time.

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

Journal of Cardiology Research ◽

10.36879/jcr.20.000132 ◽

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.

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Deep Transfer Learning Pipelines with Apache Spark and Keras TensorFlow combined with Logistic Regression to Detect COVID-19 in Chest CT Images

Walailak Journal of Science and Technology (WJST) ◽

10.48048/wjst.2021.13109 ◽

2021 ◽

Vol 18 (11) ◽

Author(s):

Houssam BENBRAHIM ◽

Hanaa HACHIMI ◽

Aouatif AMINE

Keyword(s):

Neural Network ◽

Logistic Regression ◽

Convolutional Neural Network ◽

Transfer Learning ◽

Virus Disease ◽

Ct Images ◽

Chest Ct ◽

Apache Spark ◽

Difficult Situation ◽

Novel Coronavirus

The SARS-CoV-2 (COVID-19) has propagated rapidly around the world, and it became a global pandemic. It has generated a catastrophic effect on public health. Thus, it is crucial to discover positive cases as early as possible to treat touched patients fastly. Chest CT is one of the methods that play a significant role in diagnosing 2019-nCoV acute respiratory disease. The implementation of advanced deep learning techniques combined with radiological imaging can be helpful for the precise detection of the novel coronavirus. It can also be assistive to surmount the difficult situation of the lack of medical skills and specialized doctors in remote regions. This paper presented Deep Transfer Learning Pipelines with Apache Spark and KerasTensorFlow combined with the Logistic Regression algorithm for automatic COVID-19 detection in chest CT images, using Convolutional Neural Network (CNN) based models VGG16, VGG19, and Xception. Our model produced a classification accuracy of 85.64, 84.25, and 82.87 %, respectively, for VGG16, VGG19, and Xception. HIGHLIGHTS Deep Transfer Learning Pipelines with Apache Spark and Keras TensorFlow combined with Logistic Regression using CT images to screen for Corona Virus Disease (COVID-19) Automatic detection of COVID-19 in chest CT images Convolutional Neural Network (CNN) based models VGG16, VGG19, and Xception to predict COVID-19 in Computed Tomography image GRAPHICAL ABSTRACT

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An Outbreak of Epidemic Keratoconjunctivitis Caused by Human Adenovirus Type 8 in Primary School, Southwest China

10.21203/rs.2.514/v4 ◽

2019 ◽

Author(s):

Duo Li ◽

Jie-Nan Zhou ◽

Hong Li ◽

Cun-Ying He ◽

Qing-Shan Dai ◽

...

Keyword(s):

Risk Factors ◽

Primary School ◽

Primary Schools ◽

Southwest China ◽

Close Contact ◽

Clinical Manifestations ◽

Epidemic Keratoconjunctivitis ◽

Blurred Vision ◽

Epidemiological Characteristics ◽

Acute Conjunctivitis

Abstract Background: Two outbreaks of epidemic keratoconjunctivitis (EKC) occurred successively with an interval of five days in two primary boarding schools in Weixi Lisu Autonomous County, Diqing, and Tibetan Autonomous Prefecture, Yunnan. The aims of this study were to determine the intensity and characteristics of the outbreaks, as well as the clinical manifestations in the patients, the risk factors for infection and the pathogen responsible for the two outbreaks. Methods: An outbreak investigation was conducted in two primary schools, and a case-control study including patients from the Weixi County Ethnic Primary School was performed. Relevant specimens were collected according to the case definition, and next-generation sequencing was employed to identify the pathogen. An epidemiological investigation method was used to analyse the related epidemiological characteristics, such as risk factors. The phylogenetic tree was constructed by MEGA 7.0. Results: A total of 331 acute conjunctivitis cases, including probable cases of EKC, were reported in the two schools, and the attack rates were 30.59% (171/559, 95%CI: 26.76-34.42) and 20.41% (160/784, 95%CI: 17.58-23.24), respectively. Cases occurred in all grades and classes in both schools, and only one staff member in each school presented illness. The epidemics lasted for 54 days and 45 days, respectively. The patients had typical manifestations of EKC, such as acute onset, follicular hyperplasia, pseudomembrane formation, preauricular lymphadenopathy, corneal involvement and blurred vision, and a relatively long disease course (average 9.40 days, longest 23 days and shortest 7 days). The risk factor for infection was close contact with a patient or personal items contaminated by a patient. The pathogen responsible for the outbreaks was HAdV-8. The virus was highly similar to the 2016 HAdV-8 strain from Tibet, China. Conclusions: This study strongly suggests that HAdV-8 could lead to serious consequences. This is the second report of a HAdV-8-associated EKC outbreak in mainland China. Tibetan HAdV-8 might be circulating in southwest China; therefore, it is necessary to monitor the pathogens causing acute conjunctivitis in this area.

