ground glass opacity
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2022 ◽  
Vol 8 ◽  
Author(s):  
Xuejiao Liao ◽  
Dapeng Li ◽  
Zhi Liu ◽  
Zhenghua Ma ◽  
Lina Zhang ◽  
...  

Objective: The pulmonary sequelae of coronavirus disease 2019 (COVID-19) have not been comprehensively evaluated. We performed a follow-up study analyzing chest computed tomography (CT) findings of COVID-19 patients at 3 and 6 months after hospital discharge.Methods: Between February 2020 and May 2020, a total of 273 patients with COVID-19 at the Shenzhen Third People's Hospital were recruited and followed for 6 months after discharge. Chest CT scanning was performed with the patient in the supine position at end-inspiration. A total of 957 chest CT scans was obtained at different timepoints. A semi-quantitative score was used to assess the degree of lung involvement.Results: Most chest CT scans showed bilateral lung involvement with peripheral location at 3 and 6 months follow-up. The most common CT findings were ground-glass opacity and parenchymal band, which were found in 136 (55.3%) and 94 (38.2%) of the 246 patients at 3 months follow-up, and 82 (48.2%) and 76 (44.7%) of 170 patients at 6 months follow-up, respectively. The number of lobes involved and the total CT severity score declined over time. The total CT score gradually increased with the increasement of disease severity at both 3 months follow-up (trend test P < 0.001) and 6 months follow-up (trend test P < 0.001). Patients with different disease severity represented diverse CT patterns over time.Conclusions: The most common CT findings were ground-glass opacity and parenchymal bands at the 3 and 6 months follow-up. Patients with different disease severity represent diverse CT manifestations, indicating the necessary for long-term follow-up monitoring of patients with severe and critical conditions.


2022 ◽  
Vol 9 ◽  
Author(s):  
Maryam Najafinejad ◽  
Fatemeh Cheraghali ◽  
Bahman Aghcheli ◽  
Abdolhalim Rajabi ◽  
Leila Barati ◽  
...  

The COVID-19 disease usually leads to mild infectious disease in children, but some develop serious complications. Here, we describe the characteristics of children with COVID-19 in northern Iran, the Golestan province. Ninety-one confirmed cases were enrolled in the study, aged 0–18 years. Demographic, clinical, comorbidity, laboratory, and radiological data were compared based on the disease severity (admitted to intensive care unit (ICU) or not) and disease outcome (recovered or deceased). Sixteen (17.5%) cases were hospitalized in ICU, and 8/91 (8.8%) deceased. Fever and cough were the most common clinical symptoms. Among all symptoms notified there were no significant differences between severe and milder cases, or between those who deceased and recovered. Failure to thrive (FTT), malignant disease and neurological disease were significantly more prevalent in severe cases as was frequently reported comorbidities. Laterality, ground-glass opacity, and lung consolidation were the most common findings in chest computed tomography. The data confirms that the COVID-19 disease has various presentations in children, and clinical, laboratory, and radiological findings may help predict the development of severe forms of COVID-19 among children.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Yongpeng Ge ◽  
Hanbo Yang ◽  
Xinyue Xiao ◽  
Lin Liang ◽  
Xin Lu ◽  
...  

Abstract Objectives The purpose was to clarify the characteristics of interstitial lung disease (ILD) in immune-mediated necrotizing myopathy (IMNM) patients with anti-signal recognition particle (SRP) antibodies. Methods Medical records of IMNM patients with anti-SRP antibodies were reviewed retrospectively. Results A total of 60 patients were identified. Twenty-seven (45.0%) patients were diagnosed with ILD based on lung imaging: nonspecific interstitial pneumonia (NSIP) in 17 patients (63.0%) and organizing pneumonia in 9 patients (33.3%). Reticulation pattern was identified in 17 patients (63.0%) whereas 10 cases (37.0%) showed ground glass opacity and patchy shadows by high-resolution computed tomography (HRCT). Pulmonary function tests (PFTs) were available in 18 patients, 6 (33.3%) and 10 (55.6%) patients were included in the mild and moderate group, respectively. The average age at the time of ILD onset was significantly older than those without ILD (48.6 ± 14.4 years vs. 41.2 ± 15.4 years, p < 0.05), and the frequency of dysphagia in the ILD group was higher than the group without ILD (p < 0.05). Long-term follow-up was available on 9 patients. PFTs were stable in 8 (88.9%), and the HRCT remained stable in 6 (66.7%) patients. Conclusions ILD is not rare in IMNM patients with anti-SRP antibodies, most being characterized as mild to moderate in severity. NSIP is the principal radiologic pattern, and ILD typically remains stable following treatment.


