Changes in CT manifestations of patients with mild to moderate coronavirus disease 2019 in a Fangcang Shelter Hospital

Abstract Objectives: To provide a reference for CT imaging changes for patients discharged from a Fangcang shelter hospital, a large-scale, temporary hospital for the centralized treatment of patients with mild to moderate Coronavirus disease 2019 (COVID-19) to provide essential functions (isolation, triage, basic medical care, frequent monitoring and rapid referral, essential living and social engagement) to them..Methods: Patients with mild to moderate COVID-19 admitted to the Wuchang Fangcang Shelter Hospital who had undergone pre-discharge and previous CT scans were included. Changes in the CT imaging features were defined as progression, no change, improvement or recovery. Basic patient information was obtained, and imaging signs were compared between the two CT scans.Results: A total of 83 patients were included. The median age was 53 years old. The course of disease was 28.3±10.7 days. CT imaging changes indicated progression, no change, improvement, and recovery in 3, 12, 66, and 2 patients, respectively. Between the two CT scans, the imaging signs showed a significant reduction in consolidation, a significant increase in fibrosis, and a reduction or / and thinning of ground-glass opacities. None of the patients showed signs of deterioration on follow-up and thus did not need to return to the hospital for treatment.Conclusion: In the COVID-19 Fangcang shelter hospital, given the shortage of medical staff and lack of medical resources, CT imaging diagnostic methods can be used to accurately discharge patients who had met the discharge criteria for isolation and observation from the Fangcang Shelter Hospital.

Download Full-text

The Pulmonary Sequalae in Discharged Patients With COVID-19:A Short-term Observational Study

10.21203/rs.3.rs-21985/v2 ◽

2020 ◽

Author(s):

Dehan Liu ◽

Wanshu Zhang ◽

Feng Pan ◽

Lin Li ◽

Lian Yang ◽

...

Keyword(s):

Chest Ct ◽

Ct Scans ◽

Optimal Time ◽

Imaging Features ◽

Short Term ◽

Lung Lesions ◽

Cumulative Percentage ◽

Time Points ◽

Time Point

Abstract Background: A cluster of patients with coronavirus disease 2019 (COVID-19) pneumonia were discharged from hospitals in Wuhan, China. We aimed to determine the cumulative percentage of complete radiological resolution at each time point, to explore the relevant affecting factors, and to describe the chest CT findings at different time points after hospital discharge.Methods: Patients with COVID-19 pneumonia confirmed by RT-PCR who were discharged consecutively from the hospital between 5 February 2020 and 10 March 2020 and who underwent serial chest CT scans on schedule were enrolled. The radiological characteristics of all patients were collected and analysed. The total CT score was the sum of non-GGO involvement determined at discharge. Afterwards, all patients underwent chest CT scans during the 1st, 2nd, and 3rd weeks after discharge. Imaging features and distributions were analysed across different time points.Results: A total of 149 patients who completed all CT scans were evaluated; there were 67 (45.0%) men and 82 (55.0%) women, with a median age of 43 years old (IQR 36-56). The cumulative percentage of complete radiological resolution was 8.1% (12 patients), 41.6% (62), 50.3% (75), and 53% (79) at discharge and during the 1st, 2nd, and 3rd weeks after discharge, respectively. Patients ≤44 years old showed a significantly higher cumulative percentage of complete radiological resolution than patients >44 years old at the 3-week follow-up. The predominant patterns of abnormalities observed at discharge were ground-glass opacity (GGO) (65 [43.6%]), fibrous stripe (45 [30.2%]), and thickening of the adjacent pleura (16 [10.7%]). Lung lesions showed obvious resolution from 2 to 3 weeks after discharge, especially in terms of GGO and fibrous stripe. “Tinted” sign and bronchovascular bundle distortion as two special features were discovered during the evolution.Conclusion: Lung lesions in COVID-19 pneumonia patients can be absorbed completely during short-term follow-up with no sequelae. Three weeks after discharge might be the optimal time point for early radiological estimation.

Download Full-text

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

Iranian Journal of Radiology ◽

10.5812/iranjradiol.102925 ◽

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.

Download Full-text

A two-stage approach to identifying and validating modifiable factors for the prevention of depression

10.1101/759753 ◽

2019 ◽

Cited By ~ 1

Author(s):

Karmel W. Choi ◽

Murray B. Stein ◽

Kristen Nishimi ◽

Tian Ge ◽

Jonathan R.I. Coleman ◽

...

