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1.
J Bras Pneumol ; 48(1): e20220023, 2022 02 02.
Article in English, Portuguese | MEDLINE | ID: covidwho-1798565
2.
Front Biosci (Landmark Ed) ; 26(12): 1607-1612, 2021 12 30.
Article in English | MEDLINE | ID: covidwho-1614663

ABSTRACT

PURPOSE: The aim of this observational study was to highlight high resolution CT scan characteristics of COVID-19-associated pulmonary aspergillosis (CAPA) with a focus on the detection of de-novo appeared or evolved bronchiectasis. METHODS: From March 2020 to May 2021, we enrolled 350 consecutive mechanically ventilated ICU patients with COVID-19. Patients with CAPA and at least one chest CT scan performed within 15 days from the diagnosis were included. Two radiologists were asked to identify typical and atypical signs of COVID-19 pneumonia. Bronchiectasis locations were described and a modified Reiff score was calculated, as severity score. A total of 19 CAPA patients (median age 71.0, Interquartile range (IQR) 62.5-75.0; male 16, 84.2%) were included. RESULTS: According to the 2020 ECMM/ISHAM criteria, 18 patients had probable CAPA and one had proven CAPA. The median time between hospital admission and CT scan was 21 days (IQR 14.5-25.0). The incidence of bronchiectasis in the study population was 57.9% (n = 11). Tubular bronchiectasis was detected in 10 patients and were scored as follows: three patients had a score of 1, three patients had a score of score 2, one patient had a score of 5 and four patients had a score of 6. Eight patients had a previous CT scan (performed at hospital admission), among them: 5 patients developed de-novo bronchiectasis, while 2 patients demonstrated a volumetric increase of bronchiectasis. At the 6-months follow-up, the mortality rate for patients with CAPA was >60%. CONCLUSION: the radiologic detection of de-novo appearance or volumetric increase of bronchiectasis in COVID-19 should lead clinicians to search for fungal superinfections.


Subject(s)
Bronchiectasis , COVID-19 , Invasive Pulmonary Aspergillosis , Pulmonary Aspergillosis , Aged , Bronchiectasis/diagnostic imaging , Humans , Male , SARS-CoV-2 , Tomography , Tomography, X-Ray Computed
3.
Curr Med Imaging ; 17(6): 775-780, 2021.
Article in English | MEDLINE | ID: covidwho-1357473

ABSTRACT

BACKGROUND: COVID-19 has emerged recently and has become a global concern. Computed tomography (CT) plays a vital role in the diagnosis. OBJECTIVES: To characterize the pulmonary CT findings and distributions of COVID-19 infection in regard to different age groups. METHODS: Chest CT scan of 104 symptomatic patients with COVID-19 infection from 7 Iraqi isolation centers were retrospectively analyzed between March 10th to April 5th, 2020. Patients were sub-classified according to their ages into three groups (young adult:20-39 years, middle age:40-59 years, and old age:60-90 years). RESULTS: The most common findings were ground-glass opacities (GGO) (92.3%, followed by consolidation (27.9%), bronchovascular thickening (15.4%), and crazy-paving (12.5%). Less commonly, there were tree-in-bud (6.7%), pulmonary nodules (5.8%), bronchiectasis (3.8%), pleural effusion (1.9%), and cavitation (1%). There were no hallo signs, reversed hallo signs, and mediastinal lymphadenopathy. Pulmonary changes were unilateral in 16.7% and bilateral in 83.3%, central in 14.6%, peripheral in 57.3%, and diffuse (central and peripheral) in 28.1%. Most cases showed multi- lobar changes (70.8%), while the lower lobe was more commonly involved (17.7%) than the middle lobe/lingula (8.3%) and upper lobe (3.1%). In unilateral involvement, changes were more on the right (68.8%) than the left (31.2%) side. Compared with middle and old age groups, young adult patients showed significantly lesser frequency of consolidation (17% vs. 13.3% and 37%), diffuse changes 28.1% (14.2% vs. 35.3% and 40.5%), bilateral disease (71.4% vs. 94.1% and 85.2%), and multi-lobar involvement (51.4% vs. 82.4% and 81.4%) respectively. CONCLUSION: Bilateral and peripheral GGO were the most frequent findings with the right and lower lobar predilection. The pattern and the distribution of CT changes seem to be age-specific.


