ABSTRACT
Purpose. Description and illustration of the most common alternative causes of shortness of breath, cough, and acute chest pain in pandemic COVID-19 conditions. Material and methods. Authors evaluated results of the retrospective single-center study and instrumental data of 67 patients with complaints of sudden chest pain, cough and shortness of breath. For patients admitted to the hospital between March, 27 and June, 30, 2020, the first stage of diagNosis was made with the performed multispiral computed tomography (MSCT) of the chest, confirming the presence of pulmonary manifestations of COVID-19. The study did Not include patients with pneumothorax identified at the pre-And hospital stages. We describe early radiographic changes in the chest organs, main vessels, and coronary bed in patients with CT-confirmed COVID-19 admitted to O.M. Filatov Municipal Clinical Hospital No. 15, Moscow for sudden chest pain, cough, and shortness of breath. Results. In CT of the chest organs, combinations of COVID-19 and pulmonary artery thromboembolism, central/peripheral lung cancer, and acute aortic syndrome manifestations were most common. Combinations of radiation techniques in pandemic settings are COVID-19 required by patients with the acute coronary syndrome. However, it will be possible to analyze all cases of a combination of acute chest pain and sudden shortness of breath in patients with COVID-19 only after processing an extensive array of data. Conclusion. In pandemic conditions, COVID-19 performing standard imaging methods should be Not lost about the most frequent causes of chest pain and sudden shortness of breath, complementing native MSCT with contrasting enhancement in suspected pathology of the main arteries, and small circulation in high-risk patients. © 2021 Izdatel'stvo Meditsina. All rights reserved.
ABSTRACT
The first case of Coronavirus pneumonia (COVID-19) was detected in Wuhan, China, but the disease became a pandemic and health-care institutions in the Russian Federation faced confirmed cases of COVID-19. Objective. To describe the possibilities of imaging techniques with a focus on multispiral computed tomography (MSCT), as well as a dynamic analysis of pathology manifestations in patients hospitalized in Clinical Hospital No. 15 named after O.M. Filatov with a confirmed coronavirus infection. Material and methods. The retrospective study collected data from 300 patients with confirmed coronavirus infection from one of the largest multidisciplinary hospitals in the Russian Federation. General clinical manifestations were analyzed, as well as characteristics and features of the development of changes, revealed mainly by MSCT of the chest. Results. Examined 300 patients with PCR-confirmed COVID-19. Among the clinical manifestations, coughing, fever, shortness of breath prevailed. Most of the changes identified in pulmonary MSCT were polysegmental and bilateral in nature of the lesion, were more likely to be localized in the peripheral departments, 235 (78%) patients had more than two lobes involved in the pathological process, 263 (87.7%) patients had focal points of pulmonary tissue compaction by «frosted glass» type, and the combination of the above manifestations with the presence of consolidation foci and reticular changes was noted in 129 (43%) among the complications, there were more frequent: thickening of the pleura, hydrothorax, less often pneumothorax, and in rare cases, the empyema of pleura. When monitoring lung MSCT in 300 patients, rapid development of positive dynamics (on average, 5—7 days) was noted in 95 (31.6%) patients, 40 (13.2%) patients showed multidirectional dynamics, progression (CT stage in-creases) was observed in 111 (37%) cases, in 54 (18.2%) cases there were no significant changes in the dynamics of the X-ray pat-tern. Conclusions. Lung MSCT plays a key role in the diagnosis of COVID-19. The appearance of specific zones of pulmonary tissue compaction in the form of a «frosted glass», as a manifestation of a one-sided or two-sided, mono-or polyphocal lung lesion, can with a high probability indicate a manifestation of COVID-19 with a possible rapid progression of the X-ray pattern in a short period of time.