scholarly journals Immunity Profiling of COVID-19 Infection, Dynamic Variations of Lymphocyte Subsets, a Comparative Analysis on Four Different Groups

2021 ◽  
Vol 9 (10) ◽  
pp. 2036
Author(s):  
Mario Giosuè Balzanelli ◽  
Pietro Distratis ◽  
Gianna Dipalma ◽  
Luigi Vimercati ◽  
Orazio Catucci ◽  
...  
Keyword(s):  
Ct Scan ◽  
Peripheral Lymphocyte ◽  
Lymphocyte Subset ◽  
Ct Scans ◽  
Ground Glass ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Blood Samples ◽  
Inflammatory Status ◽  
F 14

Background: A novel coronavirus (SARS-CoV-2)-induced pneumonia (COVID-19) emerged in December 2019 in China, spreading worldwide. The aim of the present investigation was to evaluate the immunological response and the clinical subset of peripheral lymphocyte subset alteration in COVID-19 infection. Methods: the study was conducted on four different clinical groups (n = 4; total n = 138). Each individual was assigned to different groups based on specific criteria evaluated at the admission such as fever, dyspnea, arterial blood gas analysis (ABG), oral-nasopharyngeal swab/RT-PCR, and thoracic CT-scan. Treatment was performed only after blood samples were collected from each patient (PP and PP) at day 1. The blood samples were analyzed and tested the same day (CBC and Flowcytometry). The positive–positive group (PP n = 45; F = 18/ M = 27; median age = 62.33), comprised individuals affected by COVID-19 who showed fever, dyspnea (ABG = pO2 < 60), confirmed positive by oral-nasopharyngeal swab/RT-PCR and with CT-scan showing ground-glass opacities. The negative–positive (NP; n = 37; F = 11/M = 26; median age = 75.94) or “COVID-like” group comprised individuals with fever and dyspnea (ABG = pO2 < 60), who tested negative to nasopharyngeal swab/RT-PCR, with CT-scans showing ground-glass opacities in the lungs. The negative–affected group (NA; n = 40; F = 14/M = 26; median age = 58.5) included individuals negative to COVID-19 (RT-PCR) but affected by different chronic respiratory diseases (the CT-scans didn’t show ground-glass opacities). Finally, the negative–negative group (NN; n = 16; F = 14/M = 2) included healthy patients (NN; n = 16; median age = 42.62). Data and findings were collected and compared. Results: Lymphocytes (%) cells showed a decline in COVID-19 patients. The subsets showed a significant association with the inflammatory status in COVID-19, especially with regard to increased neutrophils, T-killer, T-active, T-suppressor, and T-CD8+CD38+ in individuals belong to the either COVID-19 and Covid-like NP group. Conclusions: Peripheral lymphocyte subset alteration was associated with the clinical characteristics and progression of COVID-19. The level of sub-set cells T-lymphocytes (either high or low) and B-lymphocytes could be used as an independent predictor for COVID-19 severity and treatment efficacy.

scholarly journals 538. The Role of N-acetylcysteine on Post Covid-19 Pulmonary Fibrosis

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S370-S371
Author(s):  
Bernard Demot ◽  
Kristin Ivan Mark Hizon
Keyword(s):  
Pulmonary Fibrosis ◽  
Ct Scan ◽  
Chest Ct ◽  
Ct Scans ◽  
Ground Glass ◽  
Nasopharyngeal Swab ◽  
High Dose ◽  
Pulmonary Consolidation ◽  
Chest Ct Scan

