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Overview

MeSH Disease

Human Phenotype

Transmission

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

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

    doi:10.21203/rs.3.rs-45453/v1 Date: 2020-07-18 Source: ResearchSquare

    Background: Although CT characteristics of Coronavirus Disease MESHD 2019 (COVID-19) pneumonia MESHD pneumonia HP between patients with mild and severe forms of the disease MESHD 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 MESHD pneumonia HP 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 MESHD pneumonia HP (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 MESHD. 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 MESHD pleural effusion HP, 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 MESHD.

    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/rs.3.rs-44768/v1 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 MESHD fever HP (80%) and cough MESHD cough HP (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 lymphadenopathy MESHD, and pleural effusion MESHD pleural effusion HP are less common. During the study period, follow-up imaging performed by some patients showed mild / moderate disease progression MESHD 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/rs.3.rs-44197/v1 Date: 2020-07-16 Source: ResearchSquare

    OBJECTIVESCT findings of COVID-19 infected patients has been well described, but it it’s roll in depicting signs of fibrosis MESHD in critically ill patients remains unclear. To our knowledge, there are no radiopathological correlations of the pulmonary pathology. Exudative and proliferative diffuse alveolar damage (DAD) are the most commonly reported injury. Few studies describe fibrosis MESHD, the last phase of DAD. Our study correlates post-mortem chest US and CT findings of COVID-19 infected patients with the histopathology from biopsies taken of the lung. It focuses on the role of CT to depict fibrosis 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 death 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 MESHD Pleural effusion HP was present in all cases. Four of the patients showed signs of fibrosis MESHD. On US, subpleural consolidation, pleural thickening HP, and B-pattern were present.All patients showed different stages of DAD, mostly proliferative DAD. Four patients presented with fibrotic DAD, all of which had been admitted for over three weeks and correlated with the CT findings of fibrosis MESHD. CONCLUSIONIn our study, signs of fibrosis MESHD on CT show a histopathological correlation. CT may be useful to identify the group of COVID-infected patients that develop fibrosis MESHD as a marker of poor prognosis, in the late stage of the disease MESHD.

    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/rs.3.rs-40937/v1 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 MESHD 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 MESHD, LUS use should not be indicated for diagnosis of COVID-19. However, it may be very useful for the assessment of pleural effusion MESHD 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 MESHD states such as pneumothorax MESHD pneumothorax HP, pleural effusions MESHD pleural effusions HP, pneumonia MESHD pneumonia HP 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 MESHD (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 (n=17, 47%), and pleural effusion MESHD pleural effusion HP (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 MESHD course. In contrast, pleural thickening HP increased in frequency over time (early: 25%, middle: 47%, late: 67%). Subpleural consolidations also appeared in higher frequency later in the disease MESHD 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 MESHD course or only occur in patients who experience clinical deterioration MESHD. Future efforts should investigate the predictive utility of consolidations, pleural thickening HP and B-lines for clinical deterioration MESHD 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 MESHD pleural effusion HP. GCOs have been shown to precede consolidations. Quantitative characterization of these regions using radiomics can facilitate accurate diagnosis, disease progression MESHD 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 MESHD pleural effusion HP 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 MESHD in the patient, which in turn can help in more accurate diagnosis, staging the severity of the disease MESHD 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.

    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/rs.3.rs-35521/v1 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 MESHD classification (p<0.05). From the symptom analysis, the proportion of fever MESHD fever HP over 38 degrees, dyspnea MESHD dyspnea HP, fatigue MESHD fatigue HP, poor appetite HP and other symptoms is diverse in different types of diseases MESHD (p<0.05). As the severity of the disease MESHD increases, the median lymphocyte count decreases, C-reactive protein increase, erythrocyte sedimentation rateincrease, albumin decrease, pleural effusion MESHD pleural effusion HP increase, D-Dimer and NT-proBNP increase significantly (p<0.05).As the disease MESHD 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 MESHD anorexia HP, fatigue MESHD fatigue HP, C reactive protein, etc (p<0.05).ConclusionThe MuLBSTA evaluation system has certain value for the evaluation of the disease MESHD, but it needs to be improved.

