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2.
Orv Hetil ; 161(23): 971-976, 2020 06.
Artigo em Húngaro | MEDLINE | ID: mdl-32453695

RESUMO

The scientific literature of coronavirus-disease 2019 (COVID-19) is rapidly expanding. There is a growing evidence on the discrepancy between clinical symptoms and radiologic findings in many patients. This case report gives details about a patient with only mild symptoms but relatively severe radiological findings. The 75-year-old patient suffering from oncologic disease had a planned a F18-fluoro-deoxy-glucose positron-emission tomography/computer tomography scan with a routine oncological indication where incidental radiomorphologic findings of pneumonia suspect for COVID-19 were detected. After immediate isolation, the patient was transferred to the corresponding medical department, where further investigations verified the diagnosis of COVID-19. With this case, our aim is to raise the awareness for the importance of the instant evaluation of chest computer tomography series when performing planned imaging examination, especially in frail patients. With this practice, potential radiomorphologic findings of pneumonia suspect for COVID-19 could be identified in time, which fundamentally determines further patient management steps. Orv Hetil. 2020; 161(23): 971-976.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Achados Incidentais , Neoplasias/terapia , Pneumonia Viral/diagnóstico por imagem , Idoso , Infecções por Coronavirus/epidemiologia , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons
3.
Korean J Radiol ; 21(6): 736-745, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32410412

RESUMO

OBJECTIVE: To identify the initial chest computed tomography (CT) findings and clinical characteristics associated with the course of coronavirus disease 2019 (COVID-19) pneumonia. MATERIALS AND METHODS: Baseline CT scans and clinical and laboratory data of 72 patients admitted with COVID-19 pneumonia (39 men, 46.2 ± 15.9 years) were retrospectively analyzed. Baseline CT findings including lobar distribution, presence of ground glass opacities, consolidation, linear opacities, and lung severity score were evaluated. The outcome event was recovery with hospital discharge. The time from symptom onset to discharge or the end of follow-up (for those remained hospitalized) was recorded. Data were censored in events such as death or discharge without recovery. Multivariable Cox proportional hazard regression was used to explore the association between initial CT, clinical or laboratory findings, and discharge with recovery, whereby hazard ratio (HR) values < 1 indicated a lower rate of discharge at four weeks and longer time until discharge. RESULTS: Thirty-two patients recovered and were discharged during the study period with a median length of admission of 16 days (range, 9 to 25 days), while the rest remained hospitalized at the end of this study (median, 17.5 days; range, 4 to 27 days). None died during the study period. After controlling for age, onset time, lesion characteristics, number of lung lobes affected, and bilateral involvement, the lung severity score on baseline CT (> 4 vs. ≤ 4 [reference]: adjusted HR = 0.41 [95% confidence interval, CI = 0.18-0.92], p = 0.031) and initial lymphocyte count (reduced vs. normal or elevated [reference]: adjusted HR = 0.14 [95% CI = 0.03-0.60], p = 0.008) were two significant independent factors that influenced recovery and discharge. CONCLUSION: Lung severity score > 4 and reduced lymphocyte count at initial evaluation were independently associated with a significantly lower rate of recovery and discharge and extended hospitalization in patients admitted for COVID-19 pneumonia.


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Adulto , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
4.
Korean J Radiol ; 21(6): 746-755, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32410413