Abstract Background Covid 19 have long lasting complications, from myalgia, body weakness to life debilitating strokes, and pulmonary fibrosis. Several mechanisms had been described but mostly viral or autoimmune which causes damages which leads to Acute respiratory distress syndrome. There is no approved treatment as of this time. Antifibrotic drugs use had been limited due to hepatoxicity, on top of Covid 19 hepatopathy. This study aims to describe the role of N-acetylcysteine on Post COVID 19 pulmonary fibrosis as an alternative treatment. Methods Patients are admitted at Baguio General Hospital and Medical Center at the COVID wards. Patients are COVID confirmed by RT PCR nasopharyngeal swab. Patient who are classified as severe were given Dexamethasone, Enoxaparin and Remdesivir for 5-10 days. Patients who are not weaned off from O2 support underwent Chest CT scan. Patients with Extensive Fibrosis were then consented to undergo High Dose IV Infusion of N-acetylcysteine. (150mg/kg in 1st hour, 50mg/kg next 4 hours and 100mg/kg last 20 hours). Repeat Chest CT Scan was done. Results Peripheral Bilateral Ground Glass Opacities and Pulmonary Consolidation was seen on pre-treatment CT Scans. Repeat CT scans showed significant regression of Ground Glass Opacities and Pulmonary Consolidation. CT SCAN pre and post treatment Conclusion High dose N-acetylcysteine showed promising results on Post COVID 19 Pulmonary Fibrosis. Disclosures All Authors: No reported disclosures

scholarly journals COVID-19 and COVID-like Patients: A Brief Analysis and Findings of Two Deceased Cases

2020 ◽  
Vol 8 (T1) ◽  
pp. 490-495
Author(s):  
Giosuè Mario Balzanelli ◽  
Pietro Distratis ◽  
Sergey K. Aityan ◽  
Felice Amatulli ◽  
Orazio Catucci ◽  
...  
Keyword(s):  
Ct Scan ◽  
Diffuse Alveolar Damage ◽  
Clinical Signs ◽  
Ground Glass Opacity ◽  
Rapid Onset ◽  
Ground Glass ◽  
Rt Pcr ◽  
Arterial Blood Gas ◽  
Small Vessels ◽  
Arterial Blood

BACKGROUND: The predominant pattern of lung lesions in patients affected by coronavirus disease (COVID-19) disease is diffuse alveolar damage with massive thromboembolism similar as described in patients infected with severe acute respiratory syndrome coronavirus and Middle East respiratory syndrome coronaviruses. Hyaline membrane formation and pneumocyte atypical hyperplasia were frequent. Importantly, the formation of platelet–fibrin thrombi in small vessels was seen consistent with coagulopathy, which appeared to be a common feature in patients who died of COVID-19. However, many were the cases found with similar COVID-19 symptomatology though negative results from nasal-pharyngeal swab performed by reverse transcription-polymerase chain reaction (RT-PCR). This latter typology of patients, otherwise named COVID-like, showed analogous clinical signs with similar arterial blood gas, cell blood count and laboratory parameters, and same computed tomography (CT)-scan ground-glass opacities. Symptoms such as cough, fever, and difficulty breathing were highly similar as well. Both forms, COVID-19 and COVID-like, are primarily respiratory with multi-organ involvement and both revealed comparable incubation periods often with a rapid onset and unexpected decay. CASE REPORT: In this brief paper, we described two cases regarding two deceased males, one confirmed COVID-19 (RT-PCR but not CT scan) and the second a COVID-like (negative for RT-PCR but positive to CT scan with ground-glass opacity) whom condition, disease patterns, and analysis were highly similar. CONCLUSION: Improved investigation is mandatory, in which RT-PCR and CT scan procedures are completed by data from more detailed laboratory analysis, ABG analysis, BALF, and a deeper clinical assessment.

scholarly journals The Spectrum of Chest CT-Scans in the Hospitalized Patients with the Coronavirus Disease

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Maria Shirvani ◽  
Alireza Janbakhsh ◽  
Feizollah Mansouri ◽  
Babak Sayad ◽  
Siavash Vaziri ◽  
...  
Keyword(s):  
Ct Scan ◽  
Clinical Symptoms ◽  
Large Family ◽  
Chest Ct ◽  
Hospitalized Patients ◽  
Ct Scans ◽  
Ground Glass ◽  
Sample Population ◽  
Ground Glass Opacification ◽  
Chest Ct Scan

