Thyroid Density in CT Imaging as a Potential Marker of Lung Involvement in COVID-19: A Retrospective Analysis.

Background The SARS-CoV-2 pandemic has underscored the multifaceted impact of the virus on human health, extending beyond the respiratory system to involve other organ systems, including the endocrine system. Emerging evidence suggests a notable interaction between COVID-19 and thyroid function, characterized by alterations in thyroid hormone levels and structural changes within the gland. This study aims to explore the association between thyroid density on CT imaging and lung involvement in patients with COVID-19, potentially offering new insights into the systemic effects of the virus. Methodology A retrospective cross-sectional analysis was conducted on 1,066 patients with COVID-19 who underwent chest CT scans without contrast at Government Medical College, Omandurar Government Estate, Chennai, which was designated as the COVID-19 care center from April to June 2021. Thyroid density and lung involvement were quantitatively assessed, and their correlation was analyzed using descriptive and inferential statistics, including the Kruskal-Wallis H test and Shapiro-Wilk test for normality. Results The study population predominantly exhibited normal thyroid density (749, 70.3%), followed by altered (212, 19.9%), nodular (104, 9.8%), and a single instance (0.1%) of absent thyroid density. Despite variability in lung involvement across different thyroid density categories, statistical analysis revealed no significant association between thyroid density and the extent of lung involvement in patients with COVID-19. Conclusions This study found no significant correlation between thyroid density and lung involvement in patients with COVID-19, suggesting that thyroid density on CT imaging may not serve as a reliable marker for lung involvement in this population. Further research is warranted to explore the complex interactions between COVID-19 and thyroid function, as well as the potential implications for patient management and prognosis.

Vaccination and Its Impact on Lung Involvement in COVID-19 Patients: A Retrospective Study in India.

Background COVID-19, caused by SARS-CoV-2, led to a global pandemic necessitating urgent vaccine development and deployment. By the end of 2020, several vaccines had reached their clinical trial endpoints. India, leveraging its pharmaceutical prowess, developed two primary vaccines: CoviShield® and Covaxin®. Despite the availability of these vaccines, vaccine hesitancy became a notable challenge. This study aimed to assess the correlation between vaccination status and lung involvement in COVID-19 patients, aiming to fortify trust in vaccines and enhance vaccine uptake in India. Methods This retrospective cross-sectional study analyzed data from 272 patients treated at a designated COVID-19 Care Center in Chennai, India, from May to July 2021. Patients were divided into vaccinated and unvaccinated groups, with vaccinated individuals further categorized based on the type and dose of vaccine received (CoviShield® or Covaxin®). Lung involvement was assessed through CT chest scans, and statistical analyses were performed to compare the severity of lung involvement across different groups. Results The vaccinated group demonstrated significantly lower mean lung involvement (28%) compared to the unvaccinated group (34.8%). Within vaccinated individuals, no significant differences were observed between different vaccine types and doses, suggesting a generalized protective effect of COVID-19 vaccination against severe lung involvement. Conclusion Vaccination against COVID-19 significantly reduces the severity of lung involvement among patients, irrespective of the vaccine brand or dose. This study reinforces the importance of vaccination in mitigating the impact of COVID-19 and supports ongoing vaccination efforts.

Anosmia in COVID-19: Investigating the Role of Paranasal Sinus Mucosal Thickening.

Background Anosmia has been identified as a distinctive symptom of COVID-19, leading to hypotheses about its pathophysiological underpinnings, including the potential role of paranasal sinus mucosal thickening. Objective To investigate the association between paranasal sinus mucosal thickening and anosmia in COVID-19 patients, providing insights into the complex clinical manifestations of the disease. Methods This retrospective cohort study analyzed CT paranasal sinus from 270 confirmed COVID-19 patients, divided into those with anosmia (n = 23, 8.52%) and those without anosmia (n = 247, 91.48%). Statistical analysis, including independent t-tests, was employed to compare mucosal thickening between the groups. Results The study found an average mucosal thickening of 0.03 in patients with anosmia and 0.02 in those without, with no statistically significant difference between the groups (p = 0.480, which is greater than 0.05). The findings suggest that mucosal thickening in the paranasal sinuses does not serve as a definitive correlate of anosmia among COVID-19 patients. Conclusion The absence of a significant correlation between paranasal sinus mucosal thickening and anosmia in COVID-19 patients indicates that the pathophysiology of anosmia may involve factors beyond anatomical changes, including direct viral effects and systemic inflammatory responses.

Exploring the Correlation Between Splenomegaly and Lung Involvement in COVID-19: A Retrospective Study.

