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.

scholarly journals A Comparative Study on the Clinical Features of Coronavirus 2019 (COVID-19) Pneumonia With Other Pneumonias

2020 ◽  
Vol 71 (15) ◽  
pp. 756-761 ◽  
Author(s):  
Dahai Zhao ◽  
Feifei Yao ◽  
Lijie Wang ◽  
Ling Zheng ◽  
Yongjun Gao ◽  
...  
Keyword(s):  
Clinical Features ◽  
Clinical Symptoms ◽  
Severe Pneumonia ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Rt Pcr ◽  
Bilateral Involvement ◽  
Radiological Features ◽  
History Of ◽  
Novel Coronavirus

Abstract Background A novel coronavirus (COVID-19) has raised world concern since it emerged in Wuhan, China in December 2019. The infection may result in severe pneumonia with clusters of illness onsets. Its impacts on public health make it paramount to clarify the clinical features with other pneumonias. Methods Nineteen COVID-19 and 15 other patients with pneumonia (non-COVID-19) in areas outside of Hubei were involved in this study. Both COVID-19 and non-COVID-19 patients were confirmed to be infected using throat swabs and/or sputa with/without COVID-2019 by real-time RT-PCR. We analyzed the demographic, epidemiological, clinical, and radiological features from those patients, and compared the differences between COVID-19 and non-COVID-19. Results All patients had a history of exposure to confirmed cases of COVID-19 or travel to Hubei before illness. The median (IQR) duration was 8 (6–11) and 5 (4–11) days from exposure to onset in COVID-19 and non-COVID-19 cases, respectively. The clinical symptoms were similar between COVID-19 and non-COVID-19. The most common symptoms were fever and cough. Fifteen (78.95%) COVID-19 but 4 (26.67%) non-COVID-19 patients had bilateral involvement while 17 COVID-19 patients (89.47%) but 1 non-COVID-19 patient (6.67%) had multiple mottling and ground-glass opacity on chest CT images. Compared with non-COVID-19, COVID-19 presents remarkably more abnormal laboratory tests, including AST, ALT, γ-GT, LDH, and α-HBDH. Conclusions The COVID-19 infection has onsets similar to other pneumonias. CT scan may be a reliable test for screening COVID-19 cases. Liver function damage is more frequent in COVID-19 than non-COVID-19 patients. LDH and α-HBDH may be considerable markers for evaluation of COVID-19.

scholarly journals CT Imaging Features During Disease Progression of 2019 Novel Coronavirus (COVID-19) Pneumonia

2020 ◽  
Vol 17 (4) ◽  
Author(s):  
Nan Yu ◽  
Yong Yu ◽  
Shubo Cai ◽  
Cong Shen ◽  
Youmin Guo
Keyword(s):  
Disease Progression ◽  
Symptom Onset ◽  
Early Stage ◽  
Ground Glass Opacity ◽  
Ct Imaging ◽  
Imaging Features ◽  
Imaging Characteristics ◽  
Novel Coronavirus ◽  
Stage 1

Objectives: To describe the characteristics of computed tomography (CT) in patients with 2019 novel coronavirus (COVID-19) pneumonia and their changes during disease progression. Patients and Methods: A total of 96 chest CT scans of 61 pneumonia patients associated with COVID-19 were reviewed to identify CT features associated with the time of symptom onset and the evolution of disease. Results: The initial CTs of 61 patients were obtained during 1 to 11 days after the onset. The main CT pattern of initial CT obtained during 1 - 3 days after the symptom onset was single (7/23, 35%) or multiple ground-glass opacity (GGO, 8/23, 35%). At 4 - 7 days after the symptom onset, the main imaging features were crazy paving GGO mixed with partial consolidation pattern (15/32, 47%). At 8 - 11 days after the symptom onset, the CT images showed consolidation pattern (3/6, 50%). A total of 35 follow up CTs were collected. The mean interval time between each follow up CT was 3 ± 2 days. The CT patterns also changed with the evolution of the disease: the features of GGO manifested at the early stage (1 - 3d). The crazy paving GGO pattern, consolidation pattern and mixed with partial consolidation pattern were found 4 to 14 days after the onset. In the absorption stage (15 - 24d), both density and extent of lesions were reduced. Conclusion: The CT imaging features are associated with the time of symptom onset and evolution of disease. Understanding the imaging characteristics of each stage is very helpful for understanding the development of disease.

scholarly journals HRCT imaging features in representative imported cases of 2019 novel coronavirus pneumonia

2020 ◽  
Vol 3 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Kaiyue Diao ◽  
Peilun Han ◽  
Tong Pang ◽  
Yuan Li ◽  
Zhigang Yang
Keyword(s):  
Ground Glass Opacity ◽  
Diagnostic Tools ◽  
Small Scale ◽  
Imaging Features ◽  
High Resolution Computed Tomography ◽  
West China Hospital ◽  
West China ◽  
Imported Cases ◽  
Novel Coronavirus