Background: Coronaviruses are a large family of RNA viruses, which range from the common cold virus to the causative agent of more severe diseases. Coronavirus was declared a pandemic in December 2019 in Wuhan, China. Iran has been an endemic zone for the spread of the coronavirus since the outset of this global epidemic and has remained among the countries largely affected by high rates of the disease. Objectives: The present study aimed to investigate the range of the chest computed tomography (CT) scan findings among the hospitalized patients with COVID-19 in Kermanshah, Iran during March-April 2020 to contribute to the accurate diagnosis of the infected patients. Methods: The sample population consisted of 286 hospitalized patients diagnosed with or suspected of the coronavirus disease. Chest CT-scan images and clinical data were reviewed, and their correlation was analyzed. Results: In total, 176 patients (61.53%) were male, and 110 (38.47%) were female. The mean age of the patients was 56 years. Polymerase chain reaction (PCR) results showed that 35.31% of the cases had coronavirus, while the results were negative in 64.69% of the cases. In addition, the CT-scan findings indicated 77.27% abnormal and 22.73% normal chest CT-scans. Among the patients, 75.87% recovered completely, and 18.53% died. The major CT abnormalities were diffuse ground-glass opacification (35.66%), peripheral ground-glass opacification (bilateral; 21.33%), and a combination of diffuse and peripheral ground-glass lesions (18.88%). The consolidation lesion of one lobe was detected in 16 patients, and the consolidation lesion of more than one lobe was observed in 40 patients. Conclusions: According to the results, the most common chest CT-scan findings in COVID-19 include diffuse ground-glass opacification, peripheral ground-glass opacification (bilateral), central ground-glass opacification (bilateral), a combination of diffuse and peripheral ground-glass opacification, a combination of central and peripheral ground-glass opacification, the consolidation lesion of one lobe, and the consolidation lesion of more than one lobe. Furthermore, significant correlations were observed between the CT-scans and the main clinical symptoms, while no significant correlations were denoted between the chest CT-scan and PCR results.

The Diagnostic Value of CT scans in the Process of Diagnosing COVID-19 in medical Centers

2021 ◽  
Author(s):  
Afshin Ostovar ◽  
Elham Ehsani-Chimeh ◽  
Zeinab Fakoorfard
Keyword(s):  
Ct Scan ◽  
Sensitivity And Specificity ◽  
Clinical Decision Making ◽  
Diagnostic Value ◽  
Chest Ct ◽  
Rapid Review ◽  
Ct Scans ◽  
Rt Pcr ◽  
Medical Centers ◽  
Pcr Test

Background: Coronavirus disease (COVID-19) has spread around the world since the beginning of 2020. The definitive diagnosis of COVID-19 is the RT-PCR laboratory test. However, because of low sensitivity, the chest CT scan has become important for the rapid diagnosis and clinical decision-making. Objectives: This study aims to define CT scan’ diagnostic value in diagnosing COVID-19 in medical centers. Methods: This study is a rapid health technology assessment (HTA) and had two major phases. In phase 1, a rapid review was done for defining the sensitivity and specificity rate of CT. During this phase, studies related to the diagnostic and technical data on the use of CT in the diagnosis of COVID-19 were reviewed, and the sensitivity and specificity of CT in these studies were extracted. In phase 2, sequential testing was run to evaluate the diagnostic value of chest CT to diagnose COVID-19 according to two scenarios before and after adding RT-PCR test results. Results: CT scan has a high sensitivity for diagnosing cases of COVID-19. Due to its low specificity, relying on CT scans to diagnose COVID-19 alone in medical centers can lead to a significant proportion of false-positive cases. This study showed that if the probability of COVID-19 before the CT scan were about 50%, with a positive CT scan, this probability would be between 60 and 70% depending on the CT specificity. Conclusions: With the available evidence, the use of a CT scan alone is not sufficient for diagnosis. The RT-PCR test is also necessary to improve the diagnosis and continue the treatment and isolation of patients.

scholarly journals A spectrum of HRCT chest findings in RT-PCR positive asymptomatic COVID-19 patients at a COVID designated hospital in Nepal