Subject(s)
COVID-19/diagnostic imaging , Lung/diagnostic imaging , Tomography, X-Ray Computed , Adult , Age Distribution , Age Factors , Aged , Aged, 80 and over , Bronchiectasis/diagnostic imaging , COVID-19/epidemiology , Female , Humans , Iraq/epidemiology , Male , Middle Aged , Pleural Effusion/diagnostic imaging , Retrospective Studies , Young Adult
4.
Rev Alerg Mex ; 67(4): 350-369, 2020.
Article in Spanish | MEDLINE | ID: covidwho-1106728

ABSTRACT

Coronavirus disease 2019 (COVID-19) is an infection caused by SARS-CoV-2 that has caused an unprecedented pandemic with a high rate of morbidity and mortality worldwide. Although most cases are mild, there are a considerable number of patients who develop pneumonia or even acute respiratory distress syndrome (ARDS). After having recovered from the initial disease, many patients continue with various symptoms (fatigue, dry cough, fever, dyspnea, anosmia, and chest pain, among others.), which has led to consider the possible existence of "post-COVID-19 syndrome". Although the definition and validity of this syndrome are not clear yet, several studies report that individuals who have recovered from COVID-19 may have persistent symptoms, radiological abnormalities, and compromised respiratory function. Current evidence suggests that there is a large number of pulmonary sequelae after COVID-19 pneumonia (interstitial thickening, ground glass opacities, crazy paving pattern, and bronchiectasis, among others.). Likewise, it seems that pulmonary function tests (spirometry, DLCO, 6MWT, and measurement of maximum respiratory pressures), in addition to high-resolution computed axial tomographies (CAT scan), are useful for the assessment of these post-COVID-19 pulmonary sequelae. This review aims to describe the possible pulmonary sequelae after COVID-19 pneumonia, as well as to suggest diagnostic procedures for their correct assessment and follow-up; thus, allowing proper management by a multidisciplinary medical team.


COVID-19 es la enfermedad causada por el virus SARS-CoV-2, la cual ha ocasionado una pandemia sin precedentes, con gran cantidad de infectados y muertos en el mundo. Aunque la mayoría de los casos son leves, existe una cantidad considerable de pacientes que desarrollan neumonía o, incluso, síndrome de distrés respiratorio agudo (SDRA). Luego de recuperarse del cuadro inicial, muchos pacientes continúan con diversos síntomas (fatiga, tos seca, fiebre, disnea, anosmia, dolor torácico, entre otras), lo que ha llevado a considerar la posible existencia del "síndrome pos-COVID-19". Aunque la definición y validez de este síndrome aún no son claras, varios estudios reportan que los individuos recuperados de la COVID-19 pueden tener persistencia de síntomas, anormalidades radiológicas y compromiso en la función respiratoria. La evidencia actual sugiere que existe gran cantidad de secuelas pulmonares despues de una neumonía por COVID-19 (engrosamiento intersticial, infiltrado en vidrio esmerilado, patrón en empedrado, bronquiectasias, entre otras.). De igual forma, parece ser que las pruebas de función pulmonar (espirometría, prueba de difusión pulmonar de monóxido de carbono, prueba de caminata de seis minutos y la medición de las presiones respiratorias máximas), además de la tomografía axial computarizada de alta resolución, son útiles para evaluar las secuelas pulmonares pos-COVID-19. En esta revisión se pretende describir las posibles secuelas a nivel pulmonar posteriores a neumonía por COVID-19, así como sugerir procedimientos diagnósticos para su correcta evaluación y seguimiento, que permitan el manejo adecuado por parte de un equipo médico multidisciplinario.