Abstract With the spread of novel coronavirus (2019-nCoV) pneumonia, chest high-resolution computed tomography (HRCT) has been one of the key diagnostic tools. To achieve early and accurate diagnostics, determining the radiological characteristics of the disease is of great importance. In this small scale research we retrospectively reviewed and selected six cases confirmed with 2019-nCoV infection in West China Hospital and investigated their initial and follow-up HRCT features, along with the clinical characteristics. The 2019-nCoV pneumonia basically showed a multifocal or unifocal involvement of ground-glass opacity (GGO), sometimes with consolidation and fibrosis. No pleural effusion or lymphadenopathy was identified in our presented cases. The follow-up CT generally demonstrated mild to moderate progression of the lesion, with only one case showing remission by the reducing extent and density of the airspace opacification.

scholarly journals Variety of radiological findings in a family with COVID-19: a case report

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Farideh Gharekhanloo ◽  
Iraj Sedighi ◽  
Salman Khazaei
Keyword(s):  
Ct Scan ◽  
Clinical Symptoms ◽  
Close Contact ◽  
Pediatric Population ◽  
Case Series ◽  
Lower Lobe ◽  
Ground Glass Opacity ◽  
Imaging Features ◽  
Standard Regimen ◽  
Asymptomatic Children

Abstract Introduction In December 2019, a case series of pneumonia associated with seafood and wet animal market was reported as coronavirus disease 2019 (COVID-19) in Wuhan, Hubei, China. The COVID-19 less frequently affects the pediatric group, and asymptomatic children are commonly reported. This feature is important due to the potential transmissibility of COVID-19 through these cases. There is a variety of atypical clinical symptoms and imaging manifestations among children infected with COVID-19. Case presentation We report two sisters with COVID-19 pneumonia who had close contact with their 77-year-old grandmother. Their grandmother expired with a confirmed diagnosis of COVID-19. The older sister (15 years old) firstly presented with severe cough, fever, dyspnea, diarrhea, and lymphopenia. A chest computed tomography (CT) scan showed atypical lobar pneumonic infiltration only in the left lower lobe. The younger sister (6 years old) was affected the following day with milder symptoms (i.e., fever and cough). Her chest CT scan demonstrated typical mild generalized patchy ground-glass opacity with interlobular septal thickening scattered in both lungs. The CT presentation of their grandmother showed typical bilateral white lungs with crazy paving appearance. The standard regimen for both sisters was administrated, and the patients’ respiratory conditions improved after 5 days of treatment. Both cases were discharged with good general conditions. Conclusion Children are considered potentially important causes of COVID-19 transmission. The symptoms in children are milder, and clinicians should be aware of taking a definite history of infected family members. Atypical clinical symptoms and imaging features are more common in children than adults; therefore, it is necessary to identify the typical and atypical imaging patterns of COVID-19 pneumonia in the pediatric population.

scholarly journals CT Findings in a Novel Coronavirus Disease (COVID-19) Pneumonia at Initial Presentation

2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Chao Xiang ◽  
Ji Lu ◽  
Jun Zhou ◽  
Li Guan ◽  
Cheng Yang ◽  
...  
Keyword(s):  
Left Lung ◽  
Lower Lobe ◽  
Ground Glass Opacity ◽  
Initial Presentation ◽  
Ground Glass ◽  
Imaging Features ◽  
Reticular Pattern ◽  
Novel Coronavirus ◽  
Age Range ◽  
Ct Features

Background. COVID-19 first broke out in China and spread rapidly over the world. Objectives. To describe the CT features of COVID-19 pneumonia and to share our experience at initial diagnoses. Patients and Methods. Data from 53 patients (31 men, 22 women; mean age, 53 years; age range, 16-83 years) with confirmed COVID-19 pneumonia were collected. Their complete clinical data was reviewed, and their CT features were recorded and analyzed. Results. The average time between onset of illness and the initial CT scan was six days (range, 1-42 days). A total of 399 segments were involved and distributed bilaterally (left lung: 186 segments [46.6%], right lung: 213 segments [53.4%]) and peripherally (38 [71.7%] patients). Multiple lobes (45 [84.9%]) and bilateral lower lobes (left lower lobe: 104 [26.1%], right lower lobe: 107 [26.8%], and total: 211 [52.9%]) were the most commonly involved. Ground-glass opacity with consolidation (24 [45.3%]) and pure ground-glass opacity (28 [52.8%]) were the main findings. The other findings were crazy-paving (14 [26.4%]), bronchiectasis (12 [22.6%]), atelectasis (7 [13.2%]), parenchymal bands (6 [11.3%]), air bronchogram (6 [11.3%]), interlobular thickening (5 [9.4%]), reticular pattern (1 [1.9%]), and pleural effusion (1 [1.9%]). Conclusions. Most COVID-19 pneumonia patients had abnormalities on chest CT images at initial presentation. Imaging features combined with patient’s exposure history and onset symptoms could facilitate the identification of the suspected patient for further examinations.

