New grading system for post-COVID-19 pulmonary fibrosis based on computed tomography findings.

BACKGROUND: There is currently no objective computed tomography (CT)-defined grading system for coronavirus disease (COVID-19)-related pulmonary fibrosis. We propose a CT-based radiological scale that adapts the histological fibrosis scale to pulmonary fibrosis CT findings, to evaluate possible predictive factors for the degree of fibrosis in these patients. METHODS: A new radiological fibrosis grading system was created based on existing histological fibrosis scales. One hundred forty-seven COVID-19 patients with any degree of fibrosis on CT were evaluated. Smoking status, the presence of hypertension, the duration of hospital stays, the presence of comorbid diseases, and the levels of prognostic and predictive factors for COVID-19 were evaluated, and how these parameters affected the fibrosis scores was examined. RESULTS: Of 147 patients, 17.7% had grade 1, 17% had grade 2, 51.7% had grade 3, and 13.6% had grade 4 fibrosis. ANOVA revealed statistically significant relationships between the fibrosis scores and lactate dehydrogenase values, lymphocyte count, C-reactive protein level, and length of hospital stay. Smoking, advanced age, hypertension, and male sex showed significantly higher scores for fibrosis. CONCLUSIONS: Using our CT-defined lung fibrosis grading system, we could predict the severity of fibrosis as well as the resultant lung pathology in COVID-19 patients. Thus, disease exacerbation and development of permanent severe fibrosis can be prevented using the appropriate treatment methods in high-risk patients.

Comparison of SARS-COV-2 antibody assays in PCR negative and PCR positive Turkish patients.

BACKGROUND: To the Editor, Serology may offer valuable information during COVID-19 pandemic; however, published papers mainly reported the results of symptomatic patients having positive RT-PCR on upper respiratory tract specimens [1]. More studies are needed to address whether asymptomatic patients, or patients with chest imaging compatible with COVID-19 but negative RT-PCR, have different antibody response that could influence assays performances. We wanted to share our data from Turkey where 4,323,596 COVID-19 cases were detected out of 44,087,628 PCR tests by April 20, 2021 but there are only a couple of published studies about serodiagnosis of the infection. DISCUSSION: The authors have no funding source for the study. The authors have no conflicts of interest to declare.

Clinical and radiologic characteristics of symptomatic pregnant women with COVID-19 pneumonia

Objective: To describe the radiological features, diagnostic accuracy and features of imaging studies and their relation with clinical course of Coronavirus disease-2019 (COVID-19) pneumonia in pregnant women. Material and Methods: The clinical, laboratory and radiological features of symptomatic pregnant women suspected of COVID-19 were retrospectively reviewed. Chest radiography (CXR) and chest computed tomography (CT) findings of COVID-19 in pregnant women were identified. Results: Fifty-five of eighty-one pregnant women were included in the final analysis. The most common admission symptoms were dry cough (45.4%), fever (29.1%) and dyspnea (34.5%). Radiological imaging studies were performed in 34 (61.8%) patients. Fourteen (66.7%) of the laboratory-confirmed COVID-19 patients had parenchymal abnormalities on CXR, and most common abnormalities were airspace opacities (61.9%) and prominent bronchovascular shadows (28.6%). Seventeen (85.0%) of the patients had parenchymal abnormalities consistent with COVID-19 on their chest CT. Chest CT most commonly showed bilateral (88.2%), multilobe (100%) involvement; peripheral and central distribution (70.6%); patchy-shape (94.1%) and ground-glass opacity (94.1%). The sensitivity of CXR and chest CT was calculated as 66.7% and 83.3%, respectively. Preterm birth rate was 41.2% (n=7/17). Five (9.1%) of the 55 pregnant women admitted to the intensive care unit, three of those developed acute respiratory distress syndrome and one died. Conclusion: This study describes the main radiological features of symptomatic pregnant women infected with COVID-19. The refusal rate among pregnant women for the imaging modalities involving ionizing radiation was high but these had high sensitivity for COVID-19 diagnosis. The preterm birth and cesarean section rates were observed as remarkably increased.

Differences between radiological findings of COVID-19 and non-COVID-19 infections in pediatric patients.

BACKGROUND: This study aimed to reveal the differences between coronavirus disease 2019 (COVID-19) infections and non-COVID-19 respiratory tract infections in pediatric patients. METHODS: Sixty pediatric patients admitted to the hospital between March 11, 2020 and April 15, 2020 with respiratory tract infections were evaluated retrospectively. Among them, 20 patients with reverse transcription-polymerase chain reaction (RT-PCR) tests and chest computed tomography (CT) examinations were included in the study. According to the RT-PCR test results, the patients were divided into the COVID-19 and non-COVID-19 groups. The clinical observations, laboratory results, and radiological features from the two groups were then compared. RESULTS: According to the RT-PCR test results, 12 patients were assigned to the COVID-19 group and 8 to the non-COVID-19 group. There were no significant differences between the two groups in terms of clinical or laboratory features. In terms of radiological features, the presence of bronchiectasis and peribronchial thickening was statistically significantly higher in the non-COVID-19 group (P = 0.010 and P = 0.010, respectively). CONCLUSIONS: In pediatric cases, diagnosing COVID-19 using radiological imaging methods plays an important role in determining the correct treatment approach by eliminating the possibility of other infections.