COVID-19 pneumonia - increased incidence of pneumothorax/mediastinal emphysema after invasive mechanical and non-invasive ventilation.

Introduction: COVID pneumonia can lead to pneumomediastinum or pneumothorax during non-invasive or invasive mechanical ventilation. This affects the prognosis. Methodology: During the study period, 121 patients with SARS-CoV-2 infections and invasive or non-invasive ventilation therapy were recorded in our hospital. All patients with a pneumothorax or pneumomediastinum were analyzed in more detail. Result(s): Pneumothorax and pneumomediastinum occurred in 12 patients and resulted in 7 deaths. Discussion(s): The incidence of pneumothorax with COVID infection ranges from 0.56 to 1%, reaching 3.5% in our own studies and 4.2% under invasive mechanical ventilation. The incidence of pneumomediastinum was 10% and 9.2% in our own patients. Overall mortality was 58.3% and similar to that reported in the literature, up to 60%.Copyright © 2023 Dustri-Verlag Dr. K. Feistle.

Impact of Thymic Response in COVID-19 Pneumonia on Disease Severity and Mortality-As Assessed on CT-Chest

Objective: To determine the effect of thymic response to COVID-19 pneumonia on imaging and its impact on disease severity and outcome. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Radiology and Imaging (AFIRI), Rawalpindi Pakistan, from Mar to Jul 2020. Methodology: A total of 1620 COVID-19 patients above the age of 18, of either gender, were included in the study. Their findings on High-Resolution CT (HRCT) chest were recorded and graded according to the CT severity score (CTSS) out of a total of 40;less than or equal to 19 was taken as mild while >20 scores were considered as severe disease. The thymic response was assessed by imaging appearance on CT and was graded from 0-3 as follows: fatty, predominantly fatty, mixed density (fat and soft density), and soft density. Fatty replacement implied thymic involution, while soft density depicted a reactivation of thymic tissue after a disease process depictive adequate thymic response. Results: A significant difference in thymic response was observed in patients of different age groups (p<0.001), with the younger age group demonstrating thymic reactivation/ response in the majority (170/244, 69.7%). CT severity score and mortality were significantly higher in older patients demonstrating poor thymic response to COVID pneumonia. Conclusion: Response of the thymus to acute viral infection by Sars COVID-19 is impaired as age progresses;this accounts for greater disease severity, morbidity and mortality in older patients.

A parallel epidemic of sino-nasal mucormycosis post-COVID pneumonia, and its anesthetic implications: a case report

BackgroundThere has been a rise in cases of sino-nasal mucormycosis in patients who contracted the COVID-19 virus and were on steroids. Population at risk includes diabetics and on immunosuppressant therapy and/or immunocompromised state. Perioperative management becomes challenging due to residual pulmonary disease secondary to COVID pneumonia and complication following systemic antifungal therapy. Such patients often have other associated illnesses like hypertension, obesity, and deranged renal functions, either as a part of metabolic syndrome or post-systemic antifungal therapy.Case presentationWe report a case of a 64-year-old female, a poorly controlled hypertensive, with class 1 obesity, and diabetic on oral hypoglycemic agents, hypothyroid on oral medications, and post-COVID pneumonia with recently diagnosed sino-nasal mucormycosis who was posted for debridement of the sino-nasal fungal mass. The gamut of co-morbid conditions along with post-COVID pneumonia status presents an anesthetic challenge apropos the optimization of the clinical conditions and timing of the surgery considering the emergent nature of the surgery.ConclusionsThe timing of operative intervention for such patients is imperative and the treating team of anesthesiologist and the otorhinolaryngologist should aim to strike a balance between timely intervention to negate the spread of the infection to the orbit and brain causing potential irreparable damage and optimizing the cardio-respiratory and renal functions.

