scholarly journals Clinical presentation and CT features in pediatric patients with COVID‐19 infection

2021 ◽  
Author(s):  
Huseyin Avni Solgun ◽  
Isıl Yurdaısık
Keyword(s):  
Pediatric Patients ◽  
Clinical Laboratory ◽  
Close Contact ◽  
Laboratory Data ◽  
Chest Ct ◽  
Pharyngeal Swab ◽  
Laboratory Findings ◽  
Pulmonary Lesions ◽  
Novel Coronavirus ◽  
Ct Features

Abstract Background The aim of this study includes to discuss the clinical, laboratory, and chest computed tomography (CT) in pediatric patients with 2019 novel coronavirus (COVID-19) infection. Material and Methods The clinical, laboratory, and chest CT features of 17 pediatric inpatients with COVID-19 infection confirmed by pharyngeal swab COVID‐19 polymerase chain reaction(PCR). All clinical and laboratory data have been recorded and analyzed during march-february 2021. Chest CT have been performed to all Covid 19 PCR confirmed patients and radiologicall view have been noted. Results Seventeen pediatric patients with a history of close contact with COVID-19 diagnosed family members included to the study. Fever (10/17, 58%) and cough (13/17, 76%) were the most common symptoms. For laboratory findings, c reactive protein elevation (15/17, 88%) seem to be the most finding. A total of 4 patients presented with unilateral pulmonary lesions (4/17, 23%), 9 with bilateral pulmonary lesions (9/17, 52%) and 13 cases showed bilateral diffuse covid pattern on chest CT (13/17, 76%). Non-spesific consolidation with was observed in 8 patients (8/17, 47%), ground‐glass opacities were observed in 11 patients (11/17, 64%), nodules were observed in 7 patients (7/17, 41%), and tiny nodules were observed in 2 patients (2/17, 11%). Conclusion In pediatric patients with positive COVID-19 nucleic acid test from pharyngeal swab samples; the early detection of lesions by CT can be efficient; in management and early treatment for pediatric patients. However; early chest CT screening and COVİD-19 PCR testing together can be more efficent in diagnose.

scholarly journals The Novel Coronavirus Disease (COVID-19): A PRISMA Systematic Review and Meta-analysis of Clinical and Paraclinical characteristics

2020 ◽  
Author(s):  
Hamidreza Hasani ◽  
Shayan Mardi ◽  
Sareh Shakerian ◽  
Nooshin Taherzadeh-Ghahfarokhi ◽  
Parham Mardi
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Clinical Laboratory ◽  
Meta Analysis ◽  
Imaging Features ◽  
The Novel ◽  
Laboratory Findings ◽  
Global Concern ◽  
Novel Coronavirus ◽  
Ct Features

AbstractAn outbreak of pneumonia, caused by a novel coronavirus (COVID-19) was Identified in China in Dec 2019. This virus expanded worldwide, causing global concern. Clinical, laboratory and imaging features of this infection are characterized in some observational studies. We undertook a systematic review and meta-analysis to assess the frequency of clinical, laboratory, and CT features in COVID-19 patients.We did a systematic review and meta-analysis using three databases to identify clinical, laboratory, and CT features of rRT-PCR confirmed cases of COVID-19. Data for 3420 patients from 30 observational studies were included.Overall, the results showed that fever (84.2%, 95%CI 82.6-85.7), cough (62%, 95%CI 60-64), and fatigue (39.4%, 95%CI 37.2-41.6%) were the most prevalent symptoms in COVID-19 patients. Increased CRP level, decreased lymphocyte count, and increased D-dimer level were the most common laboratory findings. Among COVID-19 patients, 92% had a positive CT finding, most prevalently GGO (60%, 95%CI 58-62) and peripheral distribution (64%, 95%CI 60-69).These results demonstrate the clinical, paraclinical, and imaging features of COIVD-19.

scholarly journals Clinical and laboratory data, radiological structured report findings and quantitative evaluation of lung involvement on baseline chest CT in COVID-19 patients to predict prognosis

