Corpus overview


MeSH Disease

Human Phenotype


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    Computed Tomography Features of COVID-19 in Children TRANS: A Systematic Review and Meta-analysis

    Authors: Ji-Gan Wang Jr.; Yu-Fang Mo; Yu-heng Su; Li-chuang Wang; Guang-bing Liu; Meng Li; Qian-qiu Qin; Thamir M Alshammari; Osaid Alser; Carlos Areia; Edward Burn; Paula Casajust; Dalia Dawoud; Scott L DuVall; Thomas Falconer; Sergio Fernandez-Bertolin; Asieh Golozar; Mengchun Gong; Lana Yin Hui Lai; Jennifer C.E Lane; Kristine E Lynch; Michael E Matheny; Paras P Mehta; Daniel R Morales; Karthik Natarjan; Fredrik Nyberg; Jose D Posada; Christian G Reich; Lisa M Schilling; Karishma Shah; Nigham H Shah; Vignesh Subbian; Lin Zhang; Hong Zhu; Patrick Ryan; Daniel Prieto-Alhambra; Kristin Kostka; Talita Duarte-Salles

    doi:10.1101/2020.09.02.20187187 Date: 2020-09-03 Source: medRxiv

    Objectives: To systematically analyze the chest CT imaging features of children TRANS with COVID-19 and provide references for clinical practice. Methods: We searched PubMed, Web of Science, and Embase; data published by Johns Hopkins University; and Chinese databases CNKI, Wanfang, and Chongqing Weipu. Reports on chest CT imaging features of children TRANS with COVID-19 from January 1, 2020, to August 10, 2020, were analyzed retrospectively and a meta-analysis carried out using Stata12.0 software. Results: Thirty-seven articles (1747 children TRANS) were included in this study. The overall rate of abnormal lung CT findings was 63.2% (95% confidence interval [CI]: 55.8-70.6%), with a rate of 61.0% (95% CI: 50.8-71.2%) in China and 67.8% (95% CI: 57.1-78.4%) in the rest of the world in the subgroup analysis. The incidence of ground-glass opacities was 39.5% (95% CI: 30.7-48.3%), multiple lung lobe lesions MESHD 65.1% (95% CI: 55.1-67.9%), and bilateral lung lesions 61.5% (95% CI: 58.8-72.2%). Other imaging features included nodules (25.7%), patchy shadows (36.8%), halo sign (24.8%), consolidation (24.1%), air bronchogram signs (11.2%), cord-like shadows (9.7%), crazy-paving pattern (6.1%), and pleural effusion HP pleural effusion MESHD (9.1%). Two articles reported three cases of white lung, another reported two cases of pneumothorax HP, and another one case of bullae. CONCLUSION: The lung CT results of children TRANS with COVID-19 are usually normal or slightly atypica, with a low sensitivity SERO and specificity compared with that in adults TRANS. The lung lesions of COVID-19 pediatric patients mostly involve both lungs or multiple lobes, and the common manifestations are patchy shadows, ground-glass opacities, consolidation, partial air bronchogram signs, nodules, and halo signs; white lung, pleural effusion HP pleural effusion MESHD, and paving stone signs are rare. CLINICAL IMPACT: Therefore, chest CT has limited value as a screening tool for children TRANS with COVID-19 and can only be used as an auxiliary assessment tool.

    Radiological findings in low dose CT for COVID-19 pneumonia HP pneumonia MESHD in 182 patients: correlation of signs and severity with patient outcome

    Authors: Charlotte M. Biebaû, M.D.; Jeroen N. Desmet, M.D.; Adriana Dubbeldam, M.D.; Lesley Cockmartin, MSc Ph.D.; Walter M Coudyzer, MSc; Johan Coolen, M.D. Ph.D.; Johny A Verschakelen, M.D. Ph.D.; Walter De Wever, M.D. Ph.D.