COVINet: A hybrid model for classification of COVID and Non-COVID pneumonia in CT and X-Ray imagery

The COVID-19 pandemic has resulted in a significant increase in the number of pneumonia cases, including those caused by the Coronavirus. To detect COVID pneumonia, RT-PCR is used as the primary detection tool for COVID-19 pneumonia but chest imaging, including CT scans and X-Ray imagery, can also be used as a secondary important tool for the diagnosis of pneumonia, including COVID pneumonia. However, the interpretation of chest imaging in COVID-19 pneumonia can be challenging, as the signs of the disease on imaging may be subtle and may overlap with normal pneumonia. In this paper, we propose a hybrid model with the name COVINet which uses ResNet-101 as the feature extractor and classical K-Nearest Neighbors as the classifier that led us to give automated results for detecting COVID pneumonia in X-Rays and CT imagery. The proposed hybrid model achieved a classification accuracy of 98.6%. The model's precision, recall, and F1-Score values were also impressive, ranging from 98-99%. To back and support the proposed model, several CNN-based feature extractors and classical machine learning classifiers have been exploited. The outcome with exploited combinations suggests that our model can significantly enhance the accuracy and precision of detecting COVID-19 pneumonia on chest imaging, and this holds the potential of being a valuable resource for early identification and diagnosis of the illness by radiologists and medical practitioners. © 2023

Encephalitis or Stroke? A Case Report of Thalamic Stroke in COVID Era

Introduction: Since 2019, COVID-19 pneumonia caused by SARS-CoV-2 virus has led to a worldwide pandemic. Since then, various neurological manifestations of COVID-19 pneumonia have been reported. Neurological manifestations include headache, anosmia, seizures, and altered mental status. In some cases, it presents as stroke, encephalitis, and neuropathy. Artery of Percheron (AOP) is a variant in the posterior circulation. Here, a single artery arises from the posterior cerebral artery p1 segment. It supplies bilateral thalamus with or without midbrain. Thrombosis in this artery leads to clinical symptoms like reduced level of consciousness, altered mental status, and memory impairment. Case Report: Here, we present a case who presented with fever and altered sensorium without any focal neurological deficits and without known risk factors for stroke. His COVID-19 PCR was positive. He was initially diagnosed as COVID-19 pneumonia with encephalitis and was started on treatment for the same. His initial CT brain and lumbar puncture were normal. The next day, when MRI brain with and without contrast was done, the thalamic stroke due to AOP infarction was diagnosed and appropriate treatment for stroke was initiated. Discussion(s): Many patients miss the window for thrombolysis because of variable presentation in clinical symptoms with negative imaging. It is also difficult to assess the time of onset of stroke in this varied presentation. Our patient had fever and cough for 2 days and had altered mental status since the morning of admission. During hospital stay, he developed bilateral third nerve palsy. This case also highlights the importance of detailed evaluation in COVID-19 patients with neurological complaints. This helps to avoid delays in treatment and to improve clinical outcomes. As our knowledge of COVID-19 and its varied neurological manifestations evolve, we need to be prepared for more atypical presentation to facilitate timely interventions.Copyright © 2022 The Author(s). Published by S. Karger AG, Basel.

Air Leak Syndrome In Patients With Severe Covid Pneumonia.

Abstract: There are number of emerging studies that link the air leak syndrome (ALS) with COVID 19 disease but still data to explain the association, incidence and outcome in these patients is lacking. We aim to understand the risk factors and clinical outcome of these air leakage events in COVID 19 patients admitted to our institution. Methods: This is a single-centered case series conducted at the COVID unit of the SMBBIT in Karachi, Pakistan. Data collection was done from April 24, 2020 to June 10, 2021. Results: There were 19 patients with severe COVID pneumonia who developed air leaks. Most common finding was subcutaneous emphysema 94%. Four patients (21%) didn't receive positive pressure ventilation in any form. Median time of developing air leak from admission is 5 [2-9] and from PPV is 2 [1-3] days. There was high percentage of mortality 84.5 % in these patients.

Successful Lung Clearing Even after Spontaneous Pneumomediastinum and COVID-19 ARDS

In severe COVID pneumonia, we have seen reports of patients suffering from spontaneous pneumomediastinum, as well as pneumothorax as a unique complication. Diffuse alveolar damage can be the etiology behind this. We report a case of a 51-year-old mountaineer female who had severe COVID pneumonia, developed air leaks, but her lung injury and scarring completely improved in 5 months.

Interim Analysis of Impact of Adding Low Dose Pulmonary Radiotherapy to Moderate COVID-19 Pneumonia Patients: IMpaCt-RT Study.