    The Chest CT Features of Coronavirus Disease MESHD 2019 (COVID-19) in China: A Meta-analysis of 19 Trials

    Authors: Haitao Yang; lan yuzhu; Xiujuan Yao; Sheng Lin; Baosong Xie

    doi:10.1101/2020.05.31.20118059 Date: 2020-06-03 Source: medRxiv

    Objective: This study aimed to summarize the characteristics of chest CT imaging in Chinese patients with Coronavirus Disease MESHD 2019 (COVID-19) to provide reliable evidence for further guiding clinical routine. Methods: PubMed, Embase and Web of Science databases were thoroughly searched to identified relevant articles involving the features of chest CT imaging in Chinese patients with COVID-19. All data were analyzed utilizing R software version i386 4.0.0. Random-effects models were employed to calculate pooled mean differences. Results: 19 trials incorporating 1332 cases were included in the study. The results demonstrated that the incidence of ground-glass opacities (GGO) was 0.79, consolidation was 0.34; mixed GGO and consolidation was 0.46; air bronchogram sign was 0.41; crazy paving pattern was 0.32; interlobular septal thickening was 0.55; reticulation was 0.30; bronchial wall thickening was 0.24; vascular enlargement was 0.74. subpleural linear opacity was 0.28; intrathoracic lymph node enlargement was 0.03; pleural effusions MESHD pleural effusions HP was 0.03. The distribution in lung: the incidence of central was 0.05; peripheral was 0.74; peripheral involving central was 0.38; diffuse was 0.19; unifocal involvement was 0.09; multifocal involvement was 0.57; unilateral was 0.16; bilateral was 0.83; The incidence of lobes involved (>2) was 0.70; lobes involved ([less double equals]2) was 0.35. Conclusion: GGO, vascular enlargement, interlobular septal thickening more frequently occurred in patients with COVID-19. Peripheral, bilateral, involved lobes >2 might be the features of COVID-19 in the distribution aspect. Therefore, based on the aboved features of COVID-19 in chest CT imaging, it might be a promising means for identifying COVID-19.

    Pulmonary Thromboembolic Disease MESHD in Patients with COVID-19 Undergoing Computed Tomography Pulmonary Angiography (CTPA): Incidence and Relationship with Pulmonary Parenchymal Abnormalities

    Authors: Cheng Fang; Giorgio Garzillo; Bhavna Batohi; James T Teo; Marko Berovic; Paul Sidhu; Hasti Robbie

    doi:10.1101/2020.06.01.20118505 Date: 2020-06-02 Source: medRxiv

    Purpose This study aims to report the incidence, severity and extent of pulmonary thromboembolic disease MESHD (PTD) in patients with confirmed COVID-19 who have undergone CT pulmonary angiography (CTPA) in a tertiary centre. Materials and Methods This is a retrospective analysis of all patients undergoing CTPA between 23rd March 2020 and 19th April 2020 in a tertiary centre. The presence of PTD, location and involved pulmonary lobes were documented. The pattern and extent of pulmonary parenchymal abnormalities including the presence of fibrosis MESHD, lymph node enlargement and pleural effusion MESHD pleural effusion HP were evaluated by two experienced observers independently and consensus was achieved for the most disparate results. Inter-observer agreement was assessed using Kappa statistics. Student t-test, Chi square and Mann-Whitney U tests were used to compare imaging features between PTD and non-PTD sub-groups. Results During the study period, 2157 patients were confirmed with COVID-19, 297/2157 (13.8%) had CT imaging, 100/2157 (4.6%) were CTPA studies, 93 studies were analysed, excluding sub-optimal studies. Overall incidence of PTD was 41/93 (44%) with a third of patients showing segmental and subsegmental PTD (n=28/93, 30%,). D-dimer was elevated in 90/93 (96.8%) of cases. High Wells score did not differentiate between PE and non-PE groups (p=0.801). The inter-observer agreement was fair (Kappa=0.659) for parenchymal pattern and excellent (Kappa = 0.816) for severity. Lymph node enlargement was found in 34/93 of cases (36.6%) with 29/34 (85.3%) showing no additional source of infection MESHD. Fibrosis MESHD was seen in 16/93 (17.2%) of cases, mainly demonstrating fibrotic organising pneumonia MESHD pneumonia HP. Conclusion There is a high incidence of PTD in COVID -19 patients undergoing CTPA, complicated by lack of a valid risk stratification tool. Our data indicates a much higher suspicion of PTD is needed in severe COVID-19 patients. The concomitant presence of fibrotic features on CT indicates the need for follow-up for evaluation of chronic pulmonary complications.

    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/rs.3.rs-33158/v1 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 MESHD pleural effusion HP on admission and 13 of them still carried hydrothorax MESHD 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.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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