RESUMO

OBJECTIVE: To identify predictors of pulmonary fibrosis development by combining follow-up thin-section CT findings and clinical features in patients discharged after treatment for COVID-19. MATERIALS AND METHODS: This retrospective study involved 32 confirmed COVID-19 patients who were divided into two groups according to the evidence of fibrosis on their latest follow-up CT imaging. Clinical data and CT imaging features of all the patients in different stages were collected and analyzed for comparison. RESULTS: The latest follow-up CT imaging showed fibrosis in 14 patients (male, 12; female, 2) and no fibrosis in 18 patients (male, 10; female, 8). Compared with the non-fibrosis group, the fibrosis group was older (median age: 54.0 years vs. 37.0 years, p = 0.008), and the median levels of C-reactive protein (53.4 mg/L vs. 10.0 mg/L, p = 0.002) and interleukin-6 (79.7 pg/L vs. 11.2 pg/L, p = 0.04) were also higher. The fibrosis group had a longer-term of hospitalization (19.5 days vs. 10.0 days, p = 0.001), pulsed steroid therapy (11.0 days vs. 5.0 days, p < 0.001), and antiviral therapy (12.0 days vs. 6.5 days, p = 0.012). More patients on the worst-state CT scan had an irregular interface (59.4% vs. 34.4%, p = 0.045) and a parenchymal band (71.9% vs. 28.1%, p < 0.001). On initial CT imaging, the irregular interface (57.1%) and parenchymal band (50.0%) were more common in the fibrosis group. On the worst-state CT imaging, interstitial thickening (78.6%), air bronchogram (57.1%), irregular interface (85.7%), coarse reticular pattern (28.6%), parenchymal band (92.9%), and pleural effusion (42.9%) were more common in the fibrosis group. CONCLUSION: Fibrosis was more likely to develop in patients with severe clinical conditions, especially in patients with high inflammatory indicators. Interstitial thickening, irregular interface, coarse reticular pattern, and parenchymal band manifested in the process of the disease may be predictors of pulmonary fibrosis. Irregular interface and parenchymal band could predict the formation of pulmonary fibrosis early.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Fibrose Pulmonar/diagnóstico por imagem , Fibrose Pulmonar/virologia , Adulto , Idoso , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/patologia , Feminino , Humanos , Masculino , Microtomia/métodos , Pessoa de Meia-Idade , Pandemias , Alta do Paciente , Derrame Pleural/patologia , Derrame Pleural/virologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/patologia , Valor Preditivo dos Testes , Fibrose Pulmonar/patologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos
5.
Monaldi Arch Chest Dis ; 90(2)2020 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-32425014

RESUMO

SARS-CoV-2 infection, responsible for COVID-19, can determine cardiac events, which require a quick diagnosis and management, and should not be overlooked due to the presence of COVID-19 infection. In some cases, cardiovascular symptoms can also be the first and only manifestation of SARS-CoV-2 infection. In patients with COVID-19, the full cardiovascular disease diagnostic algorithm can be hindered by logistic restrain mainly derived from the difficulty of transporting patients in critical conditions to Radiology or Hemodynamics wards. The echocardiography in SARS-CoV-2 pandemic can help for differential diagnosis of cardiac events, which can be related or unrelated by the infection and can likely impact on short-term prognosis. Indeed, transthoracic echocardiography plays a key role in the screen for CV complications of COVID-19 infection: it must be focused cardiac ultrasound study (FoCUS) performed at bedside. All transthoracic, transesophageal and stress echocardiograms in patients in which test results are unlikely to change the management strategy should be postponed.


Assuntos
Doenças Cardiovasculares/diagnóstico por imagem , Doenças Cardiovasculares/virologia , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/fisiopatologia , Ecocardiografia/métodos , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/fisiopatologia , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/virologia
6.
Laeknabladid ; 106(5): 247-250, 2020.
Artigo em Islandês | MEDLINE | ID: mdl-32367812

RESUMO

A gentleman in his early fifties became ill with flu-like symptoms after vacationing abroad and was diagnosed with COVID-19 after returning to Iceland. A few days later he was admitted to the University Hospital, Landspitali, due to worsening respiratory symptoms and severe fatigue. A computed tomography scan of lthe lungs showed diffuse bilateral consolidations and ground glass changes. He developed respiratory failure and was transferred to the intensive care unit where he received further treatment, including tocilizumab (IL-6 receptor inhibitor). He subsequently showed clinical improvement and did not require endotracheal intubation.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Pneumonia Viral/tratamento farmacológico , Betacoronavirus , Infecções por Coronavirus/diagnóstico por imagem , Humanos , Islândia , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Viagem , Resultado do Tratamento
7.
Eur Rev Med Pharmacol Sci ; 24(8): 4523-4528, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32373990