Background: Treatment for coronavirus disease 2019 (COVID-19) pneumonia remains largely supportive till date and multiple clinical trials took place within the short span of time to evaluate the role of investigational therapies. The anti-inflammatory effect of low dose whole lung radiation in treating pneumonia has been documented earlier. This clinical trial analyzed the effect of low dose radiation therapy (LDRT) in a moderately affected COVID-19 pneumonia patient cohort and has evaluated its effect in stopping the conversion of moderate disease into severe disease. Methods: Patients with moderate COVID-19 pneumonia as characterized by the Ministry of Health and Family Welfare (MOHFW), Government of India, were randomized (1:1) to low dose whole lung radiation versus no radiation. All treatment of patients was concurrently being given as per institutional protocol. Patients were followed up with clinical and laboratory parameters monitored on Days 1, 3, 7, and 14. Computed tomography scan (CT scan) of thorax was performed on Days 1 and 7. Patients were evaluated for conversion of moderate into severe disease as per National Early Warning Score-2 (NEWS-2 score) as the primary end point. The secondary endpoints included changes in ratio between peripheral capillary oxygen saturation and fraction of inspired oxygen (SpO2/FiO2), biochemical markers, 25-point CT severity score, and radiation induced acute pulmonary toxicities. Findings: At the interim analysis, there were seven patients in the radiation arm and six in the control. A whole lung LDRT improved the outcome of SpO2/FiO2 at Day 3; however it did not convert into a statistically significant improvement for the NEWS-2 score. The serum levels of LDH, CRP, Ferritin and D-dimer were significantly reduced on 14 days in the LDRT arm in comparison to the baseline value but were not significant between the two groups. Interpretation: LDRT seems to have the potential to prevent moderate COVID-19 pneumonia from a deteriorating to severe category. However, further randomized clinical trial with an adequate number of such patients is warranted to establish the definitive role of LDRT in the management of COVID-19 pneumonia. Funding: An intramural research project bearing code: I-27/621, was sanctioned from the All India Institute of Medical Sciences, Patna, India. Clinical Trial Registration: Clinical Trials Registry-India (CTRI/2021/06/033912, 25th May 2021) ctri.nic.in/Clinicaltrials/login.php.

Encephalitis or Stroke? A Case Report of Thalamic Stroke in COVID Era

Introduction: Since 2019, COVID-19 pneumonia caused by SARS-CoV-2 virus has led to a worldwide pandemic. Since then, various neurological manifestations of COVID-19 pneumonia have been reported. Neurological manifestations include headache, anosmia, seizures, and altered mental status. In some cases, it presents as stroke, encephalitis, and neuropathy. Artery of Percheron (AOP) is a variant in the posterior circulation. Here, a single artery arises from the posterior cerebral artery p1 segment. It supplies bilateral thalamus with or without midbrain. Thrombosis in this artery leads to clinical symptoms like reduced level of consciousness, altered mental status, and memory impairment. Case Report: Here, we present a case who presented with fever and altered sensorium without any focal neurological deficits and without known risk factors for stroke. His COVID-19 PCR was positive. He was initially diagnosed as COVID-19 pneumonia with encephalitis and was started on treatment for the same. His initial CT brain and lumbar puncture were normal. The next day, when MRI brain with and without contrast was done, the thalamic stroke due to AOP infarction was diagnosed and appropriate treatment for stroke was initiated. Discussion: Many patients miss the window for thrombolysis because of variable presentation in clinical symptoms with negative imaging. It is also difficult to assess the time of onset of stroke in this varied presentation. Our patient had fever and cough for 2 days and had altered mental status since the morning of admission. During hospital stay, he developed bilateral third nerve palsy. This case also highlights the importance of detailed evaluation in COVID-19 patients with neurological complaints. This helps to avoid delays in treatment and to improve clinical outcomes. As our knowledge of COVID-19 and its varied neurological manifestations evolve, we need to be prepared for more atypical presentation to facilitate timely interventions.

A case report on anesthetic challenges in the post-Covid complication of active mucormycosis: Patient preparedness for family physicians.

Mucormycosis is a well-known yet complicated illness that seems benign but behaves malignantly. This article discusses the anesthesia challenges in providing care for a 49-year-old male who presented with post-Covid pneumonia and uncontrolled diabetes along with active mucormycosis and scheduled for functional endoscope sinus surgery (FESS) and debridement of necrotic tissue. We want to illustrate the importance of anticipated difficult airway, while highlighting the toxicity of intravenous amphotericin-B and its combination against anesthesia drugs.

A Case of Steroid-Responsive Severe Pneumonia Following a Recent COVID-19 Infection in a Patient With Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infection.