Author(s):  
Hooman Bahrami-Motlagh ◽  
Yashar Moharamzad ◽  
Golnaz Izadi Amoli ◽  
Sahar Abbasi ◽  
Alireza Abrishami ◽  
...  

Abstract Background Chest CT scan has an important role in the diagnosis and management of COVID-19 infection. A major concern in radiologic assessment of the patients is the radiation dose. Research has been done to evaluate low-dose chest CT in the diagnosis of pulmonary lesions with promising findings. We decided to determine diagnostic performance of ultra-low-dose chest CT in comparison to low-dose CT for viral pneumonia during the COVID-19 pandemic. Results 167 patients underwent both low-dose and ultra-low-dose chest CT scans. Two radiologists blinded to the diagnosis independently examined ultra-low-dose chest CT scans for findings consistent with COVID-19 pneumonia. In case of any disagreement, a third senior radiologist made the final diagnosis. Agreement between two CT protocols regarding ground-glass opacity, consolidation, reticulation, and nodular infiltration were recorded. On low-dose chest CT, 44 patients had findings consistent with COVID-19 infection. Ultra-low-dose chest CT had sensitivity and specificity values of 100% and 98.4%, respectively for diagnosis of viral pneumonia. Two patients were falsely categorized to have pneumonia on ultra-low-dose CT scan. Positive predictive value and negative predictive value of ultra-low-dose CT scan were respectively 95.7% and 100%. There was good agreement between low-dose and ultra-low-dose methods (kappa = 0.97; P < 0.001). Perfect agreement between low-dose and ultra-low-dose scans was found regarding diagnosis of ground-glass opacity (kappa = 0.83, P < 0.001), consolidation (kappa = 0.88, P < 0.001), reticulation (kappa = 0.82, P < 0.001), and nodular infiltration (kappa = 0.87, P < 0.001). Conclusion Ultra-low-dose chest CT scan is comparable to low-dose chest CT for detection of lung infiltration during the COVID-19 outbreak while maintaining less radiation dose. It can also be used instead of low-dose chest CT scan for patient triage in circumstances where rapid-abundant PCR tests are not available.


2022 ◽  
Vol 9 ◽  
Author(s):  
Quan Zhang ◽  
Wei Xu ◽  
Fei Peng ◽  
Si Lei ◽  
Yanjun Zhong ◽  
...  

Since the pandemic of Corona Virus Disease 2019 (COVID-19), especially in the centers most affected, the symptoms such as fever, cough, myalgia or fatigue, and radioactive signs typically related to COVID-19 like ground-glass opacity (GGO) often distract the attention of physicians from other diseases. Aspiration pneumonia and COVID-19 share similarities in some aspects. There may be risk of misdiagnosis in the case of considering radiological patterns of pneumonia. Early diagnosis and treatment often greatly improve prognosis. We herein reported a case of 40-year-old patient who underwent chest CT scan with the discovery of ground-glass opacity, intralobular reticular opacity and interlobular septal thickening, consolidation, and air bronchogram sign, which were mainly located in the middle and upper lobes of the right lung. It was considered to be infection related pneumonia based on the negative reverse transcription-PCR (RT-PCR) result of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The next-generation sequencing (NGS) of bronchoalveolar lavage fluid (BALF) was performed and detected nucleic acid sequences of Klebsiella sp. Consequently, the patient accepted sensitive intravenous antibiotics therapy for 13 days and had a remarkable clinical and radiological improvement. His case was followed up through imaging procedures. Because of possible radiologic and clinical similarities between aspiration and COVID-19 pneumonia, COVID-19 can be of some value in proposing a differential diagnosis of aspiration pneumonia. Clinicians could suggest a correct diagnosis by careful examination of the CT images together with attention to the clinical history and judicious utilization of NGS, especially.