2021 ◽  
Author(s):  
Bina Basnet ◽  
Sujata Pant ◽  
Sujit Pant ◽  
Kalpana Rai ◽  
Niraj Basanta Tulachan ◽  
...  
Keyword(s):  
Ct Scan ◽  
Clinical Status ◽  
Cross Sectional Study ◽  
Chest Ct ◽  
Public Health Care ◽  
Ground Glass ◽  
Rt Pcr ◽  
Cross Sectional ◽  
Ct Findings ◽  
Mixed Ground

Introduction: COVID-19 pandemic is grappling the world with the surge of infection time and again. Clinicians are trying to justify the ethics of public health care. Asymptomatic COVID-19 cases are going undocumented and most of them practice self-isolation. Studies have revealed significant radiological changes among RT-PCR positive asymptomatic COVID-19 cases. Objective: The aim of this cross-sectional study is to characterized chest CT findings of asymptomatic RT-PCR-positive patients in one of the COVID designated hospitals in Nepal. Results: Out of 43, 26 (60.5%) participants had positive Chest CT scan findings consistent with COVID pneumonia. 65% had bilateral and 77% had multifocal lesions. The ground-glass opacities (92%), mixed (ground-glass opacities and consolidation) pattern (30.7%), and consolidation only (34.6%) were common chest CT findings. The median CT score was 3.5 (Interquartile range; 2-6). Conclusion: The majority of the RT-PCR positive asymptomatic patient present with CT scan changes of lungs which are important to determine clinical status, prognosis, and long-term sequel in those cohorts.

scholarly journals Radiological Features on HRCT and RT-PCR Testing for the Diagnosis of Coronavirus Disease 2019 (COVID-19) in China: A Comparative Study of 78 Cases in Pregnant Women

2020 ◽  
Author(s):  
Ming Deng ◽  
Wenbo Sun ◽  
Jinxiang Hu ◽  
Liejun Mei ◽  
Dinghu Weng ◽  
...  
Keyword(s):  
Ct Scan ◽  
Pregnant Women ◽  
Predictive Value ◽  
Lower Lobe ◽  
Ct Scans ◽  
Imaging Features ◽  
Rt Pcr ◽  
Double Positive ◽  
Quantitative Parameters ◽  
Pcr Test

Abstract BackgroundIn the past four months, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global health threat. In the context of the coronavirus disease 2019 (COVID-19) epidemic, pneumonia is a critical disease that threatens the health of pregnant women and fetuses. We aimed to evaluate the quantitative parameters of CT scans performed on pregnant women with COVID-19 who had different reverse transcription-polymerase chain reaction (RT-PCR) results.MethodsPregnant women with suspected cases of COVID-19 pneumonia (confirmed by next-generation sequencing or RT-PCR) who underwent high-resolution lung CT scans were retrospectively enrolled. Patients were grouped based on the results of the RT-PCR and the first CT scan: group 1 (double positive patients; positive RT-PCR and CT scan) and group 2 (negative RT-PCR and positive CT scan). The imaging features and their distributions were extracted and compared between the two groups.ResultsSeventy-eight patients were admitted to the hospital between Dec 20, 2019, and Feb 29, 2020. The mean age of the patients was 31.82 years (SD 4.1, ranged from 21 to 46 years). The cohort included 14 (17.95%) patients with a positive RT-PCR test and 64 (82.05%) with a negative RT-PCR test, there were 37 (47.44%) patients with a positive CT scan, and 41 (52.56%) patients with a negative CT scan. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CT-based diagnosis of COVID-19 were 85.71%, 60.94%, 32.40%, 95.12% and 65.38%, respectively. COVID-19 pneumonia mainly involved the right lower lobe of the lung. There were 53 semi-quantitative and 59 quantitative parameters, which were compared between the two groups. There were no significant differences in the quantitative parameters. However, the Hellinger distance was significantly different between the two groups, albeit with a limited diagnostic value (AUC = 0.63).ConclusionsPregnant women with pneumonia usually present with typical abnormal signs on CT. Although multidimensional CT quantitative parameters are somewhat different between groups of patients with different RT-PCR results, it is still impossible to accurately predict whether the RT-PCR will be positive, which would allow for the earlier detection of SARS-CoV-2 infection.