A twenty-two-year-old woman with a history of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) on rituximab presented with fever, abdominal pain, and worsening shortness of breath requiring supplemental oxygen via nasal cannula one month after a severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection from which she was minimally symptomatic and had recovered. Radiographic studies revealed bilateral patchy consolidations interspersed with ground-glass opacities (GGO). She was started on antibiotics for presumed community-acquired pneumonia with no improvement. Echocardiography revealed preserved biventricular function and a suspected intracardiac mass. A cardiac magnetic resonance imaging (CMRI) revealed myocarditis and no intracardiac mass. Fever persisted and oxygen requirements increased from FiO2 0.4 to 1.0. Repeat CXR showed subtotal left hemithorax opacification. Bronchoscopic samples showed a negative Gram stain and an unremarkable cell count differential. In view of this and given her lack of response to antibiotics with worsening respiratory status, high-dose steroids were started. She improved rapidly, and six days later she was off oxygen. Transbronchial biopsies showed benign parenchyma with some intra-alveolar fibrin deposition with no definitive evidence of viral cytopathic effect, vasculitis, or diffuse alveolar damage (DAD). Follow-up imaging in the pulmonary clinic revealed improvement of prior airspace disease with some new migratory opacities that completely resolved after 12 weeks. Pulmonary function tests and repeat CMRI were normal three months after discharge. Multisystem inflammatory syndrome in adults (MISA), post-covid organizing pneumonia (OP), and immune reconstitution inflammatory syndrome (IRIS) are rare and potentially steroid-responsive causes of pneumonia, which were in our differential diagnosis. It is imperative to consider the rare possibility of steroid-responsive pneumonia-like MISA, post-COVID-OP, and IRIS in patients with worsening respiratory symptoms following a recent SARS-CoV 2 infection.

Ancillary findings on high resolution CT chest associated with typical features of COVID-19 pneumonia (Observational descriptive study at a tertiary care hospital).

OBJECTIVE: To determine the frequency of ancillary pulmonary signs and their relation to the severity of disease seen on high-resolution computed tomography of chest in patients of coronavirus disease-2019 pneumonia. METHODS: The observational descriptive study was conducted at the Armed Forces Institute of Radiology and Imaging, Rawalpindi, Pakistan, from March to July 2020, and included in place of comprised all coronavirus disease-2019 patients who were found positive on reverse transcription-polymerase chain reaction-and were referred to have high-resolution computed tomography of chest. Ancillary pulmonary findings in addition to typical features of coronavirus disease-2019 pneumonia were recorded. These included vacuole sign, halo sign, reverse halo sign, subpleural white line, subpleural translucent line, microvascular dilatation, fibrotic streaks and bronchiectasis. Relative frequency of these signs were determined for mild versus and severe disease, as determined by the computed tomography severity score. Data was analysed using SPSS 26. RESULTS: Of the 1645 patients, 1286(78.2%) were males and 359(21.8%) were females. The overall mean age was 47.5±15.7 years (range: 1-92). High-resolution computed tomography was normal in 418(25.4%) patients, typical findings for coronavirus disease-2019 were seen in 1110(67.5%), indeterminate in 113(16.9%) and atypical in 4(0.2%). Vacuole sign, subpleural white line, subpleural translucent sign, microvascular dilatation and fibrotic streaks were more commonly seen in severe disease (p<0.001), while discrete pulmonary nodule was identified more in the milder form (p<0.05). Halo and reverse halo signs as well as bronchiectatic changes demonstrated no significant propensity to the degree of disease severity (p>0.05). CONCLUSIONS: Coronavirus disease-2019 pneumonia demonstrated various ancillary pulmonary features on high resolution computed tomography of the chest in addition to typical findings more commonly described; radiologists should be aware of these signs and their relation to disease severity.

RYOLO v4-tiny: A deep learning based detector for detection of COVID and Non-COVID Pneumonia in CT scans and X-RAY images