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

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.

scholarly journals Imaging Findings and Changes in Discharged Moderate Novel Coronavirus Pneumonia Patients with Positive Nucleic Acid Retest

2021 ◽  
Keyword(s):  
Nucleic Acid ◽  
Positive Result ◽  
Ct Scan ◽  
Lower Lobe ◽  
Ground Glass Opacity ◽  
Hubei Province ◽  
Imaging Findings ◽  
Imaging Data ◽  
Novel Coronavirus

The clinical and imaging data belonging to 52 discharged novel coronavirus pneumonia (NCP) patients with positive nucleic acid retesting results during the follow-up period were collected from the First People’s Hospital, Xiaogan, Hubei Province, China, for analysis. These moderate NCP patients underwent a plain CT scan before the admission, at the time of discharge, and at re-admission due to the positive result of their COVID-19 nucleic acid retesting. The CT signs of these patients were analyzed in this study and a total of 32 (61.54%) patients presented with 123 lesions with patchy fuzzy shadows. In addition, 24 (75%) and 8 (25%) patients out of the 32 patients, had lesions distributed in both lungs and single lung, respectively. It is worth mentioning that the CT manifestations varied in discharged moderate NCP patients whose COVID-19 nucleic acid retest was positive in the follow-up period. Most patients presented with patchy fuzzy shadows and ground-glass opacity (GGO) lesions distributed in the lower lobe of both lungs. The results of the study indicated that some discharged moderate NCP patients with positive COVID-19 nucleic acid retest developed new patchy fuzzy shadows and GGO lesions. Moreover, the recurrence of NCP needs to be verified once patchy fuzzy shadows and GGO lesions appear and are not absorbed during the follow-up period. This study provided a reference for the follow-up NCP evaluation.

scholarly journals Radiological and clinical characteristics of 22 suspected COVID-19 patients with multiple negative RT-PCR testing

2020 ◽  
Author(s):  
Wenjun Wu ◽  
Heshui Shi ◽  
Bo Liang ◽  
Feihong Wu ◽  
Dongqiao Xiang ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Lower Lobe ◽  
Ground Glass Opacity ◽  
Pulmonary Involvement ◽  
Active Management ◽  
Rapid Progression ◽  
Rt Pcr ◽  
Reactive Protein ◽  
Group 2

Abstract This study aims to investigate radiological and clinical characteristics of suspected COVID-19 patients with negative RT-PCR testing. 22 suspected COVID-19 patients with 2-5 negative RT-PCR testing were enrolled. The most common symptoms at onset included fever (18[81.8%] patients), fatigue (16[72.7%]) and cough (12[54.5%]). 20(90.9%) patients were with normal or decreased Leukocyte count, 17 (77.3%) with decreased Lymphocyte count, 16 (72.7%) and 18 (81.8%) with increased level of C-reactive protein and D-dimers, respectively. Ground-glass opacity (GGO) (22[100]), reticular/interlobular septal thickening (11 [50%]) and consolidation (14 [63.6%)) with predominantly bilateral and peripheral distribution were typical findings at initial CT scan. The CT score of right lower lobe was significantly higher than right upper lobe (P=0.042). The total CT scores of group 2, 3, 4 (2nd week, 3rd week, 4th week and after) were significantly higher than group 1 (1st week) (P＜0.01,for all). After rapid progression at first week, the most extensive pulmonary involvement emerged at second week after symptom onset, then the involvement gradually decreased. Given the clinical symptoms, laboratory results and typical radiological manifestations, even suspected COVID-19 patients with multiple negative RT-PCR testing deserve great concern for active management.

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.

Scoring System for the Diagnosis of COVID-19

2020 ◽  
Vol 13 (1) ◽  
pp. 413-414 ◽  
Author(s):  
Mohamed Farouk Allam
Keyword(s):  
Scoring System ◽  
Clinical Symptoms ◽  
False Negative ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Pcr Assay ◽  
Negative Results ◽  
False Negative Results ◽  
Symptoms And Signs

Due to the international spread of COVID-19, the difficulty of collecting nasopharyngeal swab specimen from all suspected patients, the costs of RT-PCR and CT, and the false negative results of RT-PCR assay in 41% of COVID-19 patients, a scoring system is needed to classify the suspected patients in order to determine the need for follow-up, home isolation, quarantine or the conduction of further investigations. A scoring system is proposed as a diagnostic tool for suspected patients. It includes Epidemiological Evidence of Exposure, Clinical Symptoms and Signs, and Investigations (if available). This scoring system is simple, could be calculated in a few minutes, and incorporates the main possible data/findings of any patient.

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