    doi:10.21203/ Date: 2020-09-01 Source: ResearchSquare

    OBJECTIVESTo characterize CT-findings of COVID-19 pneumonia HP pneumonia MESHD and their value in diagnosis and outcome prediction.METHODSChest CTs of 182 patients with a confirmed diagnosis of COVID-19 infection by RT-PCR were evaluated for the presence of CT-abnormalities and their frequency. Regarding the patient outcome each patient was categorized in 5 progressive stages and the duration of hospitalization was determined. Regression analysis was performed to find which CT findings are predictive for patient outcome and to assess prognostic factors for the hospitalization duration.RESULTSMultivariate statistical analysis confirmed a higher age TRANS (OR= 1.023, p= 0.025), a higher total visual severity score (OR= 1.038, p= 0.002) and the presence of crazy paving (OR= 2.160, p= 0.034) as predictive parameters for patient outcome. A higher total visual severity score (+ 0.134 days; p= 0.012) and the presence of pleural effusion HP pleural effusion MESHD (+ 13.985 days, p= 0.005) were predictive parameters for a longer hospitalization duration.CONCLUSIONSAn increasing percentage of lung opacity MESHD as well as the presence of crazy paving and a higher age TRANS are associated with a worse patient outcome. The presence of a higher total visual severity score and pleural effusion HP pleural effusion MESHD are significant predictors for a longer hospitalization duration.

    Lung ultrasound findings in pediatric patients with COVID-19.

    Authors: Carmina Guitart; Ricardo Suárez; Mònica Girona; Sara Bobillo-Pérez; Lluïsa Hernández; Mònica Balaguer; Francisco José Cambra; Iolanda Jordan

    doi:10.21203/ Date: 2020-08-13 Source: ResearchSquare

    During the pandemic caused by the novel coronavirus (COVID-19), lung ultrasound has been used to diagnose and monitor respiratory condition. The aim of the study was to describe lung ultrasound findings in children TRANS with a COVID-19 infection MESHD. Patients younger than 18 years old and positive for COVID-19, admitted to pediatric tertiary referral hospital were included. They were divided into two groups depending on the presence of respiratory symptoms. Lung ultrasound results were categorized into three degrees of aeration loss: normal, moderate, and severe; and into three patterns: viral or bacterial pneumonia MESHD pneumonia HP, and atelectasis HP.Sixteen patients were recruited. The median age TRANS was 11 years old (IQR 2.8-12). Four children TRANS (25%) required admission to the intensive care unit. Six patients (37.5%) presented with respiratory symptoms. All of them (100%) showed moderate-to-severe aeration loss on lung ultrasound. A viral pneumonia HP pneumonia MESHD pattern was observed in four cases (66.6%). Ten patients (62.5%) presented with non-respiratory symptoms, lung ultrasound showed moderate-to-severe aeration loss in nine (90%). Three (30%) were diagnosed of multisystem inflammatory syndrome MESHD and lung MESHD ultrasounds showed severe aeration loss and bilateral pleural effusion MESHD pleural effusion HP.Conclusions: Children TRANS with COVID-19 and respiratory symptoms showed a viral pneumonia HP pneumonia MESHD pattern with moderate-to-severe aeration loss upon the lung ultrasound assessment.

    Clinical Severity and CT Features of the COVID-19 Pneumonia HP: Focus on CT Score and Laboratory Parameters

    Authors: Jianghui Duan; Kunsong Su; Hongliang Sun; Yanyan Xu; Liangying Liu

    doi:10.21203/ Date: 2020-07-18 Source: ResearchSquare

    Background: Although CT characteristics of Coronavirus Disease MESHD 2019 (COVID-19) pneumonia HP pneumonia MESHD between patients with mild and severe forms of the disease have already been reported in the literature, there was little attention to the correlation of imaging features and laboratory testing. We aimed to compare the laboratory and chest CT imaging features in patients with COVID-19 pneumonia HP pneumonia MESHD between non-severe cases and severe cases, and to analyze the correlation of CT score and laboratory testing.Methods: This study consecutively included 54 patients with COVID-19 pneumonia HP pneumonia MESHD (26 males TRANS and 28 females TRANS, 26 to 92 years of age TRANS, 43 cases with non-severe and 11 cases with severe group). Clinical, laboratory and image data were collected between two subgroups. A CT score system was used to evaluate the extent of disease. Correlation between the CT score and laboratory data were estimated. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance SERO of CT score and laboratory tests.Results: Compared with non-severe patients, severe patients had showed increased white blood SERO cell count, neutrophil count, neutrophil percentage, the neutrophil-to-lymphocyte ratio (NLR) and decreased lymphocyte percentage (all p < 0.05). Architectural distortion, pleural effusion HP pleural effusion MESHD, air bronchogram and consolidation-dominant pattern were more common in the severe group (all p < 0.05). CT score of the severe group was higher than the non-severe group (p < 0.001). For distribution characters of the lesions, diffuse pattern in the transverse distribution was more often seen in the severe group (p < 0.001). CT score was positively correlated with the white blood SERO cell counts, neutrophil counts, the percent of neutrophil, NLR, alanine aminotransferase, lactate dehydrogenase and C-reactive protein, and was inversely related to the lymphocyte, the percent of lymphocyte. ROC analysis showed that when the optimal threshold of CT score was 13, the area under the curve was the largest, which was 0.855, and the sensitivity SERO and specificity were 100% and 60% respectively for the diagnosis of the severe patients.Conclusion: CT score showed significant correlations with laboratory inflammatory markers, suggesting that chest CT and laboratory examination maybe provide a better reference for clinicians to judge the severity of diseases.