Subject(s)
COVID-19/complications , Convalescence , Lung Diseases/etiology , Respiratory Distress Syndrome/etiology , Bronchiectasis/diagnostic imaging , Bronchiectasis/etiology , Bronchiectasis/physiopathology , Disease Progression , Follow-Up Studies , Humans , Hypoxia/blood , Hypoxia/etiology , Hypoxia/physiopathology , Lung Diseases/diagnostic imaging , Lung Diseases, Interstitial/diagnostic imaging , Lung Diseases, Interstitial/etiology , Lung Diseases, Interstitial/physiopathology , Mental Disorders/etiology , Mental Disorders/physiopathology , Oxygen/blood , Pulmonary Embolism/diagnostic imaging , Pulmonary Embolism/etiology , Pulmonary Embolism/physiopathology , Respiratory Distress Syndrome/physiopathology , Respiratory Function Tests , Spirometry , Tomography, X-Ray Computed
5.
Monaldi Arch Chest Dis ; 90(4)2020 Sep 18.
Article in English | MEDLINE | ID: covidwho-1060341

ABSTRACT

The coronavirus disease 2019 (COVID-19) is a recent pandemic that affected more than 5 million people worldwide. Chest high resolution computed tomography (HRCT) is an essential tool in diagnosis and management of the disease. Pulmonary parenchymal opacity is a typical sign of the disease, but not the only one. Pneumothorax, pneumomediastinum, bronchiectasis and cysts are probably underrated complications of COVID-19 that can worsen prognosis, in terms of prolonged hospitalization and need of oxygen therapy. In our single center case series, we outline four different manifestations of pneumothorax, pneumomediastinum and cysts in hospitalized patients with COVID-19 pneumonia.


Subject(s)
Bronchiectasis/diagnostic imaging , Coronavirus Infections/diagnostic imaging , Cysts/diagnostic imaging , Lung/diagnostic imaging , Mediastinal Emphysema/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Pneumothorax/diagnostic imaging , Adult , Betacoronavirus , Bronchiectasis/etiology , COVID-19 , Coronavirus Infections/complications , Cysts/etiology , Humans , Italy , Lung Diseases/diagnostic imaging , Lung Diseases/etiology , Male , Mediastinal Emphysema/etiology , Middle Aged , Pandemics , Pneumonia, Viral/complications , Pneumothorax/etiology , SARS-CoV-2 , Subcutaneous Emphysema/diagnostic imaging , Subcutaneous Emphysema/etiology , Tomography, X-Ray Computed
7.
Curr Med Imaging ; 17(6): 775-780, 2021.
Article in English | MEDLINE | ID: covidwho-999948

ABSTRACT

BACKGROUND: COVID-19 has emerged recently and has become a global concern. Computed tomography (CT) plays a vital role in the diagnosis. OBJECTIVES: To characterize the pulmonary CT findings and distributions of COVID-19 infection in regard to different age groups. METHODS: Chest CT scan of 104 symptomatic patients with COVID-19 infection from 7 Iraqi isolation centers were retrospectively analyzed between March 10th to April 5th, 2020. Patients were sub-classified according to their ages into three groups (young adult:20-39 years, middle age:40-59 years, and old age:60-90 years). RESULTS: The most common findings were ground-glass opacities (GGO) (92.3%, followed by consolidation (27.9%), bronchovascular thickening (15.4%), and crazy-paving (12.5%). Less commonly, there were tree-in-bud (6.7%), pulmonary nodules (5.8%), bronchiectasis (3.8%), pleural effusion (1.9%), and cavitation (1%). There were no hallo signs, reversed hallo signs, and mediastinal lymphadenopathy. Pulmonary changes were unilateral in 16.7% and bilateral in 83.3%, central in 14.6%, peripheral in 57.3%, and diffuse (central and peripheral) in 28.1%. Most cases showed multi- lobar changes (70.8%), while the lower lobe was more commonly involved (17.7%) than the middle lobe/lingula (8.3%) and upper lobe (3.1%). In unilateral involvement, changes were more on the right (68.8%) than the left (31.2%) side. Compared with middle and old age groups, young adult patients showed significantly lesser frequency of consolidation (17% vs. 13.3% and 37%), diffuse changes 28.1% (14.2% vs. 35.3% and 40.5%), bilateral disease (71.4% vs. 94.1% and 85.2%), and multi-lobar involvement (51.4% vs. 82.4% and 81.4%) respectively. CONCLUSION: Bilateral and peripheral GGO were the most frequent findings with the right and lower lobar predilection. The pattern and the distribution of CT changes seem to be age-specific.


