scholarly journals Hypoxemia indicative of Rendu Osler disease during SARS Cov-2 pandemic

Author(s):  
Herveat RAMANANDAFY ◽  
Princy Parfait Andriamahenina ◽  
Harison Michel Tiaray ◽  
Anjara Mihaja Nandimbiniaina ◽  
Angela Zamelina Razafindrasoa ◽  
...  

Rendu Osler’s disease is a genetic disease characterized by mucocutaneous and visceral telangiectasias. Rendu Osler’s disease was discovered during hypoxemia during an outbreak of SARS-Cov2.This was a 36-year-old woman with exertional dyspnea and severe hypoxemia revealing pulmonary arteriovenous malformations on chest CT scan.

2021 ◽  
Vol 123 (4) ◽  
pp. 815-822
Author(s):  
Joanne Guerlain ◽  
Fabienne Haroun ◽  
Alexandra Voicu ◽  
Charles Honoré ◽  
Franck Griscelli ◽  
...  

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Fatemeh Khatami ◽  
Mohammad Saatchi ◽  
Seyed Saeed Tamehri Zadeh ◽  
Zahra Sadat Aghamir ◽  
Alireza Namazi Shabestari ◽  
...  

AbstractNowadays there is an ongoing acute respiratory outbreak caused by the novel highly contagious coronavirus (COVID-19). The diagnostic protocol is based on quantitative reverse-transcription polymerase chain reaction (RT-PCR) and chests CT scan, with uncertain accuracy. This meta-analysis study determines the diagnostic value of an initial chest CT scan in patients with COVID-19 infection in comparison with RT-PCR. Three main databases; PubMed (MEDLINE), Scopus, and EMBASE were systematically searched for all published literature from January 1st, 2019, to the 21st May 2020 with the keywords "COVID19 virus", "2019 novel coronavirus", "Wuhan coronavirus", "2019-nCoV", "X-Ray Computed Tomography", "Polymerase Chain Reaction", "Reverse Transcriptase PCR", and "PCR Reverse Transcriptase". All relevant case-series, cross-sectional, and cohort studies were selected. Data extraction and analysis were performed using STATA v.14.0SE (College Station, TX, USA) and RevMan 5. Among 1022 articles, 60 studies were eligible for totalizing 5744 patients. The overall sensitivity, specificity, positive predictive value, and negative predictive value of chest CT scan compared to RT-PCR were 87% (95% CI 85–90%), 46% (95% CI 29–63%), 69% (95% CI 56–72%), and 89% (95% CI 82–96%), respectively. It is important to rely on the repeated RT-PCR three times to give 99% accuracy, especially in negative samples. Regarding the overall diagnostic sensitivity of 87% for chest CT, the RT-PCR testing is essential and should be repeated to escape misdiagnosis.


2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Vikram rao Bollineni ◽  
Koenraad Hans Nieboer ◽  
Seema Döring ◽  
Nico Buls ◽  
Johan de Mey

Abstract Background To evaluate the clinical value of the chest CT scan compared to the reference standard real-time polymerase chain reaction (RT-PCR) in COVID-19 patients. Methods From March 29th to April 15th of 2020, a total of 240 patients with respiratory distress underwent both a low-dose chest CT scan and RT-PCR tests. The performance of chest CT in diagnosing COVID-19 was assessed with reference to the RT-PCR result. Two board-certified radiologists (mean 24 years of experience chest CT), blinded for the RT-PCR result, reviewed all scans and decided positive or negative chest CT findings by consensus. Results Out of 240 patients, 60% (144/240) had positive RT-PCR results and 89% (213/240) had a positive chest CT scans. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of chest CT in suggesting COVID-19 were 100% (95% CI: 97–100%, 144/240), 28% (95% CI: 19–38%, 27/240), 68% (95% CI: 65–70%) and 100%, respectively. The diagnostic accuracy of the chest CT suggesting COVID-19 was 71% (95% CI: 65–77%). Thirty-three patients with positive chest CT scan and negative RT-PCR test at baseline underwent repeat RT-PCR assay. In this subgroup, 21.2% (7/33) cases became RT-PCR positive. Conclusion Chest CT imaging has high sensitivity and high NPV for diagnosing COVID-19 and can be considered as an alternative primary screening tool for COVID-19 in epidemic areas. In addition, a negative RT-PCR test, but positive CT findings can still be suggestive of COVID-19 infection.


CHEST Journal ◽  
2013 ◽  
Vol 144 (2) ◽  
pp. 700-703 ◽  
Author(s):  
Sarah Bastawrous ◽  
Jan V. Hirschmann

CHEST Journal ◽  
2018 ◽  
Vol 154 (4) ◽  
pp. 576A
Author(s):  
JINCEY SRIRAM ◽  
IRMA VAN DE BEEK ◽  
PAUL JOHANNESMA ◽  
MICHIEL VAN WERKUM ◽  
TIJMEN VAN DER WEL ◽  
...  