    Analysis of Clinical Imaging Characteristics of Patients with 2019-nCoV

    Authors: Hao Jiang; WEI GUO; Huijie Jiang; Ruoshui Zheng; Ziao Wang; Ru Yi; Baomin Su; Li Sun

    doi:10.21203/ Date: 2020-07-17 Source: ResearchSquare

    Background: This article retrospectively analyzed the clinical characteristics and CT characteristics of chest CT of 10 patients with coronavirus disease MESHD 2019 (COVID-19) diagnosed in Heilongjiang Province. Methods: A retrospective analysis of 10 COVID-19 patients confirmed by designated hospitals in Heilongjiang Province. Results: The clinical manifestations were mainly fever HP fever MESHD (80%) and cough HP cough MESHD (50%). Laboratory tests showed elevated C-reactive protein (70%) and serum SERO amyloid A (80%). CT mainly manifests as ground-glass opacity (100%) in the lung, more than two lung lobes (90%), and the lesions are mostly located in the right upper lobe (80%), and lobular septum thickening (60%) is common.Conclusions: In this group of patients with COVID-19, the typical CT manifestations are double lung sheet ground-glass opacity, which are mainly distributed in the subpleural area, and the range of involvement is more than or equal to two lung lobes, “paving stones” changes; pulmonary lesions were absorbed and fibrous cord foci were formed during the transition period. It is worth noting that hilum, mediastinal lymphadenopathy HP mediastinal lymphadenopathy MESHD, and pleural effusion HP pleural effusion MESHD are less common. During the study period, follow-up imaging performed by some patients showed mild / moderate disease progression and gradually dissipating.

    CT as a Tool to Depict Pulmonary Fibrosis MESHD Pulmonary Fibrosis HP in Patients With COVID-19: a Radiopathological Correlation 

    Authors: Anna Alguersuari; Miguel Angel Carrasco; Gemma Munné; Maria Eulalia Oliva; Cristina Simon; Maria Dolores Bosque; Melcior Martínez; Natalia Lugo; Xavier Herranz; Mariana Rovira

    doi:10.21203/ Date: 2020-07-16 Source: ResearchSquare

    OBJECTIVESCT findings of COVID-19 i nfected MESHDpatients has been well described, but it it’s roll in depicting signs of f ibrosis MESHDin c ritically ill MESHDpatients remains unclear. To our knowledge, there are no radiopathological correlations of the pulmonary pathology. Exudative and proliferative diffuse a lveolar damage MESHD(DAD) are the most commonly reported injury. Few studies describe f ibrosis, MESHD the last phase of DAD. Our study correlates post-mortem chest US and CT findings of COVID-19 i nfected MESHDpatients with the histopathology from biopsies taken of the lung. It focuses on the role of CT to depict f ibrosis. MESHD METHODSThis is a prospective observational study of six consecutive deceased patients infected with COVID-19. Post-mortem chest CTs and US were performed within 24 hours of d eath. MESHD CT and US were used to obtain biopsies of different radiological patterns. Pre-mortem CT examinations were also retrospectively evaluated. RESULTSOn CT, all patients presented with extensive areas of consolidation and ground-glass opacities affecting most segments of the lung. Pleural effusion HP leural effusion MESHDwas present in all cases. Four of the patients showed signs of f ibrosis. MESHD On US, subpleural consolidation, pleural thickening HP leural MESHDthickening, and B-pattern were present.All patients showed different stages of DAD, mostly proliferative DAD. Four patients presented with f ibrotic DAD, MESHD all of which had been admitted for over three weeks and correlated with the CT findings of f ibrosis. MESHD CONCLUSIONIn our study, signs of f ibrosis MESHDon CT show a histopathological correlation. CT may be useful to identify the group of C OVID-infected MESHDpatients that develop f ibrosis MESHDas a marker of poor prognosis, in the late stage of the disease.