2020 ◽  
Author(s):  
Cappabianca Salvatore ◽  
Fusco Roberta ◽  
de Lisio Angela ◽  
Paura Cesare ◽  
Clemente Alfredo ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Clinical Laboratory ◽  
Laboratory Data ◽  
Lung Parenchyma ◽  
Chest Ct ◽  
Critical Conditions ◽  
Lung Involvement ◽  
Laboratory Findings ◽  
Visual Score ◽  
Healthy Lung

Abstract Objective To evaluate by means of regression models the relationships between baseline clinical and laboratory data and lung involvement on baseline chest CT and to quantify the thoracic disease using an artificial intelligence tool and a visual scoring system to predict prognosis in patients with COVID-19 pneumonia. Materials and methods This study included 103 (41 women and 62 men; 68.8 years of mean age—range, 29–93 years) with suspicious COVID-19 viral infection evaluated by reverse transcription real-time fluorescence polymerase chain reaction (RT-PCR) test. All patients underwent CT examinations at the time of admission in addition to clinical and laboratory findings recording. All chest CT examinations were reviewed using a structured report. Moreover, using an artificial intelligence tool we performed an automatic segmentation on CT images based on Hounsfield unit to calculate residual healthy lung parenchyma, ground-glass opacities (GGO), consolidations and emphysema volumes for both right and left lungs. Two expert radiologists, in consensus, attributed at the CT pulmonary disease involvement a severity score using a scale of 5 levels; the score was attributed for GGO and consolidation for each lung, and then, an overall radiological severity visual score was obtained summing the single score. Univariate and multivariate regression analysis was performed. Results Symptoms and comorbidities did not show differences statistically significant in terms of patient outcome. Instead, SpO2 was significantly lower in patients hospitalized in critical conditions or died while age, HS CRP, leukocyte count, neutrophils, LDH, d-dimer, troponin, creatinine and azotemia, ALT, AST and bilirubin values were significantly higher. GGO and consolidations were the main CT patterns (a variable combination of GGO and consolidations was found in 87.8% of patients). CT COVID-19 disease was prevalently bilateral (77.6%) with peripheral distribution (74.5%) and multiple lobes localizations (52.0%). Consolidation, emphysema and residual healthy lung parenchyma volumes showed statistically significant differences in the three groups of patients based on outcome (patients discharged at home, patients hospitalized in stable conditions and patient hospitalized in critical conditions or died) while GGO volume did not affect the patient's outcome. Moreover, the overall radiological severity visual score (cutoff ≥ 8) was a predictor of patient outcome. The highest value of R-squared (R2 = 0.93) was obtained by the model that combines clinical/laboratory findings at CT volumes. The highest accuracy was obtained by clinical/laboratory and CT findings model with a sensitivity, specificity and accuracy, respectively, of 88%, 78% and 81% to predict discharged/stable patients versus critical/died patients. Conclusion In conclusion, both CT visual score and computerized software-based quantification of the consolidation, emphysema and residual healthy lung parenchyma on chest CT images were independent predictors of outcome in patients with COVID-19 pneumonia.

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.

Visual and quantitative assessment of COVID-19 pneumonia on chest CT: The relationship with disease severity and clinical findings

2021 ◽  
Vol 17 ◽  
Author(s):  
Furkan Kaya ◽  
Petek Şarlak Konya ◽  
Emin Demirel ◽  
Neşe Demirtürk ◽  
Semiha Orhan ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Disease Severity ◽  
Pearson Correlation ◽  
Laboratory Data ◽  
Length Of Hospital Stay ◽  
Chest Ct ◽  
Laboratory Findings ◽  
Pneumonia Severity ◽  
High Attenuation ◽  
The Relationship