2020 ◽  
Vol 8 (2) ◽  
pp. 1-8
Author(s):  
Nasir Ahmad Lone ◽  
Akshit Kumar ◽  
Waseem Ahmed Sheikh

Pulmonary arteriovenous malformations (PAVM) are a group of vascular anomalies of lung which present with variable clinical symptoms. Most patients with PAVM are asymptomatic but it can cause dyspnea on exertion, paradoxical emboli to brain causing various central nervous system complications like stroke and brain abscess, hemoptysis and rupture. The age at the presentation can range from 1st to 7th decade but the majority of patients present before the age of 30 years. PAVM is strongly associated with hereditary haemorrhagic telangiectasis which presents with epistaxis, mucocutaneous telangiectasias and AV malformations of various organs. In our case series, we have patients ranging from 3 yrs to 75 years with presentation ranging from asymptomatic to exertional dyspnea, hemoptysis and neurological complications.


Author(s):  
Dong-Hyun Joo ◽  
Hyun Woo Lee ◽  
Seo-Young Yoon ◽  
Tae Yun Park ◽  
Eun Young Heo ◽  
...  

Author(s):  
Mehrdad Nabahati ◽  
Soheil Ebrahimpour ◽  
Reza Khaleghnejad Tabari ◽  
Rahele Mehraeen

Abstract Background We aimed to prospectively assess the lung fibrotic-like changes, as well as to explore their predictive factors, in the patients who survived Coronavirus Disease 2019 (COVID-19) infection. In this prospective cross-sectional study, we recruited patients who had been treated for moderate or severe COVID-19 pneumonia as inpatients and discharged from Rohani hospital in Babol, northern Iran, during March 2020. The clinical severity of COVID-19 pneumonia was classified as per the definition by World Health Organization. We also calculated the CT severity score (CSS) for all patients at admission. Within the 3 months of follow-up, the next chest CT scan was performed. As the secondary outcome, the patients with fibrotic abnormalities in their second CT scan were followed up in the next 3 months. Results Totally, 173 COVID-19 patients were finally included in the study, of whom 57 (32.9%) were male and others were female. The mean age was 53.62 ± 13.67 years old. At 3-month CT follow-up, evidence of pulmonary fibrosis was observed in 90 patients (52.0%). Consolidation (odds ratio [OR] = 2.84), severe disease (OR 2.40), and a higher CSS (OR 1.10) at admission were associated with increased risk of fibrotic abnormalities found at 3-month CT follow-up. Of 62 patients who underwent chest CT scan again at 6 months of follow-up, 41 patients (66.1%) showed no considerable changes in the fibrotic findings, while the rest of 21 patients (33.9%) showed relatively diminished lung fibrosis. Conclusion Post-COVID-19 lung fibrosis was observed in about half of the survivors. Also, patients with severe COVID-19 pneumonia were at a higher risk of pulmonary fibrosis. Moreover, consolidation, as well as a higher CSS, in the initial chest CT scan, was associated with increased risk of post-COVID-19 lung fibrosis. In addition, some patients experienced diminished fibrotic abnormalities in their chest CT on 6-month follow-up, while some others did not.


Author(s):  
Hamidreza Hatamabadi ◽  
Majid Shojaee ◽  
Mohammad Bagheri ◽  
Masoomeh Raoufi

Introduction: Lung US has been reported to be as useful as a chest CT scan and much better than a chest x-ray for the evaluation of pneumonia. Objective: This study aimed to compare the findings of lung ultrasound (US) and chest CT scan of patients with COVID-19-associated pneumonia in the Emergency Department (ED). Methods: This retrospective observational pilot study was carried out on confirmed COVID-19 patients in the isolation corona ward of the Imam Hussein Hospital ED from March 15 to March 22, 2020. After obtaining demographic data, the patients underwent a pulmonary bedside US examination, with the patients in the sitting position, turning their back to the examiner. A 10-point lung US was performed. Each lung was divided into two areas: posterior (three zones) and lateral (two zones). The patients’ lung ultrasound and chest CT scan as the standard imaging were blindly reviewed and recorded. The clinical value of ultrasound was evaluated with different severity of lung involvement according to CT severity score. Results: Nineteen patients (38 zones), including 13 males, were evaluated with a mean age of 62.5±16.8 years. B2 lines and consolidation observed in the US examinations were significantly correlated with ground-glass opacity and consolidation observed in CT scan examinations, respectively (p <0.0001). US sensitivity and specificity of finding B2 lines were 90% and 100%, respectively. Also, the sensitivity and specificity of US in identifying consolidation were 82% and 100%, respectively. In the lungs with moderate and severe lobar involvement, US findings were significantly correlated (p <0.05) with CT scan findings. Conclusions: Ultrasound evaluation is a safe, fast, and rapid technique for the evaluation of patients with moderate to severe COVID-19-associated pneumonia. It is a reproducible procedure and can be implemented by the operator after a short course of training.


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