scholarly journals Chest CT features of COVID-19 in the region of Abu Dhabi, UAE- A single institute study

2020 ◽  
Author(s):  
Ghufran Aref Saeed ◽  
Abeer Ahmed Al Helali ◽  
Safaa Almazrouei ◽  
Asad Shah ◽  
Luai A. Ahmed
Keyword(s):  
Ct Scan ◽  
Diagnostic Performance ◽  
Chest Ct ◽  
Abu Dhabi ◽  
Ground Glass ◽  
Rt Pcr ◽  
Negative Results ◽  
Chest Ct Scan ◽  
Ct Features ◽  
Pcr Test

AbstractOBJECTIVEOur aim is to investigate high resolution CT features of COVID-19 infection in Abu Dhabi, UAE, and to compare the diagnostic performance of CT scan with RT-PCR test.METHODSData of consecutive patients who were suspected to have COVID-19 infection and presented to our hospital, was collected from March 2, 2020, until April 12, 2020. All patients underwent RT-PCR test; out of which 53.8% had chest CT scan done. Using RT-PCR as a standard reference, the sensitivity and specify of CT scan was calculated. We also analyzed the most common imaging findings in patients with positive RT-PCR results.RESULTSThe typical HRCT findings were seen in 50 scans (65.8%) out of total positive ones; 44 (77.2%) with positive RT-PCR results and 6 (31.6%) with negative results. The peripheral disease distribution was seen in 86%, multilobe involvement in 70%, bilateral in 82%, and posterior in 82% of the 50 scans.The ground glass opacities were seen in 50/74 (89.3%) of positive RT-PCR group. The recognized GGO patterns in these scans were: rounded 50%, linear 38%, and crazy-paving 24%.Using RT-PCR as a standard of reference, chest HRCT scan revealed sensitivity of 68.8% and specificity of 70%.CONCLUSIONThe commonest HRCT findings in patients with COVID-19 pneumonia were peripheral, posterior, bilateral, multilobe rounded ground glass opacities.

scholarly journals Characteristics of Peripheral Lymphocyte Subset Alteration in COVID-19 Pneumonia

2020 ◽  
Vol 221 (11) ◽  
pp. 1762-1769 ◽  
Author(s):  
Fan Wang ◽  
Jiayan Nie ◽  
Haizhou Wang ◽  
Qiu Zhao ◽  
Yong Xiong ◽  
...  
Keyword(s):  
T Cells ◽  
B Cells ◽  
Cd8 T Cells ◽  
Treatment Efficacy ◽  
Clinical Characteristics ◽  
Peripheral Lymphocyte ◽  
Lymphocyte Subset ◽  
Inflammatory Status ◽  
Before And After ◽  
Novel Coronavirus

Abstract Background In December 2019, novel coronavirus (SARS-CoV-2) pneumonia (COVID-19) was reported in Wuhan and has since rapidly spread throughout China. We aimed to clarify the characteristics and clinical significance of peripheral lymphocyte subset alteration in COVID-19. Methods The levels of peripheral lymphocyte subsets were measured by flow cytometry in 60 hospitalized COVID-19 patients before and after treatment, and their association with clinical characteristics and treatment efficacy was analyzed. Results Total lymphocytes, CD4+ T cells, CD8+ T cells, B cells, and natural killer (NK) cells decreased in COVID-19 patients, and severe cases had a lower level than mild cases. The subsets showed a significant association with inflammatory status in COVID-19, especially CD8+ T cells and CD4+/CD8+ ratio. After treatment, 37 patients (67%) showed clinical response, with an increase in CD8+ T cells and B cells. No significant change in any subset was detected in nonresponsive cases. In multivariate analysis, posttreatment decrease in CD8+ T cells and B cells and increase in CD4+/CD8+ ratio were indicated as independent predictors of poor efficacy. Conclusions Peripheral lymphocyte subset alteration was associated with clinical characteristics and treatment efficacy of COVID-19. CD8+ T cells tended to be an independent predictor for COVID-19 severity and treatment efficacy.