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An Outbreak of Epidemic Keratoconjunctivitis Caused by Human Adenovirus Type 8 in Primary School, Southwest China

10.21203/rs.2.514/v5 ◽

2019 ◽

Author(s):

Duo Li ◽

Jie-Nan Zhou ◽

Hong Li ◽

Cun-Ying He ◽

Qing-Shan Dai ◽

...

Keyword(s):

Risk Factors ◽

Primary School ◽

Primary Schools ◽

Southwest China ◽

Close Contact ◽

Clinical Manifestations ◽

Epidemic Keratoconjunctivitis ◽

Blurred Vision ◽

Epidemiological Characteristics ◽

Acute Conjunctivitis

Abstract Background: Two outbreaks of epidemic keratoconjunctivitis (EKC) occurred successively with an interval of five days in two primary boarding schools in Weixi Lisu Autonomous County, Diqing, and Tibetan Autonomous Prefecture, Yunnan. The aims of this study were to determine the intensity and characteristics of the outbreaks, as well as the clinical manifestations in the patients, the risk factors for infection and the pathogen responsible for the two outbreaks. Methods: An outbreak investigation was conducted in two primary schools, and a case-control study including patients from the Weixi County Ethnic Primary School was performed. Relevant specimens were collected according to the case definition, and next-generation sequencing was employed to identify the pathogen. An epidemiological investigation method was used to analyse the related epidemiological characteristics, such as risk factors. The phylogenetic tree was constructed by MEGA 7.0. Results: A total of 331 acute conjunctivitis cases, including probable cases of EKC, were reported in the two schools, and the attack rates were 30.59% (171/559, 95%CI: 26.76-34.42) and 20.41% (160/784, 95%CI: 17.58-23.24), respectively. Cases occurred in all grades and classes in both schools, and only one staff member in each school presented illness. The epidemics lasted for 54 days and 45 days, respectively. The patients had typical manifestations of EKC, such as acute onset, follicular hyperplasia, pseudomembrane formation, preauricular lymphadenopathy, corneal involvement and blurred vision, and a relatively long disease course (average 9.40 days, longest 23 days and shortest 7 days). The risk factor for infection was close contact with a patient or personal items contaminated by a patient. The pathogen responsible for the outbreaks was HAdV-8. The virus was highly similar to the 2016 HAdV-8 strain from Tibet, China. Conclusions: This study strongly suggests that HAdV-8 could lead to serious consequences. This is the second report of a HAdV-8-associated EKC outbreak in mainland China. Tibetan HAdV-8 might be circulating in southwest China; therefore, it is necessary to monitor the pathogens causing acute conjunctivitis in this area.

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What is the Role of Chest CT Scan for Pediatric Patient Diagnosis of COVID-19?

10.21203/rs.3.rs-35415/v1 ◽

2020 ◽

Author(s):

Yaqin Zhang ◽

Guangming Li ◽

Hongsheng Liu ◽

Binghui Chen ◽

Zeyu Cai ◽

...

Keyword(s):

Pediatric Patients ◽

Virus Disease ◽

Close Contact ◽

Ground Glass ◽

Imaging Features ◽

Illness Onset ◽

Significant Difference ◽

Line Test

Abstract Objectives To retrospectively analyze the CT imaging features and patterns at baseline and as they evolve with time as the disease progresses or resolves in a cohort of pediatric patients affected with 2019 corona virus disease (COVID-19) pneumonia from three different cities in China.Methods We evaluated 29 pediatric patients with COVID-19 in the authors’ institution from Jan 1 to Feb 20, 2020. Cases were confirmed by laboratory test and were analyzed for epidemiological, demographic, clinical, radiological features and patterns.Results 29 initial scans and 23 follow-up scans were obtained from 29 patients. 15(52%) patients had been to Hubei Province and 26 (90%) of them had close contact with the COVID-19 positive patients in 14 days prior to the illness onset. The peak severity time was 5-8 days after symptom onset. A significant difference between the number of involved segments at different time points was indicated (p=0.019). Half (52%) of the laboratory confirmed patients had no CT positive findings. Nine (31%) of the laboratory confirmed patients had no symptoms. Six (21%) had no CT positive findings nor symptoms. All the patients of one center(n=6) whose fecal samples remained positive after the respiratory samples became negative.Conclusion The common positive CT findings included ground-glass opacities (50%), ground-glass opacities mixed with consolidation (36%), peribronchial thickening (21%), and consolidations (14%). We recommend for pediatric patients CT should not be used as a first-line test to diagnose COVID-19.