RESUMO

OBJECTIVE: Coronavirus disease 2019 (COVID-19) has officially been declared a pandemic by the World Health Organization (WHO). Radiological examinations, especially computed tomography (CT), play an important role in the fight against COVID-19. A comprehensive and timely review of radiological role in the fight against COVID-19 remains urgent and mandatory. Hence, the aim of this review is to summarize the radiological role in the fight against COVID-19. This review of current studies on COVID-19 provides insight into the radiological role in the detection, diagnosis, and monitoring for COVID-19. The typical radiological features of COVID-19 include bilateral, multifocal, and multilobar ground glass opacification with patchy consolidation, a peripheral/subpleural or posterior distribution (or both), mainly in the lower lobes. A combination of chest CT and repeat Reverse Transcription-Polymerase Chain Reaction (RT-PCR) testing may be beneficial for the diagnosis of COVID-19 in the setting of strongly clinical suspicion. Chest CT may improve the sensitivity for COVID-19 diagnosis, but patients' exposure to radiation should be kept as low as possible especially for children and pregnant women patients.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Betacoronavirus , Humanos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Pandemias , Radiografia Torácica , Radiologia , Tomografia Computadorizada por Raios X
8.
Eur Rev Med Pharmacol Sci ; 24(8): 4548-4553, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32374007

RESUMO

OBJECTIVE: To summarize the current practice and potential strategy in diagnosing coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS: PubMed, Web of Science were systematically searched using terms including "COVID-19", "SARS-CoV-2" and "2019-nCoV". After removing duplicates, we then identified articles, letters and commentaries regarding diagnosing COVID-19. RESULTS: Here we summarized relatively mature diagnostic methods like nuclear acid test and computed tomography. Besides, new aspects regarding these detection methods like suitable specimens for nuclear acid test, possible use of 18F-FDG PET/CT were also reported. Especially, we also presented several novel techniques for diagnosing COVID-19 like lung ultrasound. CONCLUSIONS: Chinese Clinical Guidance for COVID-19 Pneumonia Diagnosis and Treatment (7th edition) by National Health Commission is recommended to follow as it provides detailed diagnostic procedures using currently available tools. We suggest clinicians further explore the saliva's utility as a specimen for nuclear acid test and the use of lung ultrasound.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/diagnóstico , Anticorpos Antivirais/isolamento & purificação , Betacoronavirus , Técnicas de Laboratório Clínico , Humanos , Imunoensaio , Pulmão/diagnóstico por imagem , Pandemias , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , RNA Viral/isolamento & purificação , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Tomografia Computadorizada por Raios X , Ultrassonografia
9.
Rev Med Suisse ; 16(692): 955-957, 2020 May 06.
Artigo em Francês | MEDLINE | ID: mdl-32374545

RESUMO

The nasopharyngeal smear with PCR analysis is the first diagnostic test proposed to confirm infection with COVID-19 SARS-CoV-2. However, its usefulness in emergency centers is limited due to its imperfect sensitivity (56-83 %), limited availability and the time required to obtain results. For this reason, the chest CT-scan has been proposed as a rapid triage tool for diagnosis in these suspect Covid-19 patients. However, its specificity is limited, exposing to the risk of over-diagnosis, and further data are needed to confirm its usefulness, and to highlight the possible prognostic value of the CT, in detecting early lesions associated with poor outcome, indicating the need for admission to intensive care.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Triagem , Betacoronavirus , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Humanos , Pandemias , Prognóstico
10.
Nan Fang Yi Ke Da Xue Xue Bao ; 40(2): 159-163, 2020 Feb 29.
Artigo em Chinês | MEDLINE | ID: mdl-32376543