Background Coronavirus disease 2019 (COVID-19), resulting from the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), has not only shown substantial effects on the respiratory system but also on extrapulmonary systems, including cardiovascular, gastrointestinal, hematological, and immune responses, notably spleen enlargement. The connection between the enlargement of the spleen and pulmonary complications in individuals with COVID-19 is still not well elucidated, with current studies offering divergent conclusions. Objective This study aims to elucidate the correlation between splenomegaly, as assessed by computed tomography (CT) imaging, and the extent of lung involvement (LI) in COVID-19 patients, thereby offering insights into potential prognostic indicators. Methodology A hospital-based, cross-sectional, retrospective study was conducted involving 1058 symptomatic COVID-19 patients confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR), aged 18 years and above. CT imaging was utilized to evaluate spleen size and LI. Statistical analyses, including Pearson correlation and simple linear regression, were performed to explore the relationship between spleen size and LI. Results The study cohort exhibited a mean spleen size of 9.49 cm and a mean LI score of 0.272. The Pearson correlation coefficient was calculated at 0.0495, indicating a marginal positive correlation between spleen size and LI. Regression analysis demonstrated a minimal impact of spleen size on LI, with spleen size accounting for only 0.2% of the variance in LI scores. Conclusions The study found a slight, statistically non-significant correlation between splenomegaly and LI in COVID-19 patients, suggesting that while splenic enlargement may reflect systemic disease involvement, it is not a strong independent predictor of lung damage extent. The findings highlight the complexity of extrapulmonary manifestations and highlight the need for additional research to fully understand the implications of splenic involvement in COVID-19.

Lung Involvement Patterns in COVID-19: CT Scan Insights and Prognostic Implications From a Tertiary Care Center in Southern India.

Background COVID-19, caused by the SARS-CoV-2 virus, has presented an unparalleled challenge and a profound learning curve globally. Among the myriad of investigative tools, CT scans of the chest have become instrumental in assessing the magnitude of lung involvement in the pathogenesis of this disease. Objectives This study aimed to evaluate the distribution and patterns of lung involvement depicted in the CT chest scans of COVID-19 patients admitted to a specialized tertiary care center located in a southern state of India. Methods With clearance secured from the Institutional Ethics Committee, an analytical cross-sectional study was conducted. It encompassed CT chest images from all symptomatic COVID-19 patients within the designated study center during the specified study timeline. Subsequent data analysis ensued. Results Among the 1066 COVID-19 patients evaluated, ground-glass opacities (GGO) were the predominant lung involvement pattern. Distinct patterns, such as GGOs combined with solid consolidation or atelectasis, were noted, with the highest mortality linked to GGOs paired with pneumomediastinum (PM). Data underscored a direct correlation between the extent of lung involvement and patient prognosis, with specific lung regions, namely the right apical, right posterior, right superior basal, left superior lingular, and left inferior lingular segments, showing frequent involvement. Conclusion Amidst the pandemic, our study emphasizes that ground-glass opacities on CT scans are robust indicators of COVID-19 in RT-PCR-positive patients. Early identification can enhance patient management, with findings highlighting a strong link between lung involvement and prognosis. This insight aids in refining patient triage, while further research is warranted to delve deeper into variations in lung involvement and guide treatment advancements.

Assessing Lobe-wise Burden of COVID-19 Infection in Computed Tomography of Lungs using Knowledge Fusion from Multiple Datasets.

Segmentation of COVID-19 infection in the lung tissue and its quantification in individual lobes is pivotal to understanding the disease's effect. It helps to determine the disease progression and gauge the extent of medical support required. Automation of this process is challenging due to the lack of a standardized dataset with voxel-wise annotations of the lung field, lobes, and infections like ground-glass opacity (GGO) and consolidation. However, multiple datasets have been found to contain one or more classes of the required annotations. Typical deep learning-based solutions overcome such challenges by training neural networks under adversarial and multi-task constraints. We propose to train a convolutional neural network to solve the challenge while it learns from multiple data sources, each of which is annotated for only a few classes. We have experimentally verified our approach by training the model on three publicly available datasets and evaluating its ability to segment the lung field, lobes and COVID-19 infected regions. Additionally, eight scans that previously had annotations for infection and lung have been annotated for lobes. Our model quantifies infection per lobe in these scans with an average error of 4.5%.

Volume Assessment in Hemodialysis: A Comparison of Present Methods in Clinical Practice with Sonographic Lung Comets.

Dry weight assessment in dialysis patients remains a challenging endeavor owing to the limitations of the available methods for volume assessment. Lung ultrasound is emerging as an invaluable tool to assist in the appropriate assessment and assignment of dry weight. The objectives of this study are (1) to determine the reliability of clinical signs and symptoms for volume assessment, (2) to compare lung ultrasound with High Resolution Computed Tomography (HRCT) chest-A noninvasive gold standard tool for detecting pulmonary congestion and with inferior vena cava diameter (IVCD) - another time-tested volume assessment method, and (3) to analyze if lung ultrasound could detect dialysis induced fluid status variations. The cross-sectional study involves 50 patients on maintenance hemodialysis. Lung ultrasound for B line estimation and ultrasonographic measurement of IVCD performed before and after hemodialysis by a nephrologist trained in ultrasonography. Limited HRCT was obtained just before hemodialysis. Edema, crackles, and dyspnea had a poor sensitivity of 37.9%, 11.5%, and 52.6%, respectively, to detect clinically significant pulmonary congestion by lung ultrasound. A highly significant correlation was obtained between B-line score and HRCT signs of pulmonary congestion (P < 0.001) before dialysis. B lines showed statistically significant reduction with dialysis. The absolute reduction of B lines showed significant correlation with ultrafiltration volume and weight loss. Bedside lung ultrasound appears a sensitive tool for evaluating real-time changes in extravascular lung water and would serve to optimize volume status in dialysis patients.