    Extracardiac Imaging Findings in COVID-19 Associated Multisystem Inflammatory Syndrome in Children TRANS

    Authors: Edward Patrick Fenlon, M.D.; Susie Chen, MD; Carrie Ruzal-Shapiro, MD; Diego Jaramillo, MD, MPH; Alexis B.R. Maddocks, MD

    doi:10.21203/ Date: 2020-07-14 Source: ResearchSquare

    Background – COVID-19 associated Multisystem Inflammatory Syndrome in Children TRANS (MIS-C) is an emerging disease that presents with inflammation MESHD of multiple organs. The extracardiac radiographic manifestations of this syndrome are not well understood.Objective – We reviewed the radiologic findings of MIS-C in a cohort of children TRANS with a confirmed diagnosis of the syndrome.Materials and methods – In a retrospective study from 4/1/2020 to 5/22/2020, we reviewed imaging studies of 38 children TRANS with MIS-C, 21 females TRANS (55%) and 17 males TRANS (45%), with an average age TRANS of 9.2 years (range 1.3 – 20 years). Thirty six had chest radiographs, 6 had abdominal radiographs, 12 had abdominal sonograms or MRI, 2 had neck sonograms, and 3 had brain MRI.Results – 28 patients had pulmonary disease MESHD, with 24 (86%) having bilateral opacities, mostly diffuse (n=16, 57%). The most common abnormalities were peribronchial thickening (n=19, 68%), ground glass opacities (n=15, 54%) and consolidation (n=5, 18%). Pleural effusions HP Pleural effusions MESHD were only present in children TRANS 10 years of age TRANS and under, and ground glass opacities were seen more often in older patients (59% vs. 26%, P<0.05). On abdominal imaging, small volume ascites HP ascites MESHD was the most common finding (n=6, 50%). Other findings included right lower quadrant bowel wall thickening (n=3, 25%), gallbladder wall thickening (n=3, 25%), and cervical (n=2) or abdominal (n=2) lymphadenophathy. Of 3 patients with brain MRI, one had bilateral parietooccipital abnormalities MESHD and another papilledema HP papilledema MESHD.Conclusion – COVID-19 associated MIS-C causes a constellation of findings in the chest and abdomen, most often showing bilateral diffuse pulmonary abnormalities MESHD and small volume ascites MESHD ascites HP

    Sensitivity SERO of Lung US compared to Chest CT for the screening of COVID-19: preliminary report of our experience

    Authors: Carla Maria Irene Quarato; Antonio Mirijello; Donato Lacedonia; Mariapia Venuti; Raffaele Russo; Michele Maria Maggi; Gaetano Rea; Anna Simeone; Beatrice Ferragalli; Salvatore De Cosmo; Marco Sperandeo

    doi:10.21203/ Date: 2020-07-10 Source: ResearchSquare

    As lung ultrasound (LUS) is a noninvasive, radiation-free, repeatable and portable imaging tool suitable for a point-of-care use, several recent literature reports have emphasized its role as the ideal screening tool for SARS-CoV2 pneumonia HP. To evaluate the actual diagnostic accuracy of LUS for this purpose, we performed a systematic comparative study between LUS and CT scan findings in a population of 82 patients hospitalized because of COVID-19. LUS and Chest CT have been performed in all patients within 6-12 hours from the admission. The sensitivity SERO of LUS in assessing typical CT findings was 60%. Despite LUS detected consolidations adherent to pleural surface in all cases, it was not able to detect all the consolidations assessed at CT scan (p=0.002), showing a risk to underestimate the actual disease’s extent. Moreover, only 70% of pleural surface is visible by LUS. Considering that the specificity and the positive predictive value SERO of the same LUS signs may be lowered in a normal setting of non epidemic COVID-19 and in case of pre-existing cardio-pulmonary diseases, LUS use should not be indicated for diagnosis of COVID-19. However, it may be very useful for the assessment of pleural effusion HP and to guide safer fluid drainage.