To diagnose COVID and Non-COVID Pneumonia in CT scans and X-RAY images researchers have developed intelligent and robust classifiers owing to disease recognition using artificial intelligence-based solutions. However, recognition of the disease itself doesn’t suffice the purpose. In order to develop robust systems, there exists a dire need for COVID and Non-COVID Pneumonia detectors that can perform both classification and detection by drawing bounding boxes in the infected images. To develop a lightweight and robust COVID and Non-COVID Pneumonia detector, in this work we have proposed the RYOLO v4-tiny detector which is developed by integrating the residual network in the existing YOLO v4-tiny feature extraction network. In order to train and test the detector, we have created a richly annotated dataset consisting of images for COVID and Non-COVID Pneumonia in CT scans and X-RAY images. On the created dataset, the proposed RYOLO v4-tiny detector achieved a mAP (Mean Average Precision) value of 88.18% which was 7.91% higher as compared to the baseline YOLO v4-tiny detector. Furthermore, the proposed detector achieved 10% higher precision, 14% higher recall, and 11% higher F1 Score as compared to the YOLO v4-tiny detector. The proposed RYOLO v4-tiny detector is a useful tool for medical practitioners for autonomous diagnosis and detection of COVID and Non-COVID Pneumonia in CT scans and X-RAY images.

CT Image Enhancement Using Variational Mode Decomposition for AI-Enabled COVID Classification

SARS-COV-2, also known as COVID-19 pandemic, has escalated calamity in the entire world. Due to its contagious properties, the disease spreads swiftly from person to person via direct contact. More than 210 million people got infected worldwide with more than 18 million active patients as of August 29, 2021. In numerous places, the test process for COVID-19 detection takes longer than 2 days. Once the patient is affected by COVID-19, the obstruction in lungs causes difficulty in analyzing the presence of other lung diseases, such as variants of pneumonia. In this paper, we propose an enhancement technique via the acclaimed signal processing method called variational mode decomposition (VMD) aiding any X-ray image classification method for the detection of pneumonia using convolutional neural networks (CNN). The experiments were conducted on VGG-16 model loaded with ImageNet weights followed by numerous configurations of dense layers. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Radiographic patterns on Chest X-ray as a supporting imaging tool in triaging of suspected Corona Virus Disease (COVID) patients.

Objective: To evaluate the radiographic patterns on Chest X-Ray (CXR) in accordance with Modified Brixia Scoring as supporting imaging tool in triaging of Corona Virus Disease (COVID-19) pneumonia. Methods: In this cross-sectional study, chest radiographs of suspected COVID patients at emergency triage, Lady Reading Hospital (LRH) from April 18th to July 22nd 2020 were evaluated for patterns of COVID pneumonia and scored in accordance with modified Brixia score. Each zone was categorized as score of "one" for interstitial pattern, "two" for mixed interstitial /alveolar pattern and "three" for alveolar pattern. Radiographic patterns consistent with COVID pneumonia or patients having strong clinical suspicion were advised Polymerase Chain Reaction (PCR) tests. Results: Total of 2,225 individuals were screened for patterns of COVID-19 pneumonia on chest radiograph. Out of these 1465(65.8%) had normal chest radiograph and 760(34.2%) had abnormal findings. Out of the total, 648 suspected COVID patients were selected for PCR. The radiographic patterns ranged from mixed interstitial/alveolar pattern in 261(40.3%) patients, alveolar pattern in 231(35.6%), interstitial pattern in 87(13.4%), pleural effusion in 12(1.9%), other findings in 5(0.8%) while 52(8%) suspected Covid patients had normal radiographs. The PCR was positive in 326(50.3%), negative in 100(15.4%) and inconclusive in 60(9.3%) while 162(25%) were lost to follow up. Amongst the 52 suspected Covid patients having normal chest radiographs, 10 were positive on PCR, 21 negative, seven suspected and two inconclusive, while 12 were lost to follow up. Conclusion: Chest radiograph is used for triaging of suspected COVID pneumonia patients in emergency settings. It assesses the severity of disease according to modified Brixia scoring for treatment plan.

Novel Diagnostic System for COVID19 Pneumonia using Forward Propagation of Convolutional Neural Network comparing with Artificial Neural Network

Aim: To enhance the poor diagnosing system for detecting COVID Pneumonia using AI and to compare the algorithms and their performances in diagnosis prediction. Materials and methods: The technique of Convolutional Neural Network(CNN) with forward propagation for the feature extraction from X-ray images of patients diagnosis. The implementation has been carried out with the help of Tensorflow and Keras. The algorithms tested over 700 sets of chest x-ray images which has been utilised for test and train dataset images respectively, that are user chest x-rays classified and predicted with the novel diagnosis.Result: The analysis on the data set and test cases has been performed successfully and acquired 91% accuracy for the CNN with forward propagation algorithm and compared to the artificial neural network algorithm(ANN), which gave 73% accuracy. With the level of significance (p<0.005), the resultant data depicts the reliability in independent sample t tests. Conclusion: On the whole process of prediction of accuracy for the image recognition, through the CNN with forward propagation gives significantly better performance when compared to ANN. © The Electrochemical Society

TRPC6 is altered in COVID-19 pneumonia.

