Prognostic impact of CT severity score in childhood cancer with SARS-CoV-2

BackgroundCT chest severity score (CTSS) is a semi-quantitative measure done to correlate the severity of the pulmonary involvement on the CT with the severity of the disease.The objectives of this study are to describe chest CT criteria and CTSS of the COVID-19 infection in pediatric oncology patients, to find a cut-off value of CTSS that can differentiate mild COVID-19 cases that can be managed at home and moderate to severe cases that need hospital care.A retrospective cohort study was conducted on 64 pediatric oncology patients with confirmed COVID-19 infection between 1 April and 30 November 2020. They were classified clinically into mild, moderate, and severe groups. CT findings were evaluated for lung involvement and CTSS was calculated and range from 0 (clear lung) to 20 (all lung lobes were affected).ResultsOverall, 89% of patients had hematological malignancies and 92% were under active oncology treatment. The main CT findings were ground-glass opacity (70%) and consolidation patches (62.5%). In total, 85% of patients had bilateral lung involvement, ROC curve showed that the area under the curve of CTSS for diagnosing severe type was 0.842 (95% CI 0.737–0.948). The CTSS cut-off of 6.5 had 90.9% sensitivity and 69% specificity, with 41.7% positive predictive value (PPV) and 96.9% negative predictive value (NPV). According to the Kaplan–Meier analysis, mortality risk was higher in patients with CT score > 7 than in those with CTSS < 7.ConclusionPediatric oncology patients, especially those with hematological malignancies, are more vulnerable to COVID-19 infection. Chest CT severity score > 6.5 (about 35% lung involvement) can be used as a predictor of the need for hospitalization.

Incidence of incidental positron emission tomography and computed tomography signs of COVID-19 in asymptomatic cancer patients in Egypt.

Background: COVID-19 was first reported in Egypt on 14 February 2020 and continues to be a major threat to public health. Aims: We studied the incidence of incidental positron emission tomography/computed tomography (PET/CT) signs of COVID-19 in asymptomatic cancer patients and compared this with the number of reported COVID-19 cases during the same period. Methods: We included all cancer patients who underwent PET/CT at Misr Radiology Center, Cairo, between 2 May and 7 August 2020. Results: There were 479 patients who underwent PET/CT primarily for follow-up, and 66 (13.78%) of them showed radiological signs of COVID-19, with the peak incidence in weeks 7-8 of the study. This coincided and strongly correlated with the peak incidence of COVID-19 in Egypt (Pearson's correlation coefficient test = 0.943). Conclusion: The incidence of incidental PET/CT signs of COVID-19 was in accordance with the officially reported incidence of COVID-19 in Egypt between 2 May and 7 August 2020. These results could be helpful for implementing and adjusting public health and social measures during the COVID-19 pandemic.

Incidence of incidental positron emission tomography and computed tomography signs of COVID-19 in asymptomatic cancer patients in Egypt

Contexte : La COVID-19 a été signalée pour la première fois en Égypte le 14 février 2020 et demeure une menace majeure pour la santé publique. Objectifs : Nous avons étudié l'incidence des signes fortuits de COVID-19 détectés au moyen de la tomographie par émission de positons/de la tomodensitométrie (TEP/TDM) chez des patients asymptomatiques atteints de cancer. Puis, nous avons comparé cette incidence au nombre de cas de COVID-19 notifiés pendant la même période. Méthodes : Nous avons inclus tous les patients atteints de cancer qui ont subi une TEP/TDM au Misr Radiology Center, au Caire, entre le 2 mai et le 7 août 2020. Résultats : Au total, 479 patients ont subi une TEP/TDM principalement à des fins de suivi, et 66 (13,78 %) d'entre eux ont présenté des signes radiologiques de COVID-19, avec un pic d'incidence au cours des semaines sept et huit de l'étude. Cela a coïncidé et était fortement corrélé avec le pic d'incidence de la COVID-19 en Égypte (test du coefficient de corrélation de Pearson = 0,943). Conclusion : L'incidence des signes fortuits de COVID-19 détectés par TEP/TDM était conforme à l'incidence officiellement notifiée de la COVID-19 en Égypte entre le 2 mai et le 7 août 2020. Ces résultats pourraient être utiles pour mettre en œuvre et ajuster les mesures sociales et de santé publique durant la pandémie de COVID-19.Alternate :Background: COVID-19 was first reported in Egypt on 14 February 2020 and continues to be a major threat to public health. Aims: We studied the incidence of incidental positron emission tomography/computed tomography (PET/CT) signs of COVID-19 in asymptomatic cancer patients and compared this with the number of reported COVID-19 cases during the same period. Methods: We included all cancer patients who underwent PET/CT at Misr Radiology Center, Cairo, between 2 May and 7 August 2020. Results: There were 479 patients who underwent PET/CT primarily for follow-up, and 66 (13.78%) of them showed radiological signs of COVID-19, with the peak incidence in weeks 7-8 of the study. This coincided and strongly correlated with the peak incidence of COVID-19 in Egypt (Pearson's correlation coefficient test = 0.943). Conclusion: The incidence of incidental PET/CT signs of COVID-19 was in accordance with the officially reported incidence of COVID-19 in Egypt between 2 May and 7 August 2020. These results could be helpful for implementing and adjusting public health and social measures during the COVID-19 pandemic.

Incidental radiological findings suggestive of COVID-19 in asymptomatic patients.

Despite routine screening of patients for coronavirus disease 2019 (COVID-19) symptoms and signs at hospital entrances, patients may slip between the cracks and be incidentally discovered to have lung findings that could indicate COVID-19 infection on imaging obtained for other reasons. Multiple case reports and case series have been published to identify the pattern of this highly infectious disease. This article addresses the radiographic findings in different imaging modalities that may be incidentally seen in asymptomatic patients who carry COVID-19. In general, findings of COVID-19 infection may appear in computed tomography (CT), magnetic resonance imaging, positron emission tomography-CT, ultrasound, or plain X-rays that show lung or only apical or basal cuts. The identification of these characteristics by radiologists and clinicians is crucial because this would help in the early recognition of cases so that a rapid treatment protocol can be established, the immediate isolation to reduce community transmission, and the organization of close monitoring. Thus, it is important to both the patient and the physician that these findings are highlighted and reported.