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.

    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.

    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.

    Radiologic evaluation of discharge quality in patients with COVID-19

    Authors: Jingwen Li; Xi Long; Fang Fang; Xuefei Lv; Dandan Zhang; Yu Sun; Na Li; Qing Zhang; Xi Fang; Shaoping Hu; Zhicheng Lin; Nian Xiong

    doi:10.21203/ Date: 2020-06-02 Source: ResearchSquare

    Background   Worldwide spread of the novel coronavirus disease MESHD 2019 (COVID-19) has made hundreds of thousands people sick and fortunately many of them have been treated and discharged. However, it remains unclear how well the discharged patients were recovering. Chest CT scan, with demonstrated high sensitivity SERO to COVID-19, was used here to examine clinical manifestations in patients at discharge.Methods This study registered retrospectively single-center case series of 180 discharged patients, all confirmed with COVID-19 at Wuhan Red Cross Hospital in Wuhan, China. Epidemiological, demographic, clinical, laboratory and treatment data were collected. CT imaging features of absorption vs progressive stage were compared and analyzed.Results Five pulmonary lobes were affected in 54 (30%) of the 180 patients at the absorption stage, comparing to 66% of them at the progressive stage (P=1.45×10-11). Forty five (25%) patients had pleural effusion HP pleural effusion MESHD on admission and 13 of them still carried hydrothorax when discharged as per standard discharge criteria(P=4.48×10-6). Besides, compared with those at progressive stage, 97 (54%) discharged patients had interlobular thickening (P=6.95×10-3) and 43% of them still presented adjacent pleura thickening (P=5.58×10-5). The median total CT score of discharged patients at absorption stage was lower than progressive stage (3 vs 12.5 ). The median total CT score recovery rate was 67% (range, 0-100%) and 139 (77%) patients showed less than 90% improvement at discharge.Conclusions A majority (77%) of the discharged patients had not recovered completely. The current discharge criteria may need to include 90% or higher CT score-based recovery rate.Authors Jingwen Li, Xi Long, Fang Fang, and Xuefei Lv contributed equally to this work.Authors Zhicheng Lin and Nian Xiong are joint last coauthors.

    Distinguishing COVID-19 from influenza pneumonia HP pneumonia MESHD in the early stage through CT imaging and clinical features

    Authors: Zhiqi Yang; Daiying Lin; Xiaofeng Chen; Jinming Qiu; Shengkai Li; Ruibin Huang; Hongfu Sun; Yuting Liao; Jianning Xiao; Yanyan Tang; Guorui Liu; Renhua Wu; Xiangguang Chen; Zhuozhi Dai

    doi:10.1101/2020.04.17.20061242 Date: 2020-04-22 Source: medRxiv

    Purpose: To identify differences in CT imaging and clinical features between COVID-19 and influenza pneumonia HP pneumonia MESHD in the early stage, and to identify the most valuable features in the differential diagnosis. Materials and Method: A consecutive cohort of 73 COVID-19 and 48 influenza pneumonia HP pneumonia MESHD patients were retrospectively recruited from five independent institutions. The courses of both diseases were confirmed to be in the early stages (mean 2.66 (SD 2.62) days for COVID-19 and mean 2.19 (SD 2.10) days for influenza pneumonia MESHD pneumonia HP after onset). The chi-square test, student`s t-test, and Kruskal-Wallis H-test were performed to compare CT imaging and clinical features between the two groups. Spearman or Kendall correlation tests between feature metrics and diagnosis outcomes were also assessed. The diagnostic performance SERO of each feature in differentiating COVID-19 from influenza pneumonia HP pneumonia MESHD was evaluated with univariate analysis. The corresponding area under the curve (AUC), accuracy, specificity, sensitivity SERO and threshold were reported. Results: The ground-glass opacification (GGO) was the most common imaging feature in COVID-19, including pure-GGO (75.3%) and mixed-GGO (78.1%), mainly in peripheral distribution. For clinical features, most COVID-19 patients presented normal white blood SERO cell (WBC) count (89.04%) and neutrophil count (84.93%). Twenty imaging features and 6 clinical features were identified to be significantly different between the two diseases. The diagnosis outcomes correlated significantly with the WBC count (r=-0.526, P<0.001) and neutrophil count (r=-0.500, P<0.001). Four CT imaging features had absolute correlations coefficients higher than 0.300 (P<0.001), including crazy-paving pattern, mixed-GGO in peripheral area, pleural effusions HP pleural effusions MESHD, and consolidation. Conclusions: Among a total of 1537 lesions and 62 imaging and clinical features, 26 features were demonstrated to be significantly different between COVID-19 and influenza pneumonia MESHD pneumonia HP. The crazy-paving pattern was recognized as the most powerful imaging feature for the differential diagnosis in the early stage, while WBC count yielded the highest diagnostic efficacy in clinical manifestations.


    Authors: Michele Gaeta; Giuseppe Cicero; Maria Adele Marino; Tommaso D'Angelo; Enrico Maria Mormina; Silvio Mazziotti; Alfredo Blandino; Giulio Siracusano; Aurelio La Corte; Massimo Chiappini; Giovanni Finocchio

    doi:10.1101/2020.04.16.20061044 Date: 2020-04-17 Source: medRxiv

    Background CT is a very sensitive technique to detect pneumonia HP pneumonia MESHD in COVID-19 patients. However, it is impaired by high costs, logistic issues and high risk of exposure. Chest x-ray (CXR) is a low-cost, low-risk, not time consuming technique and is emerging as the recommended imaging modality to use in COVID-19 pandemic. This technique, although less sensitive than CT-scan, can provide useful information about pulmonary involvement. Purpose To describe chest x-ray features of COVID-19 pneumonia HP pneumonia MESHD and to evaluate the sensitivity SERO of this technique in detecting pneumonia HP pneumonia MESHD. A further scope is to assess the effectiveness of a post-processing algorithm in improving lung lesions detectability MESHD. Materials and Methods 72 patients with laboratory-confirmed COVID-19 underwent bedside chest X-ray. Two radiologists were asked to express their opinion about: (i) presence of pneumonia HP pneumonia MESHD (negative or positive); (ii) localization (unilateral or bilateral); (iii) topography (according to pulmonary fields); (iv) density (non consolidative ground-glass or inhomogeneous opacities; consolidative nodulartype or triangular; mixed consolidative e non-consolidative); and (v) presence of pleural effusion HP pleural effusion MESHD. The point (i) was evaluated separately, while the other points in consensus. A quality assessment of post-processed x-ray images was performed by two different readers. Results The agreement about presence of pneumonia HP pneumonia MESHD was almost perfect with K value of 0.933 and p < 0.001. Sensitivity SERO was 69%. The following findings were seen: unilateral lung involvement in 50%; lower lung lesions MESHD in 54%; peripheral distribution in 48%; and non-consolidative pattern in 44%. Post-processed images improved the detection of lesions in 7 out 72 patients ({cong}10%) Conclusion CXR owns a good sensitivity SERO in detecting COVID-19 lung involvement. Use of post-processing algorithm can improve detection of lesions. Our data support recommendations of the Radiological Society of North America (RSNA) to consider chest x-ray as first step imaging examination in Covid-19 patients.

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MeSH Disease
Human Phenotype

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