scholarly journals Radiological Features on HRCT and RT-PCR Testing for the Diagnosis of Coronavirus Disease 2019 (COVID-19) in China: A Comparative Study of 78 Cases in Pregnant Women

2020 ◽  
Author(s):  
Ming Deng ◽  
Wenbo Sun ◽  
Jinxiang Hu ◽  
Liejun Mei ◽  
Dinghu Weng ◽  
...  
Keyword(s):  
Ct Scan ◽  
Pregnant Women ◽  
Predictive Value ◽  
Lower Lobe ◽  
Ct Scans ◽  
Imaging Features ◽  
Rt Pcr ◽  
Double Positive ◽  
Quantitative Parameters ◽  
Pcr Test

Abstract Objective: We aimed to evaluate the quantitative parameters of CT scans performed on pregnant women with COVID-19 who had different reverse transcription-polymerase chain reaction (RT-PCR) results.Methods: Pregnant women with suspected cases of COVID-19 pneumonia (confirmed by next-generation sequencing or RT-PCR) who underwent high-resolution lung CT scans were retrospectively enrolled. Patients were grouped based on the results of the RT-PCR and the first CT scan: group 1 (double positive patients; positive RT-PCR and CT scan) and group 2 (negative RT-PCR and positive CT scan). The imaging features and their distributions were extracted and compared between the two groups.Results: Seventy-eight patients were admitted to the hospital between Dec 20, 2019, and Feb 29, 2020. The mean age of the patients was 31.82 years (SD 4.1, ranged from 21 to 46 years). The cohort included 14 (17.95%) patients with a positive RT-PCR test and 64 (82.05%) with a negative RT-PCR test, there were 37 (47.44%) patients with a positive CT scan, and 41 (52.56%) patients with a negative CT scan. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CT-based diagnosis of COVID-19 were 85.71%, 60.94%, 32.40%, 95.12% and 65.38%, respectively. COVID-19 pneumonia mainly involved the right lower lobe of the lung. There were 53 semi-quantitative and 59 quantitative parameters, which were compared between the two groups. There were no significant differences in the quantitative parameters. However, the Hellinger distance was significantly different between the two groups, albeit with a limited diagnostic value (AUC=0.63).Conclusions: Pregnant women with pneumonia usually present with typical abnormal signs on CT. Although multidimensional CT quantitative parameters are somewhat different between groups of patients with different RT-PCR results, it is still impossible to accurately predict whether the RT-PCR will be positive, which would allow for the earlier detection of SARS-CoV-2 infection.

scholarly journals Combining PCR and CT testing for COVID

2020 ◽  
Author(s):  
Chen Shen ◽  
Ron Mark ◽  
Nolan J. Kagetsu ◽  
Anton S. Becker ◽  
Yaneer Bar-Yam
Keyword(s):  
Ct Scan ◽  
False Negative ◽  
Viral Pneumonia ◽  
Contact Tracing ◽  
Ct Scans ◽  
Reproduction Rate ◽  
Rt Pcr ◽  
Social Distancing ◽  
Rapid Extinction ◽  
Pneumonia Diagnosis

We analyze the effect of using a screening CT-scan for evaluation of potential COVID-19 infections in order to isolate and perform contact tracing based upon a viral pneumonia diagnosis. RT-PCR is then used for continued isolation based upon a COVID diagnosis. Both the low false negative rates and rapid results of CT-scans lead to dramatically reduced transmission. The reduction in cases after 60 days with widespread use of CT-scan screening compared to PCR by itself is as high as 50×, and the reduction of effective reproduction rate R(t) is 0.20. Our results imply that much more rapid extinction of COVID is possible by combining social distancing with CT-scans and contact tracing.

Sign in / Sign up

Export Citation Format

Share Document