Subject(s)
COVID-19/diagnostic imaging , Lung/diagnostic imaging , Tomography, X-Ray Computed , Adult , Age Distribution , Age Factors , Aged , Aged, 80 and over , Bronchiectasis/diagnostic imaging , COVID-19/epidemiology , Female , Humans , Iraq/epidemiology , Male , Middle Aged , Pleural Effusion/diagnostic imaging , Retrospective Studies , Young Adult
8.
Diagn Interv Imaging ; 102(2): 77-84, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-987475

ABSTRACT

PURPOSE: The purpose of this study was to identify clinical and chest computed tomography (CT) features associated with a severe form of coronavirus disease 2019 (COVID-19) and to propose a quick and easy to use model to identify patients at risk of a severe form. MATERIALS AND METHODS: A total of 158 patients with biologically confirmed COVID-19 who underwent a chest CT after the onset of the symptoms were included. There were 84 men and 74 women with a mean age of 68±14 (SD) years (range: 24-96years). There were 100 non-severe and 58 severe cases. Their clinical data were recorded and the first chest CT examination was reviewed using a computerized standardized report. Univariate and multivariate analyses were performed in order to identify the risk factors associated with disease severity. Two models were built: one was based only on qualitative CT features and the other one included a semi-quantitative total CT score to replace the variable representing the extent of the disease. Areas under the ROC curves (AUC) of the two models were compared with DeLong's method. RESULTS: Central involvement of lung parenchyma (P<0.001), area of consolidation (P<0.008), air bronchogram sign (P<0.001), bronchiectasis (P<0.001), traction bronchiectasis (P<0.011), pleural effusion (P<0.026), large involvement of either one of the upper lobes or of the middle lobe (P<0.001) and total CT score≥15 (P<0.001) were more often observed in the severe group than in the non-severe group. No significant differences were found between the qualitative model (large involvement of either upper lobes or middle lobe [odd ratio (OR)=2.473], central involvement [OR=2.760], pleural effusion [OR=2.699]) and the semi-quantitative model (total CT score≥15 [OR=3.342], central involvement [OR=2.344], pleural effusion [OR=2.754]) with AUC of 0.722 (95% CI: 0.638-0.806) vs. 0.739 (95% CI: 0.656-0.823), respectively (P=0.209). CONCLUSION: We have developed a new qualitative chest CT-based multivariate model that provides independent risk factors associated with severe form of COVID-19.


Subject(s)
COVID-19/diagnostic imaging , Computer Simulation , Lung/diagnostic imaging , Tomography, X-Ray Computed , Adult , Aged , Aged, 80 and over , Bronchiectasis/diagnostic imaging , Female , Humans , Male , Middle Aged , Multivariate Analysis , ROC Curve , Risk Factors , Severity of Illness Index
9.
Respiration ; 99(9): 748-754, 2020.
Article in English | MEDLINE | ID: covidwho-748829

ABSTRACT

BACKGROUND: Little is known about the damage to the respiratory system in asymptomatic patients with coronavirus disease (COVID-19). OBJECTIVE: Herein, we evaluate the findings of chest computed tomography (CT) and radiography in patients with COVID-19 who were asymptomatic. METHODS: We retrospectively investigated patients with a confirmed diagnosis of COVID-19 but who did not show any symptoms. Among the 139 patients with COVID-19 who were hospitalized in Yeungnam University Hopistal in Daegu, South Korea, 10 (7.2%) were asymptomatic. Their chest CT and radiographic findings were analyzed. RESULTS: In the results, all patients (100%) had ground-glass opacity (GGO) on chest CT. Further, the GGO lesions were predominantly distributed peripherally and posteriorly in all patients. In 9 (90%) patients, the GGO lesions were combined with reticular opacity. Air bronchogram due to bronchiolectasis surrounded by GGO was observed in 8 patients (80%). Additionally, the lung lesions were dominant on the right side in all patients. CONCLUSIONS: In conclusion, considering our results that the lung is affected in asymptomatic patients, it will be necessary to extend the indications of COVID-19 testing for effective management of COVID-19 during the pandemic.