2022 ◽  
Vol 2 (1) ◽  
pp. 64-69
Author(s):  
Abdulmohsen Alhumayn ◽  
Ibrahim Alsaif ◽  
Joud Enabi ◽  
Sharafaldeen Bin Nafisah

Background: The declaration of the COVID-19 pandemic triggered a global inquiry into the transmission, mortality, risk factors, and management of the disease. Recently, however, attention has shifted toward its long-term consequences. There is a need for a better understanding of the predictors and symptoms of post-COVID syndrome, to ensure appropriate care for patients recovering from COVID-19 beyond the acute phase. Methods: We searched PubMed, Google Scholar, Cochrane databases, and available data in the PROSPERO databases. We also explored the reference lists of included articles and any systematic reviews identified therein. We searched the keywords "Post Covid", "Post COVID syndrome", "Post- Covid" and "PostCOVID", until July 2021. Results: Of 8167 articles, 13 were included. The syndrome affects several systems with variable prevalence. Fatigue and sleep disturbance is the most common symptom of acute post-COVID syndrome, observed in more than two-thirds of patients, while a reduction in quality of life and general health status was noted in up to 69%. Furthermore, a reduced aerobic and diffusion capacity was seen in 38% of patients up to one month after presumed recovery from infection. Radiologically, in up to 52% of patients, a ground-glass opacity (GGO) was noted beyond three months post-infection. The incidence of new psychiatric illness increased from as early as 14 days after infection and up to three or six months. Hearing impairment or loss, whether sensorineural or conductive, was noted in up to 8.3% of patients, and tinnitus was seen in up to 4.2%. Conclusion: Overall, given the variability in the manifestation of post-COVID syndrome, a multidisciplinary team is required to better serve these patients. We therefore urge the establishment of such teams, encompassing internal medicine, pulmonology, cardiology, and neurocognitive services.


2022 ◽  
Vol 15 (1) ◽  
pp. e242840
Author(s):  
Tatsuya Oki ◽  
Yukihiro Nagatani ◽  
Wataru Saika ◽  
Yoshiyuki Watanabe

A 57-year-old man with acute promyelocytic leukaemia (APML) received induction therapy including all-trans-retinoic acid (ATRA). At day 15, he developed dyspnoea, haemoptysis and hypoxia. Thorax CT demonstrated diffuse ground-glass opacity and consolidation predominantly in dorsal regions, which may reflect increased vascular permeability. He was diagnosed with differentiation syndrome. After dexamethasone was administered and chemotherapy suspended, his symptoms improved and abnormal lesions mostly disappeared on follow-up CT examinations. We report a short-term high-resolution CT series of differentiation syndrome.