Keyword(s):

At Risk ◽

Social Engagement ◽

Large Scale ◽

Media Use ◽

Risk Scores ◽

Polygenic Risk ◽

Depression Risk ◽

Modifiable Factors ◽

Wide Range

AbstractBackgroundAlthough depression is recognized as the leading cause of disability worldwide, decades of research have identified few actionable preventive factors. Using phenotypic and genomic data from the UK Biobank, we took advantage of a unique opportunity to screen a wide range of potentially modifiable factors that could offset known risk factors for depression.MethodsWe curated baseline data on more than 100 lifestyle and environmental factors in participants’ lives, including behavioral (e.g., exercise, sleep, media use, diet), social (e.g., support, activities), and environmental (e.g., greenspace, pollution) variables. In a follow-up survey, participants reported on their traumatic life experiences and mental health, including depression. Polygenic risk scores for depression were generated based on large-scale genome-wide association results. Excluding those meeting criteria for depression at baseline, we identified at-risk individuals at high predicted probability (> 90th percentile) for clinically significant depression at follow-up based on their (i) polygenic risk, or (ii) reported traumatic life events. Using a factors-wide design corrected for multiple testing and adjusted for potential confounders, we identified modifiable factors associated with follow-up depression in the full sample and among at-risk individuals. Using a two-sample Mendelian randomization (MR) design, we then examined which significant factors showed potential causal influences on depression risk, or vice versa.ResultsA range of baseline modifiable factors were prospectively associated with follow-up depression, including factors related to social engagement, physical activity, media use, and diet. MR follow-up analyses provided further support for the effects of social support-seeking, TV use, and other factors on depression risk.ConclusionAs the field increasingly quantifies the role of genetic factors in complex conditions such as depression, knowledge of modifiable factors that could offset one’s genetic risk has become highly relevant. Here, we present an approach to screening for potentially modifiable factors that may offset the risk of depression in general and among at-risk individuals. In light of the burden of disease associated with depression and the urgent need for actionable preventive strategies, this approach could help prioritize candidates for follow-up studies including clinical trials for depression prevention.

Download Full-text

Correlation between Imaging Features and Pathological Stages of Primary Lung Tumors Based on Nanocontrast Agents

Computational and Mathematical Methods in Medicine ◽

10.1155/2021/2343299 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Jin Li ◽

Qian Xu ◽

Cunhua Mao ◽

Yuliang Liu

Keyword(s):

Lung Cancer ◽

Contrast Agents ◽

Adverse Reactions ◽

Lung Tumors ◽

Ct Imaging ◽

Ct Scans ◽

Imaging Features ◽

Display Time ◽

Imaging Characteristics ◽

Primary Lung Tumors

As one of the conventional methods of lung cancer detection, computed tomography (CT) usually requires the use of contrast agents to enhance the imaging effect. Conventional iodine contrast agents have poor signal-to-noise ratio and are prone to adverse reactions. It is necessary to find more effective and safe contrast agents for CT scans. The gold nanoparticles with secondary electron effect and photoelectric absorption effect can prolong the display time of the patient’s blood circulation after being injected into the patient’s body, which makes the nanocontrast agent a research hotspot in the field of CT imaging. In this study, ultrasmall gold nanoclusters with a diameter of about 5 nm were used as the contrast agent in CT scans. It was found that CT scans based on nanocontrast agents can obtain high-quality lung cancer imaging images, and the patient has no obvious adverse reactions. When observing the CT image, it was found that the stage of lung cancer patients can be clearly distinguished through the CT scan image. When analyzing the consistency of CT imaging and pathological classification, the Kappa value was 0.810, indicating that the two have a high degree of consistency. Therefore, this study believes that the imaging characteristics of primary lung tumors based on nanocontrast agents are highly correlated with their pathological types.

Download Full-text

Clinical characteristics of coronavirus disease 2019 (COVID-19) in patients out of Wuhan from China: a case control study

BMC Infectious Diseases ◽

10.1186/s12879-021-05897-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hua Zhang ◽

Feng Du ◽

Xiao-jun Cao ◽

Xia-long Feng ◽

He-ping Zhang ◽

...

Keyword(s):