In this Letter to the Editor supportive data were presented to a recent paper published in this journal reporting the involvement of TRP channels in COVID-19 pneumonia and its role for new therapies. Since gene expression of TRP channels was found in human lung tissues the protein was not being reported so far. TRP channels are supposed to be involved in the pulmonary inflammation and its symptoms such as fever, cough and others. Here, TRPC6 was investigated in tissues of normal human lungs and of SARS-Cov-2 infected lungs in a preliminary study. Tissue was obtained post mortem from anatomical body donations during dissections and during pathological dissections (13 normal, 4 COVID-19 pneumoniae) and processed for immunohistochemistry. In normal lungs TRPC6 was found in the ciliated epithelium, in the wall of larger lung vessels and in the alveolar septa. In COVID-19 pneumonia the distribution of TRPC6 was different. Inflammatory lesions, cellular infiltrates, hyaline membranes and fibrosis were labelled intensively as well as dilated capillaries. These observations are from four patients with COVID-19 pneumonia.The observations do not elucidate the molecular mechanisms but support the view that TRPC6 channels are involved in normal physiology of normal human lungs and in COVID-19 pneumonia. TRPC6 might aggravate SARS-2 induced inflammation and could be a target for inhibiting drugs.

Can Mediastinal Lymphadenopathy Signal Pericarditis, Pericardial Effusion, and Severe Disease in a COVID-19 Patient?

Severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) has created a global pandemic. As we try to understand the virus, we are learning that it can affect many organ systems. Most commonly coronavirus disease 2019 (COVID-19) virus affects the respiratory tract and the lungs impairing oxygen transport to the systemic circulation. Its effect on the cardiovascular system can be equally as devastating. Patients can develop pericarditis, myocarditis, and pericardial effusion that can at times lead to tamponade. Here we present an unusual case of a patient with COVID-19 pneumonia who presented with pericardial effusion along with enlarged mediastinal lymph nodes.

Rhinosinus Mucormycosis with Drug-induced Pancytopenia in an Immunocompromised Severe COVID-19 Patient: A Success.

Secondary infections in coronavirus disease (COVID) are becoming common. We report a case of a female known case of diabetes, sarcoidosis on steroids and methotrexate admitted with COVID pneumonia. She was treated with steroids, remdesivir, and anticoagulants and was discharged. She revisited the hospital after 2 months with complaints of severe right-sided headache, eye pain, and vomiting. Magentic resonance image of brain and paranasal sinus revealed possibility of invasive rhinosinus mucormycosis. Functional endoscopic sinus surgery (FESS) was done and culture showed growth of mucor and methicillin resistant staphylococcus aureus (MRSA) following which she was started on amphotericin B and antibiotics. She also developed methotrexate and amphotericin B-induced pancytopenia for which injection folinic acid, granulocyte-colony stimulating factor (G-CSF), and erythropoietin were given and was switched over to liposomal amphotericin B. After 5 days of ventilatory support, she was discharged in a stable condition. Extensive steroids in an immunocompromised patient might have led to this event hence physicians should always keep this possibility of secondary fungal infection in COVID patients for understanding the impact of disease. How to cite this article: Mahajan A, Tandon VS. Rhinosinus Mucormycosis with Drug-induced Pancytopenia in an Immunocompromised Severe COVID-19 Patient: A Success. Indian J Crit Care Med 2022;26(3):395-398.

Incidental COVID-19 pneumonia on oncologic 18F-FDG PET-CT scan in asymptomatic patient.

Corona virus disease 2019 (COVID-19), originated from Wuhan province of China, is responsible for causing severe respiratory syndrome (SARS-Cov-2). Initial specific investigation to diagnose the viral infection includes nasopharyngeal nucleic acid testing (RT-PCR). However other modalities can also aid in detection of COVID-19 infection. For instance, COVID pneumonitis related findings on positron emission tomography (PET/CT) scan acquired, during routine evaluation; can help in detection the viral infection in asymptomatic patients thereby preventing further spread of infection to other patients, physicians; and family members. This can alert physicians in taking prophylactic and preventive measures for management of these asymptomatic patient.