Author(s):  
Dinh Khoa Nguyen

TÓM TẮT Đặt vấn đề: Bệnh COVID-19 gây ra bởi vi rút SARS-CoV-2 hiện nay là một đại dịch toàn cầu gây ảnh hưởng lớn đến hơn 200 quốc gia trên thế giới. Mức độ nặng của bệnh lý nhu mô phổi được coi là một yếu tố nguy cơ liên quan đến kết cục tử vong, bác sĩ nhận biết được điều này sẽ cải thiện sự phân tầng nguy cơ và điều chỉnh cường độ chăm sóc, đặc biệt là những bệnh nhân có nguy cơ cao. Phương pháp: Nghiên cứu hồi cứu 220 bệnh nhân COVID-19 được cách ly và điều trị tại Trung tâm hồi sức tích cực người bệnh COVID-19 trực thuộc Bệnh viện Trung ương Huế tại TP HCM Kết quả: Chúng tôi đã lấy ngẫu nhiên 110 bệnh nhân sống và 110 bệnh nhân tử vong (TV). Tổn thương trên X-quang ở nhóm tử vong trung vị TSS là 8 (8 - 8) và gặp gần như hoàn toàn mức độ nặng 109 (49,5%), nhóm sống trung vị TSS là 6 (4 - 7), và gặp phần lớn là mức độ vừa 68 (30,9%), sự khác biệt rất có ý nghĩa thống kê với p < 0,000001 và p < 0,0001. Tổn thương trên X-quang thường phối hợp và gặp theo thứ tự sau: tổn thương kẽ 212 (96,4%), kính mờ 205 (93,2%), nốt mờ 140 (63,6%), đông đặc 103 (46,8%), tổn thương dạng nốt mờ ở nhóm TV 96 (43,6%) cao hơn hẳn nhóm sống 44 (20%) với p < 0.0001. Vị trí tổn thương gặp ở nhóm TV là lan tỏa 2 phế trường bệnh nhân, trong khi ở nhóm sống gặp ở cả ở ngoại vi 58 (26,4%) và lan tỏa 52 (23,6%), không gặp tổn thương ở quanh rốn phổi ở cả hai nhóm với p < 0,0001. Kết luận: Nghiên cứu đầu tiên ở Việt Nam chỉ ra rằng điểm TSS cao, tổn thương lan tỏa trên X-quang và tuổi cao tăng nguy cơ tử vong do COVID-19. ABSTRACT RELATIONSHIP BETWEEN CLINICAL SYMPTOMS, CHEST X-RAY ABNORMALITIES AND OUTCOME IN PATIENTS WITH COVID-19 Background: COVID-19 caused by SARS-CoV-2 virus is an unprecedented global pandemic affecting more than 200 countries worldwide. The severity of parenchymal lung disease is considered as a major risk factor for mortality. Therefore, it is important to improve its recognition by clinicians, henceits risk stratification and intensity adjustment of care, especially in high - risk patients. Methods: A retrospective study was conducted on 220 COVID-19 patients who were treated at the COVID-19 Intensive Care Center Unit run by Hue Central Hospital in Ho Chi Minh City. Results: We randomly selected 110 patients who had recovered (R) and 110 who died (D) from COVID-19. The radiographic lesion in the D group median TSS was 8 (8 - 8) and had almost complete severity 109 (49.5%) and median recovery group TSS was 6 (4 - 7), and most of them were moderate 68 (30.9%) with p < 0.00001 and p < 0.0001. Lesions on X - ray are often combined and occurred in the following order: interstitial lesions 212 (96.4%), ground - glass opacity 205 (93.2%), blurred nodules 140 (63.6%), consolidation 103 (46.8%), nodular lesions in the D group 96 (43.6%) were significantly higher than in the recovery group 44 (20%) with p < 0.0001. The location of the lesions seen in the D group was diffuse to 2 lung fields patients, while in the recovery group it was found in both peripheral 58 (26.4%) and diffuse 52 (23.6%), not found lesions around the hilum in both groups with p < 0.0001. Conclusions: This study demonstrates for the first time in Vietnam that a high TSS score, diffuse radiographic involvement, and elderly age increase the risk of death in patients with COVID-19. Keywords: Clinical symptoms, chest X-ray, TSS, outcome, COVID-19


Biomedicine ◽  
2021 ◽  
Vol 41 (4) ◽  
pp. 793-798
Author(s):  
Abeer Wali Ahmed ◽  
Rasha Nadeem Ahmed ◽  
Mohamed Muyaser Naif ◽  
Mohammed Tahseen Yahya ◽  
Khalid Salih Maulood ◽  
...  

Introduction: Due to lack of PCR kits in our area, as well as the extensive dissemination and peaking of COVID-19 since March 2020, our knowledge as radiologists has become increasingly relevant for recognizing CT patterns in order to diagnose and isolate COVID-19-infected patients. In 100 instances, the investigation began with the most prevalent CT chest abnormalities and the CT severity score index in relation to sex. The goal of this study is to better diagnose COVID-19-related lung injuries, enhance the diagnostic accuracy of chest CT scans, and track disease development in Mosul City. Materials and Methods: From June 2020 to January 2021, one hundred patients were enrolled in this cross-sectional study in Mosul, with 71 males (71%) and 29 females (29%) ranging in age from 15 to 85 years, mean SD (53.2317.80). Non contrast chest CT were done as part of investigation tool on patients were suspected COVID-19 infection. Results: A radiologist gathered data between 4 and 10 days after the onset of symptoms and evaluated it for lesion pattern, location, and severity. The commonest CT changes (ground glass opacity 55.23%, consolidation 17.44%, broncho vascular thickening 9.88%, crazy paving 5.81% and tree in bud 5.23%) were seen, along with less common pattern (bronchiectasis 1.74%, nodules 2.33%, reversed halo sign and pleural effusion 1.17%), and no lymphadenopathy were seen.  Multilobe involvement was detected in 52/100 instances (68.92%), while peripheral affection was seen in 52/100 cases (65%). The higher CT severity score 4 and 5 with male gender were found to have a significant link (P value 0.002). Conclusion: CT pulmonary are useful as a physician's helper for management and as an excellent predictor of disease severity and patient outcome. In patients with COVID-19 positive infection, the CT scan severity score is highly linked to laboratory findings, hospital stay, and oxygen demands.


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