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Early clinical and CT features of COVID-19 and community-acquired pneumonia from a fever observation ward in Ningbo, China

Singapore Medical Journal ◽

10.11622/smedj.2021004 ◽

2021 ◽

Author(s):

G Qian ◽

Y Lin ◽

AHY Ma ◽

X Zhang ◽

G Li ◽

...

Keyword(s):

Early Stage ◽

Laboratory Data ◽

Clinical Manifestations ◽

Lower Lobe ◽

Ground Glass Opacity ◽

Ct Images ◽

Community Acquired Pneumonia ◽

Ground Glass ◽

Significant Difference ◽

Eosinophil Counts

Introduction: We aimed to compare the early clinical manifestations, laboratory results and chest computed tomography (CT) images of coronavirus disease 2019 (COVID-19) patients with those of other community-acquired pneumonia (CAP) patients to differentiate COVID-19 before reverse transcription-polymerase chain reaction results are obtained. Methods: The clinical and laboratory data and chest CT images of 51 patients were assessed in a fever observation ward for evidence of COVID-19 between January and February 2020. Results: 24 patients had laboratory-confirmed COVID-19, whereas 27 individuals had negative results. No statistical difference in clinical features was found between COVID-19 and CAP patients except for diarrhoea. There was a significant difference in lymphocyte and eosinophil counts between COVID-19 and CAP patients. 22 (91.67%) COVID-19 patients had bilateral involvement and multiple lesions according to their lung CT images; the left lower lobe (87.50%) and right lower lobe (95.83%) were most often affected, and all lesions were located in peripheral zones of the lung. The most common CT feature of COVID-19 was ground-glass opacity, found in 95.83% of patients, compared to 66.67% of CAP patients. Conclusion: Diarrhoea, lymphocyte counts, eosinophil counts and CT findings (e.g. ground-glass opacity) could help to distinguish COVID-19 from CAP at an early stage of infection, based on findings from our fever observation ward.

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Different Appearance of Chest CT Images of T2DM and NDM Patients with COVID-19 Pneumonia Based on an Artificial Intelligent Quantitative Method

International Journal of Endocrinology ◽

10.1155/2021/6616069 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Shan Lu ◽

Zhiheng Xing ◽

Shiyu Zhao ◽

Xianglu Meng ◽

Juhong Yang ◽

...

Keyword(s):

Artificial Intelligence ◽

Diabetes Mellitus ◽

Blood Glucose ◽

Quantitative Method ◽

Ct Images ◽

Chest Ct ◽

Ground Glass ◽

Patients With Diabetes ◽

Group A ◽

Group B

COVID-19 is a kind of pneumonia with new coronavirus infection, and the risk of death in COVID-19 patients with diabetes is four times higher than that in healthy people. It is unclear whether there is a difference in chest CT images between type 2 diabetes mellitus (T2DM) and non-diabetes mellitus (NDM) COVID-19 patients. The aim of this study was to investigate the differences in chest CT images between T2DM and NDM patients with COVID-19 based on a quantitative method of artificial intelligence. A total of 62 patients with COVID-19 pneumonia were retrospectively enrolled and divided into group A (T2DM COVID-19 pneumonia group, n = 15) and group B (NDM COVID-19 pneumonia group, n = 47). The clinical and laboratory examination information of the two groups was collected. Quantitative features (volume of consolidation shadows and ground glass shadows, proportion of consolidation shadow (or ground glass shadow) to lobe volume, total volume, total proportion, and number) of chest spiral CT images were extracted using Dr. Wise @Pneumonia software. The results showed that among the 26 CT image features, the total volume and proportion of bilateral pulmonary consolidation shadow in group A were larger than those in group B ( P = 0.031 and 0.019, respectively); there was no significant difference in the total volume and proportion of bilateral pulmonary ground glass density shadow between the two groups ( P > 0.05 ). In group A, the blood glucose level was correlated with the volume of consolidation shadow and the proportion of consolidation shadow to right middle lobe volume, and higher than those patients in group B. In conclusion, the inflammatory exudation in the lung of COVID-19 patients with diabetes is more serious than that of patients without diabetes based on the quantitative method of artificial intelligence. Moreover, the blood glucose level is positively correlated with pulmonary inflammatory exudation in COVID-19 patients.