Background: Lungs are the primary organ of involvement of COVID-19, and the severity of pneumonia in COVID-19 patients is an important cause of morbidity and mortality. Aim: We aimed to evaluate the visual and quantitative pneumonia severity on chest computed tomography (CT) in patients with coronavirus disease 2019 (COVID-19) and compare the CT findings with clinical and laboratory findings. Methods: We retrospectively evaluated adult COVID-19 patients who underwent chest CT, clinical scores, laboratory findings, and length of hospital stay. Two independent radiologists visually evaluated the pneumonia severity on chest CT (VSQS). Quantitative CT (QCT) assessment was performed using a free DICOM viewer, and the percentage of the well-aerated lung (%WAL), high-attenuation areas (%HAA) at different threshold values, and mean lung attenuation (MLA) values were calculated. The relationship between CT scores and the clinical, laboratory data, and length of hospital stay were evaluated in this cross-sectional study. The student's t-test and chi-square test were used to analyze the differences between variables. The Pearson correlation test analyzed the correlation between variables. The diagnostic performance of the variables was assessed using receiver operating characteristic (ROC) analysis was used. Results: The VSQS and QCT scores were significantly correlated with procalcitonin, d-dimer, ferritin, and C-reactive protein levels. Both VSQ and QCT scores were significantly correlated with disease severity (p<0.001). Among the QCT parameters, the %HAA-600 value showed the best correlation with the VSQS (r=730,p<0.001). VSQS and QCT scores had high sensitivity and specificity in distinguishing disease severity and predicting prolonged hospitalization. Conclusion: The VSQS and QCT scores can help manage the COVID-19 and predict the duration of hospitalization.

scholarly journals Novel Coronavirus Infection (COVID-19) in Humans: A Scoping Review and Meta-Analysis

2020 ◽  
Vol 9 (4) ◽  
pp. 941 ◽  
Author(s):  
Israel Júnior Borges do Nascimento ◽  
Nensi Cacic ◽  
Hebatullah Mohamed Abdulazeem ◽  
Thilo Caspar von Groote ◽  
Umesh Jayarajah ◽  
...  
Keyword(s):  
Scoping Review ◽  
Clinical Symptoms ◽  
Meta Analysis ◽  
Laboratory Data ◽  
Gastrointestinal Symptoms ◽  
Common Disease ◽  
Imaging Data ◽  
Laboratory Findings ◽  
Number Of Patients ◽  
Novel Coronavirus

A growing body of literature on the 2019 novel coronavirus (SARS-CoV-2) is becoming available, but a synthesis of available data has not been conducted. We performed a scoping review of currently available clinical, epidemiological, laboratory, and chest imaging data related to the SARS-CoV-2 infection. We searched MEDLINE, Cochrane CENTRAL, EMBASE, Scopus and LILACS from 01 January 2019 to 24 February 2020. Study selection, data extraction and risk of bias assessment were performed by two independent reviewers. Qualitative synthesis and meta-analysis were conducted using the clinical and laboratory data, and random-effects models were applied to estimate pooled results. A total of 61 studies were included (59,254 patients). The most common disease-related symptoms were fever (82%, 95% confidence interval (CI) 56%–99%; n = 4410), cough (61%, 95% CI 39%–81%; n = 3985), muscle aches and/or fatigue (36%, 95% CI 18%–55%; n = 3778), dyspnea (26%, 95% CI 12%–41%; n = 3700), headache in 12% (95% CI 4%–23%, n = 3598 patients), sore throat in 10% (95% CI 5%–17%, n = 1387) and gastrointestinal symptoms in 9% (95% CI 3%–17%, n = 1744). Laboratory findings were described in a lower number of patients and revealed lymphopenia (0.93 × 109/L, 95% CI 0.83–1.03 × 109/L, n = 464) and abnormal C-reactive protein (33.72 mg/dL, 95% CI 21.54–45.91 mg/dL; n = 1637). Radiological findings varied, but mostly described ground-glass opacities and consolidation. Data on treatment options were limited. All-cause mortality was 0.3% (95% CI 0.0%–1.0%; n = 53,631). Epidemiological studies showed that mortality was higher in males and elderly patients. The majority of reported clinical symptoms and laboratory findings related to SARS-CoV-2 infection are non-specific. Clinical suspicion, accompanied by a relevant epidemiological history, should be followed by early imaging and virological assay.