Subject(s)
Asymptomatic Infections , Bronchiectasis/diagnostic imaging , COVID-19/diagnostic imaging , Lung/diagnostic imaging , Aged , Aged, 80 and over , Antiviral Agents/therapeutic use , Bronchioles/diagnostic imaging , Bronchography , COVID-19/drug therapy , Drug Combinations , Enzyme Inhibitors/therapeutic use , Female , Humans , Hydroxychloroquine/therapeutic use , Lopinavir/therapeutic use , Male , Middle Aged , Radiography, Thoracic , Republic of Korea , Retrospective Studies , Ritonavir/therapeutic use , SARS-CoV-2 , Tomography, X-Ray Computed
11.
Diagn Interv Radiol ; 26(4): 308-314, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-607982

ABSTRACT

PURPOSE: We aimed to demonstrate the computed tomography (CT) findings observed at the initial presentation of coronavirus disease 2019 (COVID-19) pneumonia and reveal the most frequent infiltration and distribution patterns of the disease. METHODS: One hundred and eighty-five patients (87 men, 98 women; mean age, 48.7 years), who underwent RT-PCR sampling and high-resolution CT examination in our hospital between March 15, 2020, and April 15, 2020, and got a definitive diagnosis of COVID-19 disease via initial or follow-up RT-PCR test, were included in the study. We comprehensively analyzed the most common and relatively rare CT imaging features (e.g., distribution pattern, density of the lesions, additional CT signs) in patients diagnosed with COVID-19 pneumonia. RESULTS: Thirty-eight patients (20.6%) had no evidence of pneumonia on their initial high-resolution CT images. Among 147 patients (79.4%) who had parenchymal infiltration consistent with pneumonia, 10 (6.8%) had a negative baseline RT-PCR test, and positivity was detected as a result of repeated tests. Most of the patients had multifocal (89.1%) and bilateral (86.4%) lesions. The most common location, right lower lobe, was affected in 87.8% of the patients. Lesions were distributed predominantly at peripheral (87.1%) and posterior (46.3%) areas of lung parenchyma. Most of the patients had pure ground glass opacity (GGO) (82.3%) followed by GGO with consolidation (32.7%) and crazy paving pattern (21.8%). Pure consolidation, solid nodules, halo sign, reverse halo sign, vascular enlargement, subpleural line, air-bronchogram, and bronchiectasis were the other findings observed in at least 15% of the cases. Halo sign, acinar nodules, air-bubble sign, pleural thickening and effusion, mediastinal and/or hilar lymphadenopathy were seen rarely (2%-12.9%). Pericardial effusion, pneumothorax, cavitation, and tree-in-bud pattern were not detected in our study group. CONCLUSION: Multifocal and bilateral GGO infiltration predominantly distributed in peripheral, posterior, and lower lung areas was the most common infiltration pattern.


Subject(s)
Betacoronavirus/genetics , Coronavirus Infections/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Pneumonia/diagnostic imaging , Tomography, X-Ray Computed/methods , Adult , Aged , Bronchiectasis/diagnostic imaging , Bronchiectasis/pathology , Bronchiectasis/virology , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Disease Progression , Female , Humans , Lung/diagnostic imaging , Lung/pathology , Lung/virology , Lymphadenopathy/diagnostic imaging , Lymphadenopathy/pathology , Lymphadenopathy/virology , Male , Mediastinum/diagnostic imaging , Mediastinum/pathology , Mediastinum/virology , Middle Aged , Pandemics , Pericardial Effusion/diagnostic imaging , Pericardial Effusion/pathology , Pericardial Effusion/virology , Pneumonia/pathology , Pneumonia/virology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , Pneumothorax/diagnostic imaging , Pneumothorax/pathology , Pneumothorax/virology , Retrospective Studies , Reverse Transcriptase Polymerase Chain Reaction/methods , SARS-CoV-2 , Turkey/epidemiology
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