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Outcome of Pulmonary Spherical Ground-glass Opacities on Ct in Patients With Coronavirus Disease 2019 (Covid-19): A Retrospective Analysis

10.21203/rs.3.rs-30665/v1 ◽

2020 ◽

Author(s):

Wangjia Li ◽

Liangbo Hu ◽

Junhao Huang ◽

Fajin Lv ◽

Binjie Fu ◽

...

Keyword(s):

Retrospective Study ◽

Ct Scan ◽

Retrospective Analysis ◽

Ct Images ◽

Chest Ct ◽

Ground Glass ◽

Direct Absorption ◽

Simultaneous Decrease ◽

Chest Ct Scan

Abstract Background: Pulmonary spherical ground-glass opacities (GGOs) are commonly detected on initial chest CT scan in patients with coronavirus disease 2019 (COVID-19).We aimed to investigate the evolution of spherical GGOs to better understand their clinical significance.Materials and Methods:A retrospective study of 33 consecutive patients with confirmed COVID-19 and pulmonary spherical GGOs was performed from January 21, 2020, to March 6, 2020. The initial and follow-up CT images and clinical data were reviewed. The initial CT manifestations of spherical GGOs and their subsequent changes were mainly evaluated. Results:A total of 101 pulmonary spherical GGOs, including 38 with and 63 without consolidation, were found in 33 patients. Of the 101 spherical GGOs, 71 (70.3%) and 30 (29.7%) showed progression and direct absorption on follow-up CT images, respectively. GGOs with consolidation were more likely to progress than those without (84.2% vs. 61.9%, p = 0.017). The 71 progressed lesions mainly showed an increase in size and/or density and most (70.4%) of them extended toward the pleura and developed from spherical to patchy. Internal consolidation appeared and increased in 18 (25.4%) and 22 (31.0%) lesions, respectively. During absorption, all the previous progressed and directly absorbed lesions exhibited a simultaneous decrease in size and density. On each patient’s final CT, more lesions with progression had a residual mixed GGO (40.8% vs. 6.7%, p = 0.002) and fewer had pure GGO (39.4% vs. 60.0%, p = 0.016) than those with direct absorption.Conclusion: In patients with COVID-19, most pulmonary spherical ground-glass opacities would progress, especially those with consolidation, and develop into patchy, subpleural lesions.

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Screening and Analysis of COVID-19 cases in non-epidemic areas: A Retrospective Study

10.21203/rs.3.rs-32811/v1 ◽

2020 ◽

Author(s):

Yan Zhu ◽

Yan Guo ◽

Juan Ma ◽

Mao-shi Li ◽

Jia-fei Chen ◽

...

Keyword(s):

Virus Disease ◽

Close Contact ◽

White Blood Cells ◽

Chest Ct ◽

Control Group ◽

Study Group ◽

Imaging Characteristics ◽

Number Of Patients ◽

Epidemic Area ◽

And Control

Abstract Objective: To compare the epidemiological and clinical characteristics of confirmed and suspected corona virus disease 2019 (COVID-19) cases via the process of “triage-screening-isolation-transfer” in the hospitals of non-epidemic areas.Methods: The general data, epidemiological history, clinical symptoms, laboratory examination, and chest computed tomography (CT) imaging characteristics of 38 patients with suspected COVID-19, admitted between January 21 and March 5, 2020, were analyzed.Results: According to the results of the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) ribonucleic acid (RNA) testing, the patients were divided into study group (RNA positive) and control group (RNA negative). Ultimately, 8 cases were RNA-positive and diagnosed as CDVID-19, and 30 cases were negative. Approximately half of the patients in the study group returned to Chongqing from Wuhan; this number was significantly larger than that of the control group (P<0.05). The number of subjects in close contact with the confirmed cases with SARS-CoV-2 RNA-positive and the incidence of aggregation was significantly larger in the study group than in the control group (both P<0.05). The clinical symptom of the study group was mainly low fever (with or without cough). The patients with decreased white blood cells (WBC) in the study group were significantly more than those in the control group (P<0.05). Both group had reduced lymphocytes (Lym) but the number of patients with increased C-reactive protein (CRP) in the study group was significantly more than that in the control group (P<0.05). There were different degrees of chest CT abnormalities in both study and control group (P > 0.05). Conclusion: The epidemiological investigations in screening for infectious diseases is crucial. The risk of infection was high from the primary epidemic area and/or in close contact with the confirmed case. The most common form of clustering occurrence was family aggregation. CDVID-19 was mainly characterized by fever and respiratory symptoms, although asymptomatic infection may also occur. Decreased WBC, decreased Lym, and increased CRP are common characteristics but can also be combined with other respiratory tract virus infections. COVID 19 screening by chest CT alone had certain limitations in non- epidemic areas.

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