Pathophysiology and Grading of the Ventral Displacement of Dorsal Spinal Cord Spectrum.

STUDY DESIGN: A retrospective study of the ventral displacement of dorsal spinal cord (VDDSC) spectrum pathophysiology and grading. PURPOSE: This study aimed at examining the pathophysiology of VDDSC between D3 and D7, using magnetic resonance imaging (MRI) correlation and severity grading. OVERVIEW OF LITERATURE: The pathologies that lead to VDDSC were previously discussed in various articles. We attempted to group these pathological conditions under a single spectrum, and grade them according to their severity. METHODS: We reviewed the MRI images of the dorsal spines of 1,350 patients over a period of 4 years (February 2013-February 2017); all MRI images were analyzed by two experienced radiologists. RESULTS: Of the 1,350 patients, 28 exhibited VDDSC between D3 and D7. Additional findings included ventral transdural herniation of the spinal cord (n=10), anterior spinal cord adhesion (n=7), arachnoid web (n=6), and arachnoid cyst (n=5). CONCLUSIONS: We grouped the pathologies that lead to VDDSC at the thoracic level into a single spectrum of varying severity and graded VDDSC, from mild to severe.

Dorsal Spinal Ligamentum Flavum Thickening: A Magnetic Resonance Imaging Study.

STUDY DESIGN: A retrospective radiological study of the ligamentum flavum (LF). PURPOSE: We determined the relationship of dorsal spinal LF thickening with age and sex using magnetic resonance imaging (MRI). We also determined whether LF thickening has a predominant tendency to occur at a specific dorsal level and on a specific side. OVERVIEW OF LITERATURE: Many researchers have studied LF thickness at dorsal levels in patients with compressive myelopathy. However, there is a dearth of literature pertaining to the study of dorsal LF thickness in patients without myelopathy. METHODS: LF thickness was measured at dorsal levels from T1 to T12 on both sides using MRI in 100 individuals. The patients were divided into three groups based on age: 20 to 40, 41 to 60, and >60 years. On axial T2-weighted imaging at the mid-disc level, LF thickness was measured perpendicular to the lamina border, either at half the length of LF or at maximum thickness, whichever was greater. RESULTS: We found that LF thickness does not increase significantly with increasing age and there was no significant disparity in LF thickness between the sides and sexes. We also found that there was a significant increase in LF thickness at the T10-T11 level (mean value, 3.27±0.94 mm). CONCLUSIONS: LF thickness does not appear to have any side/sex dominance. LF thickening has a predominant tendency to occur specifically at the T10-T11 level. This may be due to maximum tensile strength and mobility at this level. Because there is an increased tendency for LF thickening at the T10-T11 level, this may be used as a reference point for counting the vertebral levels.

Role of 3D SPACE sequence and susceptibility weighted imaging in the evaluation of hydrocephalus and treatment-oriented refined classification of hydrocephalus.

OBJECTIVE: The aim of our study was to evaluate the diagnostic utility of three-dimensional sampling perfection with application optimized contrast using different flip angle evolution (3D SPACE) sequence and Susceptibility Weighted Imaging (SWI) in hydrocephalus and to propose a refined definition and classification of hydrocephalus with relevance to the selection of treatment option. MATERIALS AND METHODS: A prospective study of 109 patients with hydrocephalus was performed with magnetic resonance imaging (MRI) brain using standardized institutional sequences along with additional sequences 3D SPACE and SWI. The images were independently read by two senior neuroradiologists and the etiopathogenesis of hydrocephalus was arrived by consensus. RESULTS: With conventional sequences, 46 out of 109 patients of hydrocephalus were diagnosed as obstructive of which 21 patients showed direct signs of obstruction and 25 showed indirect signs. In the remaining 63 patients of communicating hydrocephalus, cause could not be found out in 41 patients. Whereas with 3D SPACE sequence, 88 patients were diagnosed as obstructive hydrocephalus in which all of them showed direct signs of obstruction and 21 patients were diagnosed as communicating hydrocephalus. By including SWI, we found out hemorrhage causing intraventricular obstruction in three patients and hemorrhage at various sites in 24 other patients. With these findings, we have classified the hydrocephalus into communicating and noncommunicating, with latter divided into intraventricular and extraventricular obstruction, which is very well pertaining to the selection of surgical option. CONCLUSION: We strongly suggest to include 3D SPACE and SWI sequences in the set of routine MRI sequences, as they are powerful diagnostic tools and offer complementary information regarding the precise evaluation of the etiopathogenesis of hydrocephalus and have an effective impact in selecting the mode of management.