Clinical Characteristics ◽

Large Scale ◽

Time Course ◽

Second Generation ◽

Oxygenation Index ◽

Ct Imaging ◽

Moderate Degree ◽

Imaging Features ◽

Oxyhemoglobin Saturation ◽

Amyloid A

Abstract Background A large-scale global outbreak of coronavirus disease-19 (COVID-19) out of Wuhan, from China, occurred in January 2020. To examine the clinical characteristics of COVID-19 in infected patients out of Wuhan, from China. Methods Thirteen patients were confirmed to be infected with novel coronavirus-2019 (2019-nCoV) between January 27 and February 8, 2020, in Baoji city, Shannxi, northwestern China. Epidemiological and clinical information, and computed to morphology imaging data from all COVID-19 patients were collected; cases were divided into two groups according to the severity of infection (mild or severe). Results Nine (9/13) COVID-19 patients exhibited mild disease severity, and defined as second-generation human-to-human transmission cases. Most patients (11/13) had a history of travel to or from Wuhan. There were no differences in sex and age between the mild and severe cases (all P > 0.05). A moderate degree of fever (11/13), cough (13/13), and fatigue (8/13) were common symptoms; however, there was no statistical difference between mild and severe cases in this regard (all P > 0.05). Oxyhemoglobin saturation and oxygenation index decreased, and C-reactive protein (CRP) and serum amyloid A (SAA) levels were elevated in all patients with COVID-19 infection, with statistically significant differences between those with severe disease and mild infection (all P < 0.05). Twelve of 13 COVID-19 patients exhibited changes in chest CT imaging features, and time course changes were different between mild and severe cases (all P < 0.05). Conclusion Most cases of COVID-19 infection were second-generation human-to-human transmissions from Wuhan and were mild in severity. The clinical characteristics of COVID-19 varied. Oxyhemoglobin saturation, oxygenation index, CRP and SAA levels, and CT features were reliable parameters to evaluate the severity of COVID-19 infection. However, a few patients with mild COVID-19 disease lacked typical characteristics such as fever and changes in CT imaging features.

Download Full-text

Clinical and Imaging features in COVID-19 Patients: Analysis of Data from Patients in Non-pandemic areas

10.21203/rs.3.rs-21373/v1 ◽

2020 ◽

Author(s):

Shengkun Peng ◽

Lingai Pan ◽

Shaojin Zhang ◽

Yalong Liu ◽

Hua Zhang ◽

...

Keyword(s):

Peripheral Zone ◽

Chest Ct ◽

Ct Scans ◽

Severe Illness ◽

Imaging Features ◽

Imaging Characteristics ◽

Number Of Patients ◽

Patient Will ◽

Acid Test

Abstract Purpose To describe the imaging characteristics in COVID-19 Patients from non-pandemic regions to improve understanding of the disease. Methods We reviewed chest CT scans of 30 COVID-19 patients from three hospitals in Sichuan province, China. Results Typical CT manifestations include the involvement of multiple lobes, mostly in the peripheral zone of the lungs, and subpleural distribution. GGO, crazy paving or mixed GGO and consolidation is the most common signs. Few patients can present small amount of pleural effusion. It is worth noting that none of the lung cavities, tree buds, and lymphadenopathy appeared. The follow-up imaging findings of some patients showed progress when the initial CT score reached 7. Conclusion The CT scan still play an important role in screening the COVID-19, most of the images present positive signs, mainly subpleural, multiple GGO. CT might can predict the severity or whether the patient will progress to severe illness. A small number of patients may be missed if they are based on CT findings alone, which should be closely combined with the patient's epidemiological history and nucleic acid test.

Download Full-text

Clinical Characteristics of Coronavirus Disease 2019 (COVID-19) in Patients out of Wuhan from China

10.21203/rs.3.rs-15449/v1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Hua Zhang ◽

Feng Du ◽

Xiao-jun Cao ◽

Xia-long Feng ◽

He-ping Zhang ◽

...

Keyword(s):

Clinical Characteristics ◽

Large Scale ◽

Time Course ◽

Second Generation ◽

Severe Disease ◽

Oxygenation Index ◽

Ct Imaging ◽

Moderate Degree ◽

Imaging Features ◽

Amyloid A

Abstract Background: A large-scale global outbreak of coronavirus disease-19 (COVID-19) out of Wuhan, from China, occurred in January 2020. Objective: To examine the clinical characteristics of COVID-19in infected patients out of Wuhan, from China. Patients and Methods: Thirteen patients were confirmed to be infected with novel coronavirus-2019 (2019-nCoV) between January 27andFebruary 8, 2020, in Baoji city, Shanxi, northwestern China. Epidemiological and clinical information, and computed to morphology imaging data from all COVID-19 patients were collected; cases were divided into two groups according to the severity of infection (mild or severe). Results: Nine (9/13) COVID-19patientsexhibitedmild disease severity, and defined as second-generation, human-to-human transmission cases. Most patients (11/13) had a history of travel to or from Wuhan. There were no differences in sex and age between the mild and severe cases (all P>0.05). A moderate degree of fever (11/13), cough (13/13), and fatigue (8/13) were common symptoms; however, there was no statistical difference between mild and severe cases in this regard (all P>0.05). Oxyhemoglobin saturation and oxygenation index decreased, and C-reactive protein (CRP) and serum amyloid A (SAA) levels were elevated in all patients with COVID-19infection, with statistically significant differences between those with severe disease and mild infection (all P<0.05).Twelve of 13COVID-19patients exhibited changes in chest CT imaging features, and time course changes were different between mild and severe cases (all P<0.05).Conclusion: Most cases of COVID-19infection were second-generation human-to-human transmissions from Wuhan and were mild in severity. The clinical characteristics of COVID-19varied.Oxyhemoglobin saturation, oxygenation index, CRP and SAA levels, and CT features were reliable parameters to evaluate the severity of COVID-19 infection. However, a few patients with mild COVID-19diseaselackedtypicalcharacteristics such as fever and changes in CT imaging features.