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

2020 ◽  
Author(s):  
Ying Dai ◽  
Ying Dai ◽  
Sha Liu ◽  
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.

scholarly journals Computed Tomography Findings and Short-term follow-up with Novel Coronavirus Pneumonia

2020 ◽  
Author(s):  
Shi Qi ◽  
Hui Guo ◽  
Hua Shao ◽  
Siqin Lan ◽  
Yuanlin He ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Early Diagnosis ◽  
Close Contact ◽  
Female Group ◽  
Improvement Rate ◽  
Pleural Thickening ◽  
Small Nodule ◽  
Novel Coronavirus ◽  
Ct Features

AbstractObjectiveTo assess the characteristics of computed tomography (CT) features and changes in CT monitoring in patients with novel coronavirus pneumonia (NCP).MethodsIn this retrospective, two-center study, we reviewed the medical records of 57 patients with NCP in CT from January 21 to February 12, 2020. Cases were confirmed by the results of nucleic acid test positive, and were analyzed for demographic, clinical, and CT features.ResultsOf the 57 patients, 31cases were male, and 45.6% were female. The average age was 46.5 ± 15.8 years. Patients had fever (84.2%), cough (49.1%), weak (31.6%), muscle ache (17.5%), shortness of breath (12.3%). The distribution of abnormality was a subpleural lesions in 51 cases, with 96.5% ground-glass opacity (GGO) and 68.4% consolidation. Another observation reveals 45.6% fibrosis, 33.3% lymph node enlargement, 21.1% pleural thickening, 17.5% small nodule, 7.0% white lung, 5.3% emphysema, and 3.5% bronchiectasis. Importantly, the group of men had more septal thickening and air trapping than the female group (p<0.05); Compared with the younger, the elderly had higher of subpleural lesion, interlobular septal thickening and pleural thickening (p<0.05). In the first monitoring, there were 37.3% improvement, 60.8% progress. In the second monitoring, there were 55% improvement, 35% progress. The improvement rate during the third follow-up visit was 100%.ConclusionsCT features and CT dynamic observation play a vital role in the diagnosis and treatment with NCP. It is conducive to early diagnosis, deepen the knowledge of NCP and accumulate experience.Key pointsBilateral and subpleural regions on CT are common in patients with novel coronavirus pneumonia (NCP), which were more extensive GGOs than consolidation.At CT, NCP shows GGOs without or with consolidation, which most of the patients appear interlobular interstitium thickening, vascular bundle thickening, air bronchogram, and fibrosis. In patients with fever in close contact with eruption areas of 2019-nCoV, familiarity with the CT findings may help with early diagnosis, early isolation, and management.

scholarly journals Clinical Characteristics, Dynamic Profile of Radiology and Laboratory Findings in Coronavirus Disease 2019

2020 ◽  
Author(s):  
ailing liu ◽  
Jing Zhang ◽  
Wei Qiao ◽  
Wei Zang ◽  
Yingying Zhang ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Laboratory Data ◽  
Oxygenation Index ◽  
Laboratory Findings ◽  
Single Centre Study ◽  
History Of ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Dynamic Profile

Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, more and more data from different area and different stages of disease have been needed.Methods In this retrospective, single-centre study, we included all 38 confirmed cases of Covid-19 in Weihai from Jan 24 to Feb 24, 2020. Patients were divided into group A by normal Oxygenation Index (OI), group B by abnormal OI (less than 400 mmHg).The dynamic changes in clinical laboratory parameters were tracked from day 1 to day 32 after the onset of the disease at 4-day intervals. Cases were analyzed for clinical, radiological features and laboratory data. Outcomes were followed up until Feb 24, 2020.Results 38 patients with Covid-19 were included in this study, 68.42% patients were family clustered, and 97.37% patients had a history of exposure. The mean days between exposure and onset were about 5 days. Most patients were men, mean age was 43 years, 52.6% patients had chronic diseases. Most patients had fever or cough, about a third of patients had expectoration or fatigue, and 5 (13.16%) patients had shortness of breath.

scholarly journals A A Multicentre ICET-A Study of Confirmed SARS-CoV-2 Infection in Patients with Hemoglobinopathies: Preliminary Data from 10 Countries

