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.

    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

    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.

    Clinical Characteristics of COVID-19 and the Value of Mulbsta Scoring System in Prognosis Evaluation

    Authors: Chao Wang; Zhixiu Luo; Junyi Wu; Jie Zhou; Yahang Lin; Guilin Yan; Manman Yan; Xi Wang; Hanhua Yu; Xiaoyun Zeng

    doi:10.21203/ Date: 2020-06-14 Source: ResearchSquare

    BackgroundCOVID-19, a worldwideinfectious disease MESHD, has killed more than 420000 people, whichis extremely harmful.MethodsIn this single-center retrospective study, we included the novel coronavirus pneumonia MESHD pneumonia HP confirmed in our hospital. This study collected the basic information andclinical examination features.ResultsThe enrolled 704 patients were affirmed infected with 2019-nCoV by the test of throat swabs. There are 334 men and 369 women, and gender TRANS, age TRANS, combined with basic diseasesare distinct in diverse disease classification (p<0.05). From the symptom analysis, the proportion of fever HP fever MESHD over 38 degrees, dyspnea HP dyspnea MESHD, fatigue HP fatigue MESHD, poor appetite HP and other symptoms is diverse in different types of diseases (p<0.05). As the severity of the disease increases, the median lymphocyte count decreases, C-reactive protein increase, erythrocyte sedimentation rateincrease, albumin decrease, pleural effusion HP pleural effusion MESHD increase, D-Dimer and NT-proBNP increase significantly (p<0.05).As the disease severity increases, the average value of MuLBSTA score obviously ascend (p<0.05), MuLBSTA scoring system predicts novel coronavirus pneumonia MESHD pneumonia HP patients' prognosis is still insufficient, and may require additional indicators including anorexia HP anorexia MESHD, fatigue HP fatigue MESHD, C reactive protein, etc (p<0.05).ConclusionThe MuLBSTA evaluation system has certain value for the evaluation of the disease, but it needs to be improved.

    Lung ultrasound findings in patients with novel SARS-CoV2

    Authors: Mark Evert Haaksma; Micah L.A. Heldeweg; Jorge E. Lopez Matta; Jasper Martijn Smit; Jessica D. van Trigt; Jip Suzanne Nooitgedacht; Carlos V. Elzo Kraemer; Armand R.J. Girbes; Leo M.A. Heunks; David J. van Westerloo; Pieter R. Tuinman

    doi:10.1101/2020.05.18.20105775 Date: 2020-05-21 Source: medRxiv

    Background: Over 2 million people worldwide have been infected with Severe Acute Respiratory Distress Syndrome Corona Virus 2 MESHD Respiratory Distress HP Syndrome Corona Virus 2 ( SARS CoV2 MESHD). Lung ultrasound has been proposed to diagnose and it. However, little is known about ultrasound findings in these patients. Our aim is to present an overview of lung ultrasound characteristics in critically ill patients with SARS CoV2 pneumonia HP pneumonia MESHD overall and in relation to the duration of symptoms and clinical parameters. Methods: On the Intensive Care Unit of two academic hospitals, adult TRANS patients who tested positive for SARS-CoV2 were included. Images were analyzed for pleural MESHD line characteristics, number and appearance of B-lines, BLUE-profiles (Bedside Lung Ultrasound in Emergency), pathology in the PLAPS (Postero Lateral Alveolar MESHD and Pleural Syndrome MESHD) point and a LUS-score (lung ultrasound). The primary outcomes were frequencies, percentages and differences in lung ultrasound findings overall and between short ([≤]14 days) and long (>14 days) duration of symptoms and their correlation with clinical parameters. Results: In this pilot observational study, 61 patients were included with 75 examinations for analysis. The most prevalent ultrasound findings were decreased lung sliding (36%), thickening of the pleural HP pleural MESHD line (42%) and a C-profile per view (37%). Patients with ''long'' duration of symptoms presented more frequently with a thickened and irregular pleural MESHD line (21% (32) vs 9% (11), p=.01), C-profile per patient (47% (18) vs. 25% (8),p=.01) and pleural effusion HP pleural effusion MESHD (19% (14) vs 5% (3),p=.02) compared to patients with short duration of symptoms. Lung ultrasound findings did not correlate with P/F ratio, fluid balance or dynamic compliance, with the exception of the LUS-score and dynamic compliance (R2=0.27, p=.02). Conclusion: SARS CoV2 results in significant ultrasound changes, with decreased lung sliding, thickening of the pleural HP pleural MESHD line and a C-profile being the most observed. With time, a thickened and irregular pleural MESHD line, C-profile and pleural effusion HP pleural effusion MESHD become more common findings.