Download Full-text

The Pulmonary Sequalae in Discharged Patients With COVID-19：A Short-term Observational Study

10.21203/rs.3.rs-21985/v1 ◽

2020 ◽

Author(s):

Dehan Liu ◽

Wanshu Zhang ◽

Feng Pan ◽

Lin Li ◽

Lian Yang ◽

...

Keyword(s):

Lung Lesion ◽

Chest Ct ◽

Ct Scans ◽

Optimal Time ◽

Imaging Features ◽

Affecting Factors ◽

Short Term ◽

Cumulative Percentage ◽

Time Point

Abstract Background: A cluster of patients with coronavirus disease 2019 (COVID-19) pneumonia were discharged from hospitals in Wuhan, China. We aimed to determine the cumulative percentage of the complete radiological resolution at each time point, to explore the relevant affecting factors, and describe the chest CT findings through different timepoints after hospital discharge.Methods: Patients with COVID-19 pneumonia confirmed by RT-PCR who were discharged consecutively from hospital between 5 February 2020 to 10 March 2020 and underwent serial chest CT scans on schedule were enrolled. Radiological demonstrations of all patients were collected and analyzed. The total CT score was the sum of non-GGO invovlement determined at discharge. Afterwards, all patients underwent chest CT scans at 1st, 2nd, and 3rd week after discharge. Imaging features and distribution were analyzed across different time points.Results: 149 patients who completed all CT scans were evaluated, 67 (45.0%) men and 82 (55.0%) women with median age of 43 years old (IQR 36-56). The cumulative percentage of the complete radiological resolution was 8.1% (12 patients), 41.6% (62), 50.3% (75), 53% (79) at discharge and the 1st, 2nd, and 3rd week after discharge, respectively. Patients ≤44 years old showed a significantly higher CP than patients >44 years old after 3-week follow-up. The predominant pattern of abnormality observed at discharge were ground-glass opacification(GGO) (65 [43.6%]), fibrous stripe (45 [30.2%]), and thickening of the adjacent pleura (16 [10.7%]). Lung lesion showed obvious resolution from 2 to 3 weeks after discharge, especially in GGO and fibrous stripe. “Tinted” sign and branchovascular bundle distortion as two special features were discovered in the evolution.Conclusion: Lung lesion of COVID-19 pneumonia patient can be absorbed completely in short-term follow-up with no sequelae. 3 weeks after discharge might be the optimal time point for early radiological estimation.

Download Full-text

Prognostic Value of Admission Chest CT Findings for Invasive Ventilation Therapy in COVID-19 Pneumonia

Diagnostics ◽

10.3390/diagnostics10121108 ◽

2020 ◽

Vol 10 (12) ◽

pp. 1108

Author(s):

Eva Gresser ◽

Johannes Rueckel ◽

Daniel Puhr-Westerheide ◽

Vincent Schwarze ◽

Nicola Fink ◽

...

Keyword(s):

Risk Stratification ◽

Risk Score ◽

Clinical Information ◽

Ct Imaging ◽

Chest Ct ◽

Ct Scans ◽

Imaging Features ◽

Invasive Ventilation ◽

Diagnostic Potential ◽

Non Invasive Ventilation

(1) Background: To assess the value of chest CT imaging features of COVID-19 disease upon hospital admission for risk stratification of invasive ventilation (IV) versus no or non-invasive ventilation (non-IV) during hospital stay. (2) Methods: A retrospective single-center study was conducted including all patients admitted during the first three months of the pandemic at our hospital with PCR-confirmed COVID-19 disease and admission chest CT scans (n = 69). Using clinical information and CT imaging features, a 10-point ordinal risk score was developed and its diagnostic potential to differentiate a severe (IV-group) from a more moderate course (non-IV-group) of the disease was tested. (3) Results: Frequent imaging findings of COVID-19 pneumonia in both groups were ground glass opacities (91.3%), consolidations (53.6%) and crazy paving patterns (31.9%). Characteristics of later stages such as subpleural bands were observed significantly more often in the IV-group (52.2% versus 26.1%, p = 0.032). Using information directly accessible during a radiologist’s reporting, a simple risk score proved to reliably differentiate between IV- and non-IV-groups (AUC: 0.89 (95% CI 0.81–0.96), p < 0.001). (4) Conclusions: Information accessible from admission CT scans can effectively and reliably be used in a scoring model to support risk stratification of COVID-19 patients to improve resource and allocation management of hospitals.

Download Full-text