2020 ◽  
Vol 12 (1) ◽  
pp. e2020046 ◽  
Author(s):  
Vincenzo De Sanctis
Keyword(s):  
Clinical Laboratory ◽  
Clinical Symptoms ◽  
Respiratory Infections ◽  
Gastrointestinal Symptoms ◽  
Thalassemia Major ◽  
Absolute Number ◽  
Laboratory Findings ◽  
Radiologic Findings ◽  
Novel Coronavirus ◽  
Viral Respiratory Infections

Objectives: This study aims to investigate, retrospectively, the epidemiological and clinical characteristics, laboratory results, radiologic findings and outcomes of novel coronavirus disease-19 (COVID-19) in patients with transfusion dependent β thalassemia (β-thalassemia major-TM), non-transfusion dependent β thalassemia (β-thalassemia intermedia -TI) and sickle cell disease (SCD). Design, setting: A total of 17 Centers, from 10 countries, following 9,499 patients with hemoglobinopathies participated in the survey. Main outcome measures: Clinical, laboratory and radiologic findings and outcomes of patients with COVID-19 were collected from medical records and summarized. Results: A total of 13 patients, 7 with TM, 3 with TI and 3 with SCD, with confirmed COVID-19, were identified from 6 Centers from different countries. The overall mean age of patients was 33.7±12.3 years (range:13-66); 9/13 (69.2%) patients were females. The commonest symptoms in the 10 symptomatic patients were: fever (80%), cough (70%), headache (60%), fatigue (60%), gastrointestinal symptoms (diarrhea /vomiting/abdominal pain; 50%), tachypnea/dyspnea (40%), and sore throat (40%). Six patients had pneumonia (unilateral, bilateral or multiple opacity) and 4 needed oxygen therapy. An oxygen saturation ≤ 93% was documented in 3 patients at diagnosis. 6/10 patients had an exacerbation of anemia (2 with SCD, associated with back and chest pain in 1 patient), and 3 (<30%) had a decreased absolute number of lymphocytes. Increased C-reactive protein and D-dimers were the most common laboratory findings (66.6 %). Conclusions: The clinical presentation for COVID-19 in patients with β-thalassemia and SCD varies. Patients with mild/ordinary COVID-19 infection appear to have clinical symptoms and laboratory findings common to other viral respiratory infections. One 30 year old TM female patient with diabetes and chronic kidney disease. For a better understanding of COVID-19 in patients with hemoglobinopathies, further epidemiologic and clinical studies in a larger cohort of patients are required.

scholarly journals The Novel Coronavirus Disease (COVID-19): A PRISMA Systematic Review and Meta-Analysis of Clinical and Paraclinical Characteristics

2020 ◽  
Vol 2020 ◽  
pp. 1-16 ◽  
Author(s):  
Hamidreza Hasani ◽  
Shayan Mardi ◽  
Sareh Shakerian ◽  
Nooshin Taherzadeh-Ghahfarokhi ◽  
Parham Mardi
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Clinical Laboratory ◽  
Meta Analysis ◽  
Ct Scanning ◽  
Imaging Features ◽  
The Novel ◽  
Laboratory Findings ◽  
Global Concern ◽  
Novel Coronavirus

An outbreak of pneumonia, caused by a novel coronavirus (SARS-CoV-2), was identified in China in December 2019. This virus expanded worldwide, causing global concern. Although clinical, laboratory, and imaging features of COVID-19 are characterized in some observational studies, we undertook a systematic review and meta-analysis to assess the frequency of these features. We did a systematic review and meta-analysis using three databases to identify clinical, laboratory, and computerized tomography (CT) scanning features of rRT-PCR confirmed cases of COVID-19. Data for 3420 patients from 30 observational studies were included. Overall, the results showed that fever (84.2%, 95% CI 82.6-85.7), cough (62%, 95% CI 60-64), and fatigue (39.4%, 95% CI 37.2-41.6%) are the most prevalent symptoms in COVID-19 patients. Increased CRP level, decreased lymphocyte count, and increased D-dimer level were the most common laboratory findings. Among COVID-19 patients, 92% had a positive CT finding, most prevalently ground-glass opacification (GGO) (60%, 95% CI 58-62) and peripheral distribution opacification (64%, 95% CI 60-69). These results demonstrate the clinical, paraclinical, and imaging features of COVID-19.

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