    Comparison of initial thin-section CT features in coronavirus disease MESHD 2019 pneumonia HP pneumonia MESHD and other community-acquired pneumonia HP pneumonia MESHD

    Authors: Qiao Zhu; Cui Ren; Xiao Hua Wang

    doi:10.21203/ Date: 2020-05-19 Source: ResearchSquare

    Background Coronavirus disease MESHD 2019 (COVID-19) pneumonia HP pneumonia MESHD caused similar symptoms to other community-acquired pneumonia HP pneumonia MESHD (CAP). It is important to early quarantine suspected patients with COVID-19 pneumonia HP pneumonia MESHD from patients with other CAP to reduce cross infection MESHD. The purpose of the study is to review and compare initial thin-section computed tomography (CT) features in patients with coronavirus disease MESHD 2019 (COVID-19) pneumonia HP pneumonia MESHD and other community-acquired pneumonia HP pneumonia MESHD (CAP). Methods 24 cases of COVID-19 pneumonia HP pneumonia MESHD (14 males TRANS and 10 females TRANS; age TRANS range, 14-87 years; mean age TRANS, 48.0 years) and 28 cases of CAP caused by other pathogens (13 males TRANS and 15 females TRANS; age TRANS range, 24-85 years; mean age TRANS, 49.5 years) were included. Thin-section CT features of the lungs for all patients were retrospectively reviewed by two independent radiologists. Results There were no significant differences for the shape of main lesions, pure ground glass attenuation (GGA), mixed GGA with consolidation, air bronchogram, linear opacities, halo sign/reversed halo sign, cavitation and lymphadenopathy HP lymphadenopathy MESHD between the group of COVID-19 pneumonia HP pneumonia MESHD and the group of other CAP. However, the frequency of crazy-paving appearance, vessel dilatation HP, bilaterally involvement and peripherally distribution were significantly higher in patients with COVID-19 compared with other CAP ( p =0.031, p =0.000, p =0.029 and p =0.009, respectively). Conversely, the frequencies of pure consolidation, tree-in-bud sign and pleural effusion HP pleural effusion MESHD were significantly higher in patients with CAP than in patients with COVID-19 pneumonia HP pneumonia MESHD ( p =0.002, p =0.000 and p =0.048, respectively). Conclusion There are considerable overlaps in thin-section CT features between COVID-19 pneumonia HP pneumonia MESHD and other CAP. However, the presence of crazy paving pattern, vessel dilation, bilateral involvement and peripheral distribution contributes to the diagnosis of COVID-19 pneumonia HP pneumonia MESHD. While the presence of pure consolidation tree-in-bud sign, pleural effusion HP pleural effusion MESHD can be assisting in exclusive the diagnosis of COVID-19 pneumonia HP pneumonia MESHD.


    Authors: Simon Duchesne; Daniel Gourdeau; Patrick Archambault; Carl Chartrand-Lefebvre; Louis Dieumegarde; Reza Forghani; Christian Gagne; Alexandre Hains; David Hornstein; Huy Le; Simon Lemieux; Marie-Helene Levesque; Diego Martin; Lorne Rosenbloom; An Tang; Fabrizio Vecchio; Nathalie Duchesne

    doi:10.1101/2020.05.01.20086207 Date: 2020-05-05 Source: medRxiv

    Background - Decision scores and ethically mindful algorithms are being established to adjudicate mechanical ventilation in the context of potential resources shortage due to the current onslaught of COVID-19 cases. There is a need for a reproducible and objective method to provide quantitative information for those scores. Purpose - Towards this goal, we present a retrospective study testing the ability of a deep learning algorithm at extracting features from chest x-rays (CXR) to track and predict radiological evolution. Materials and Methods - We trained a repurposed deep learning algorithm on the CheXnet open dataset (224,316 chest X-ray images of 65,240 unique patients) to extract features that mapped to radiological labels. We collected CXRs of COVID-19-positive patients from two open-source datasets (last accessed on April 9, 2020)(Italian Society for Medical and Interventional Radiology and MILA). Data collected form 60 pairs of sequential CXRs from 40 COVID patients (mean age TRANS +/- standard deviation: 56 +/- 13 years; 23 men, 10 women, seven not reported) and were categorized in three categories: Worse, Stable, or Improved on the basis of radiological evolution ascertained from images and reports. Receiver operating characteristic analyses, Mann-Whitney tests were performed. Results - On patients from the CheXnet dataset, the area under ROC curves ranged from 0.71 to 0.93 for seven imaging features and one diagnosis. Deep learning features between Worse and Improved outcome categories were significantly different for three radiological signs and one diagnostic (Consolidation, Lung Lesion MESHD, Pleural Effusion HP Pleural Effusion MESHD and Pneumonia HP; all P < 0.05). Features from the first CXR of each pair could correctly predict the outcome category between Worse and Improved cases with 82.7% accuracy. Conclusion - CXR deep learning features show promise for classifying the disease trajectory. Once validated in studies incorporating clinical data and with larger sample sizes, this information may be considered to inform triage decisions.

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MeSH Disease
Human Phenotype

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