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1.
Ann Transl Med ; 8(9): 594, 2020 May.
Article in English | MEDLINE | ID: covidwho-612191

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) has rapidly become a pandemic worldwide. The value of chest computed tomography (CT) is debatable during the treatment of COVID-19 patients. Compared with traditional chest X-ray radiography, quantitative CT may supply more information, but its value on COVID-19 patients was still not proven. Methods: An automatic quantitative analysis model based on a deep network called VB-Net for infection region segmentation was developed. A quantitative analysis was performed for patients diagnosed as severe COVID 19. The quantitative assessment included volume and density among the infectious area. The primary clinical outcome was the existence of acute respiratory distress syndrome (ARDS). A univariable and multivariable logistic analysis was done to explore the relationship between the quantitative results and ARDS existence. Results: The VB-Ne model was sensitive and stable for pulmonary lesion segmentation, and quantitative analysis indicated that the total volume and average density of the lung lesions were not related to ARDS. However, lesions with specific density changes showed some influence on the risk of ARDS. The proportion of lesion density from -549 to -450 Hounsfield unit (HU) was associated with increased risk of ARDS, while the density was ranging from -149 to -50 HU was related to a lowered risk of ARDS. Conclusions: The automatic quantitative model based on VB-Ne can supply useful information for ARDS risk stratification in COVID-19 patients during treatment.

2.
Clin Gastroenterol Hepatol ; 18(12): 2848-2851, 2020 11.
Article in English | MEDLINE | ID: covidwho-276149
3.
Acad Radiol ; 27(7): 910-921, 2020 07.
Article in English | MEDLINE | ID: covidwho-176152

ABSTRACT

RATIONALE AND OBJECTIVES: We aimed to assess the prevalence of significant computed tomographic(CT) manifestations and describe some notable features based on chest CT images, as well as the main clinical features of patients with coronavirus disease 2019(COVID-19). MATERIALS AND METHODS: A systematic literature search of PubMed, EMBASE, the Cochrane Library, and Web of Science was performed to identify studies assessing CT features, clinical, and laboratory results of COVID-19 patients. A single-arm meta-analysis was conducted to obtain the pooled prevalence and 95% confidence interval (95% CI). RESULTS: A total of 14 articles (including 1115 patients) based on chest CT images were retrieved. In the lesion patterns on chest CTs, we found that pure ground-glass opacities (GGO) (69%, 95% CI 58-80%), consolidation (47%, 35-60%) and "air bronchogram sign" (46%, 25-66%) were more common than the atypical lesion of "crazy-paving pattern" (15%, 8-22%). With regard to disease extent and involvement, 70% (95% CI 46-95%) of cases showed a location preference for the right lower lobe, 65% (58-73%) of patients presented with ≥3 lobes involvement, and meanwhile, 42% (32-53%) of patients had involvement of all five lobes, while 67% (55-78%) of patients showed a predominant peripheral distribution. An understanding of some important CT features might be helpful for medical surveillance and management. In terms of clinical features, muscle soreness (21%, 95% CI 15-26%) and diarrhea (7%, 4-10%) were minor symptoms compared to fever (80%, 74-87%) and cough (53%, 33-72%). CONCLUSION: Chest CT manifestations in patients with COVID-19, as well as its main clinical characteristics, might be helpful in disease evolution and management.


Subject(s)
Betacoronavirus , Coronavirus Infections/diagnostic imaging , Lung/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Tomography, X-Ray Computed/methods , Adult , Biomarkers/metabolism , Bronchography/methods , C-Reactive Protein/metabolism , Clinical Laboratory Techniques/methods , Coronavirus Infections/diagnosis , Coronavirus Infections/pathology , Cough/virology , Diarrhea/virology , Female , Fever/virology , Humans , Leukopenia/virology , Lung/pathology , Lung/virology , Lymphopenia/virology , Male , Middle Aged , Myalgia/virology , Pandemics , Pneumonia, Viral/pathology , Reverse Transcriptase Polymerase Chain Reaction , Thorax
5.
Ann Palliat Med ; 2020 Apr 20.
Article in English | MEDLINE | ID: covidwho-101323

ABSTRACT

The coronavirus disease 2019 (COVID-19) is a new infectious disease, firstly appeared in Wuhan city and has rapidly spread to 114 countries outside China, which is receiving worldwide attention. As two important means of examination, computed tomography (CT) and real-time reverse transcription polymerase chain reaction (RT-PCR) have always been controversial in the clinical diagnosis of COVID-19 pneumonia. Here, we report a family cluster case of a father and a son diagnosed as COVID-19 at our hospital, and described the clinical manifestations, laboratory results, CT changes, diagnosis and treatment strategy of these two patients. Focus on the value of these two methods in the diagnosis and treatment of diseases, as well as their respective deficiencies. For patient 1 (father), the efficacy of RT-PCR is not satisfactory either in terms of diagnosis or follow-up, which may cause misdiagnosis and delay treatment. For patient 2 (son), the clinical symptoms were not obvious, but CT imaging clearly displayed dynamic changes of the lung lesions. Meanwhile, the two patients respectively underwent five chest CT examinations during their hospitalization and discharge follow-up, showing the potential harm of radiation. Therefore, in clinical work, doctors should make full use of the advantages of CT and RT-PCR, and take other measures to make up for their disadvantages.

6.
Eur Radiol ; 30(8): 4381-4389, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-10207

ABSTRACT

Coronavirus disease 2019 (COVID-19) outbreak, first reported in Wuhan, China, has rapidly swept around the world just within a month, causing global public health emergency. In diagnosis, chest computed tomography (CT) manifestations can supplement parts of limitations of real-time reverse transcription polymerase chain reaction (RT-PCR) assay. Based on a comprehensive literature review and the experience in the frontline, we aim to review the typical and relatively atypical CT manifestations with representative COVID-19 cases at our hospital, and hope to strengthen the recognition of these features with radiologists and help them make a quick and accurate diagnosis.Key Points• Ground glass opacities, consolidation, reticular pattern, and crazy paving pattern are typical CT manifestations of COVID-19.• Emerging atypical CT manifestations, including airway changes, pleural changes, fibrosis, nodules, etc., were demonstrated in COVID-19 patients.• CT manifestations may associate with the progression and prognosis of COVID-19.


Subject(s)
Betacoronavirus , Coronavirus Infections/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Disease Progression , Humans , Pandemics , Pneumonia, Viral/diagnosis , Real-Time Polymerase Chain Reaction , Thorax/diagnostic imaging , Tomography, X-Ray Computed
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