Chest Computed Tomography Severity Score to Predict Adverse Outcomes of Patients with COVID-19 / 감염과화학요법

Background@#The novel coronavirus disease 2019 (COVID-19) continues to wreak havoc worldwide. This study assessed the ability of chest computed tomography (CT) severity score (CSS) to predict intensive care unit (ICU) admission and mortality in patients with COVID-19 pneumonia. @*Materials and Methods@#A total of 192 consecutive patients with COVID-19 pneumonia aged more than 20 years and typical CT findings and reverse-transcription polymerase chain reaction positive admitted in a tertiary hospital were included. Clinical symptoms at admission and short-term outcome were obtained. A semi-quantitative scoring system was used to evaluate the parenchymal involvement. The association between CSS, disease severity, and outcomes were evaluated. Prediction of CSS was assessed with the area under the receiver-operating characteristic (ROC) curves. @*Results@#The incidence of admission to ICU was 22.8% in men and 14.1% in women. CSS was related to ICU admission and mortality. Areas under the ROC curves were 0.764 for total CSS.Using a stepwise binary logistic regression model, gender, age, oxygen saturation, and CSS had a significant independent relationship with ICU admission and death. Patients with CSS ≥12.5 had about four-time risk of ICU admission and death (odds ratio 1.66, 95% confidence interval 1.66 – 9.25). The multivariate regression analysis showed the superiority of CSS over other clinical information and co-morbidities. @*Conclusion@#CSS was a strong predictor of progression to ICU admission and death and there was a substantial role of non-contrast chest CT imaging in the presence of typical features for COVID-19 pneumonia as a reliable predictor of clinical severity and patient’s outcome.

Chest Computed Tomography Severity Score to Predict Adverse Outcomes of Patients with COVID-19 / 감염과화학요법

Background@#The novel coronavirus disease 2019 (COVID-19) continues to wreak havoc worldwide. This study assessed the ability of chest computed tomography (CT) severity score (CSS) to predict intensive care unit (ICU) admission and mortality in patients with COVID-19 pneumonia. @*Materials and Methods@#A total of 192 consecutive patients with COVID-19 pneumonia aged more than 20 years and typical CT findings and reverse-transcription polymerase chain reaction positive admitted in a tertiary hospital were included. Clinical symptoms at admission and short-term outcome were obtained. A semi-quantitative scoring system was used to evaluate the parenchymal involvement. The association between CSS, disease severity, and outcomes were evaluated. Prediction of CSS was assessed with the area under the receiver-operating characteristic (ROC) curves. @*Results@#The incidence of admission to ICU was 22.8% in men and 14.1% in women. CSS was related to ICU admission and mortality. Areas under the ROC curves were 0.764 for total CSS.Using a stepwise binary logistic regression model, gender, age, oxygen saturation, and CSS had a significant independent relationship with ICU admission and death. Patients with CSS ≥12.5 had about four-time risk of ICU admission and death (odds ratio 1.66, 95% confidence interval 1.66 – 9.25). The multivariate regression analysis showed the superiority of CSS over other clinical information and co-morbidities. @*Conclusion@#CSS was a strong predictor of progression to ICU admission and death and there was a substantial role of non-contrast chest CT imaging in the presence of typical features for COVID-19 pneumonia as a reliable predictor of clinical severity and patient’s outcome.

Lymphomatoid granulomatosis with splenomegaly and pancytopenia / 中国肺癌杂志

Lymphomatoid granulomatosis (LG) is an angiocentric lymphoproliferative disease. It usually involves lung, skin, and central nervous system, but splenomegaly and pancytopenia are the rare manifestations of the disease. We report a 15-year-old boy presented with fever, dry cough and dyspnea from two months ago, after admission patient had nodular lesions on the left leg and hepatosplenomegaly. Then he manifested neurologic signs such as seizure, aphasia and right-sided hemiplegia. Chest X-ray and CT scan revealed bilateral pulmonary nodules predominantly in lower lobes and peripheral lung fields. Laboratory exams showed pancytopenia. Skin biopsy was done, and histopathological examination and immunohistochemistry evaluation confirmed lymphomatoid granulomatosis. He was treated with steroid and cyclophosphamide but succumbed by neurologic involvement.

[ effect of Iron supplements on serum lipids profile of patients with iron deficiency]

A close relationship has been reported between level of serum iron and ischemic heart diseases, which is either brought about through direct effect of serum iron on myocardial cells or as an indirect result of elevated serum lipid profile. A widespread use of iron supplement has been observed due to the high prevalence of iron deficiency anemia. Yet an elevated serum lipid is strongly related with several major complication. This study examines the serum lipid profile before and after treatment with iron supplements. In this clinical trial, 200 patients with iron deficiency were treated with iron supplements for a period of 3 months. Hb, Ferritin, serum iron, TIBC and lipid profile were measured 1 and 3 months after the treatment. Data were then analyzed using paired t test. A total of 200 female patients were recruited. Hb level, Ferritn and SI/TIBC increased significantly after 3 months therapy [p-value < 0.001]. Cholesterol, LDL, HDL increased significantly independently of age, initial Hb level. Ferritin and SI/TIBC [p-value < 0.05]. There was also a significant increase in Triglyceride with no dependency to Ferritin, Hb and SI/TIBC. However, the elevation was related to age. Treatment with iron supplement leads to elevation of TG, CHOL, HDL, and LDL level after three months