Cardiac MRI in patients with COVID-19 infection.

OBJECTIVE: COVID-19 infection is a systemic disease with various cardiovascular symptoms and complications. Cardiac MRI with late gadolinium enhancement is the modality of choice for the assessment of myocardial involvement. T1 and T2 mapping can increase diagnostic accuracy and improve further management. Our study aimed to evaluate the different aspects of myocardial damage in cases of COVID-19 infection using cardiac MRI. METHODS: This descriptive retrospective study included 86 cases, with a history of COVID-19 infection confirmed by positive RT-PCR, who met the inclusion criteria. Patients had progressive chest pain or dyspnoea with a suspected underlying cardiac cause, either by an abnormal electrocardiogram or elevated troponin levels. Cardiac MRI was performed with late contrast-enhanced (LGE) imaging, followed by T1 and T2 mapping. RESULTS: Twenty-four patients have elevated hsTnT with a median hsTnT value of 133 ng/L (IQR: 102 to 159 ng/L); normal value < 14 ng/L. Other sixty-two patients showed elevated hsTnI with a median hsTnI value of 1637 ng/L (IQR: 1340 to 2540 ng/L); normal value < 40 ng/L. CMR showed 52 patients with acute myocarditis, 23 with Takotsubo cardiomyopathy, and 11 with myocardial infarction. Invasive coronary angiography was performed only in selected patients. CONCLUSION: Different COVID-19-related cardiac injuries may cause similar clinical symptoms. Cardiac MRI is the modality of choice to differentiate between the different types of myocardial injury such as Takotsubo cardiomyopathy and infection-related cardiomyopathy or even acute coronary syndrome secondary to vasculitis or oxygen-demand mismatch. KEY POINTS: • It is essential to detect early COVID-related cardiac injury using different cardiac biomarkers and cardiac imaging, as it has a significant impact on patient management and outcome. • Cardiac MRI is the modality of choice to differentiate between the different aspects of COVID-related myocardial injury.

Recognition of COVID-19 Pneumonia in Patients Performing Different Interventional Radiological Procedures of The Chest

Background: Coronavirus disease 2019 (COVID-19) was declared a global pandemic by the World Health Organization on March 11, 2020. Many individuals remain completely asymptomatic and can transmit the infection to the general population. The high rate of false-negative results of reverse transcription-polymerase chain reaction (RTPCR), particularly early in the course of the disease process, requires other tools to diagnose COVID-19 infection, with an important role of radiological imaging. Interventional radiology in many instances continues to provide frontline care during this pandemic and can overcome the unique challenges of safety while providing adequate and efficient highquality patient care. Objective: The aim of our study was to focus upon the detection of typical imaging features of COVID-19 infection for asymptomatic patients, performing the different interventional radiological procedures of the chest to avoid the spread of infection and thus influence better detection and further management. Patients and methods: In this cross-sectional study, we have 382 patients, coming for different interventional radiological procedures of the chest from May 2020 till 30 October 2021. Results: 35 (9.1%) patients had computed tomography (CT) features of COVID-19 pneumonia using CORADS classification. RT-PCR testing was performed in 28 cases while 7 patients showed negative results;four cases repeated the RT-PCR test and three of them became positive. The other 3 cases refused to repeat RT-PCR and were only isolated and carefully monitored. Conclusion: The radiology staff including interventional radiologists should be aware of the accidental discovery of imaging features of COVD-19 infection, before proceeding with the interventional procedure. CT chest is an important tool for detection of COVID-19 detection, even in asymptomatic patients. [ FROM AUTHOR] Copyright of Egyptian Journal of Hospital Medicine is the property of Egyptian Journal of Hospital Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Incidental Thyroid Nodules on the COVID-19 Positive CT Chest

Background: The recent widespread of COVID-19 led to a marked increase in the number of CT chest examinations. This led to frequent encounters of associated incidental findings as thyroid nodules. Thyroid imaging reporting and data system (TI-RADS) using variable ultrasound feature-allowed systematic reproducible approach for diagnosis and management of thyroid nodules. Objective: This study aimed to detect the prevalence of incidental thyroid nodules in CT chest for COVID-19 cases as well as the percentage of malignant nodules among them and the concordance of TI-RADS classification with fineneedle aspiration cytology (FNAC) results. Patients and methods: This retrospective study included 895 patients with CT findings of COVID-19 pneumonia. 203 patients were excluded due to absent PCR confirmation of COVID-19, lack of ultrasound confirmation of thyroid nodules or lack of FNAC results, so our study included 692 patients with confirmed COVID-19 pneumonia. Results: A solitary thyroid nodule was discovered in 134 CT chest scans of 692 patients with confirmed COVID-19 pulmonary pneumonia, with a 19.4% incidence. These patients underwent ultrasound evaluation for the thyroid nodule. The nodules with TI-RADS 1-3 score were considered benign yet those with 4-5 score were classified as malignant. The results of the FNAC were compared to the thyroid TI-RADS classification, with nodules classified as Bethesda II-III being benign and those classified as Bethesda IV to VI being malignant. Conclusion: Incidental thyroid nodule discovered during CT chest examination is an important finding and should be investigated and categorized using the TI-RADS system as even though the incidence of malignancy is not high, early diagnosis of thyroid malignancy can have a huge effect on the patient outcome. [ FROM AUTHOR] Copyright of Egyptian Journal of Hospital Medicine is the property of Egyptian Journal of Hospital Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)