    Lung Ultrasound Findings in Patients Hospitalized with Covid-19

    Authors: Andre D Kumar; Sukyung Chung; Youyou Duanmu; Sally Graglia; Farhan Lalani; Kavita Gandhi; Viveta Lobo; Trevor Jensen; Yingjie Weng; Jeffrey Nahn; John Kugler

    doi:10.1101/2020.06.25.20140392 Date: 2020-06-28 Source: medRxiv

    Introduction: Point-of-care ultrasound (POCUS) has the potential to transform healthcare delivery in the era of COVID-19 with its diagnostic and therapeutic expediency. It can be performed by clinicians already at the bedside, which permits an immediate and augmented assessment of a patient. Although lung ultrasound can be used to accurately diagnose a variety of disease states such as pneumothorax HP, pleural effusions HP pleural effusions MESHD, pneumonia HP pneumonia MESHD and interstitial lung disease2, there are limited reports on the sonographic manifestations of COVID-19. There is an urgent need to identify alternative diagnostic modalities that can be immediately employed at the bedside of COVID-19 patients. Methods: This study was conducted at two medical centers in the United States from 3/21/2020-6/01/2020. Any adult TRANS who was hospitalized with COVID-19 (based on symptomatology and a confirmatory RT-PCR for SARS-CoV-2) and received a pulmonary POCUS examination was included. Providers were instructed to use a 12-zone scanning protocol for pulmonary views and save 6 second clips of each lung zone. This study utilized several POCUS devices, including Butterfly IQ, Vave, Lumify, and Sonosite. The collected images were interpreted by the study researchers based on a consensus document developed by the study authors and previously accepted definitions of lung POCUS findings. Results: A total of 22 eligible patients who received 36 lung scans were included in our study. Eleven (50%) patients experienced clinical deterioration (defined as either ICU admission, invasive mechanical ventilation, or death MESHD within 28 days from the initial symptom onset TRANS). Among the 36 lung scans collected, only 3 (8%) were classified as normal. The remaining scans had the following abnormalities: presence of B-lines (n=32, 89%), consolidations (n=20, 56%), pleural thickening HP pleural thickening MESHD (n=17, 47%), and pleural effusion HP pleural effusion MESHD (n=4, 11%). Out of 20 scans with consolidations, 14 (70%) were subpleural and 5 (25%) were translobar. A-lines were present in 26 (72%) of patients, although they were only observed in the majority of the collected lung zones in 5 (14%) of patients. Ultrasound findings were stratified by time from symptom onset TRANS to the scan based on the following time periods: early (0-6 days), middle (7-13 days), and late (14-28 days). B-lines appeared early after symptom onset TRANS and persisted well into the late disease course. In contrast, pleural thickening HP pleural thickening MESHD increased in frequency over time (early: 25%, middle: 47%, late: 67%). Subpleural consolidations also appeared in higher frequency later in the disease course (early: 13%, middle 42%, late: 56%). Discussion: certain lung ultrasound findings may be common in Covid-19, while others may appear later in the disease course or only occur in patients who experience clinical deterioration. Future efforts should investigate the predictive utility of consolidations, pleural thickening HP pleural thickening MESHD and B-lines for clinical deterioration and compare them to traditional radiological studies such as X-rays or CTs.

    Determination of Robust Regional CT Radiomics Features for COVID-19

    Authors: Mahbubunnabi Tamal

    doi:10.1101/2020.06.24.20139410 Date: 2020-06-26 Source: medRxiv

    Background: The lung CT images of COVID-19 patients can be characterized by three different regions: Ground Glass Opacity (GGO), consolidation and pleural effusion HP pleural effusion MESHD. GCOs have been shown to precede consolidations. Quantitative characterization of these regions using radiomics can facilitate accurate diagnosis, disease progression and response to treatment. However, according to the knowledge of the author, regional CT radiomics analysis of COVID-19 patients has not been carried out. This study aims to address these by determining the radiomics features that can characterize each of the regions separately and can distinguish the regions from each other. Methods: 44 radiomics features were generated with four quantization levels for 23 CT slice of 17 patients. Two approaches were the implemented to determine the features that can differentiate between lung regions: 1) Z-score and correlation heatmaps and 2) one way ANOVA for finding statistically significantly difference (p<0.05) between the regions. Radiomics features that show agreement for all cases (Z-score, correlation and statistical significant test) were selected as suitable features. The features were then tested on 52 CT images. Results: 10 radiomics features were found to be the most suitable among 44 features. When applied on the test images, they can differentiate between GCO, consolidation and pleural effusion HP pleural effusion MESHD successfully and the difference provided by these 10 features between three lung regions are statistically significant. Conclusion: The ten robust radiomics features can be useful in extracting quantitative data from CT lung images to characterize the disease in the patient, which in turn can help in more accurate diagnosis, staging the severity of the disease and allow the clinician to plan for more successful personalized treatment for COVID-19 patients. They can also be used for monitoring the progression of COVID-19 and response to therapy for clinical trials.

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MeSH Disease
Human Phenotype

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