RESUMO

OBJECTIVE: To explore the value of the "dandelion clock-like" sign on chest CT for diagnosis of SARS-CoV-2-associated pneumonia. METHODS: This retrospective analysis was conducted based on the data of 119 cases from the Department of Fever and the Department of Infection undergoing chest high-resolution CT examinations in Sanshui District People's Hospital between January, 24 and February 10, 2020. The cases with no abnormality on chest CT were excluded. Twenty-three patients were diagnosed to have pneumonia, including 9 with SARS-CoV-2-associated pneumonia and 14 with other types of pneumonia. We comparatively analyzed the CT signs, location of the lesions and the dandelion clock-like sign among different types of pneumonia. RESULTS: Among the 23 patients with pneumonia, 9 (39.1%) had common or severe SARS-CoV-2- associated pneumonia with a positive epidemiological history and corresponding respiratory symptoms. Seven of the SARSCoV-2-associated pneumonia patients had multiple lesions in bilateral lungs, compromising mainly the lung field and the subpleural area and showing patchy, lumpy, and umbrella-shaped ground glass opacity, often accompanied by pulmonary vascular thickening and increased microvessels, interlobular septal thickening and fibrosis and lined with grid-like and small-bubble-like "crazy-paving" patterns. The dandelion clock-like sign was found in all the 9 patients with SARSCoV-2-associated pneumonia, with a total of 46 lesions (60.5%, 76 total lesions); 9 of the lesions presented with a "dandelion clek-like" sign and 37 with a "dandelion seed sign". These signs were not found in the 14 patients with other types of pneumonia. CONCLUSIONS: The dandelion clock-like sign is a common and characteristic chest CT finding in patients with SARS-CoV-2-associated pneumonia, and can help to distinguish SARS-CoV-2-associated pneumonia from other types of pneumonia.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Betacoronavirus , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Humanos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Pandemias , Estudos Retrospectivos
11.
Acta Biomed ; 91(2): 97-105, 2020 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-32420933

RESUMO

Since February 21st, 2020 CoVID-19 spread throughout all Italy expanding like a "tsunami" from Codogno (Lodi, Lombardy, Northern Italy) to neighboring cities. In a few days Lodi, Piacenza, Milano, Brescia and Bergamo were forced to deal with this disaster starting the lockdown at different time. No national plan had been prepared. As result, CoVID-19 has paralyzed the Italian healthcare system. At time of writing, in Italy there are 169 323 infected patients and 22 260 deaths. Italy is fighting hard to manage CoVID-19 crisis even if most hospitals were unprepared to deal with massive influx of critically ill CoVID-19 patients. Piacenza in Emilia-Romagna region (Northern Italy) is one of the epicenters of the Italian pandemic, and the local hospital - Guglielmo da Saliceto - has quickly become a "CoVID-19 hospital" with the great effort of all the medical staff. Here we report the experience of our hospital, particularly the strategy adopted in the Orthopedics and Traumatology Department.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Fraturas Ósseas , Pneumonia Viral/epidemiologia , Infecções por Coronavirus/diagnóstico por imagem , Fraturas Ósseas/diagnóstico por imagem , Hospitais , Humanos , Itália/epidemiologia , Ortopedia , Pandemias , Pneumonia Viral/diagnóstico por imagem , Tomografia Computadorizada por Raios X
12.
Acta Biomed ; 91(2): 169-171, 2020 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-32420940

RESUMO

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new virus responsible for the coronavirus disease 2019 (COVID-19), a respiratory disease that ranges from an asymptomatic or mild flu-like illness to severe pneumonia, multiorgan failure, and death. Imaging might play an important role in clinical decision making by supporting rapid triage of patients with suspected COVID-19 and assessing supervening complications, such as super-added bacterial infection and thrombosis. Further studies will clarify the real impact of imaging on COVID-19 patients' management and the potential role of radiology in future outbreaks.


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Infecções por Coronavirus/epidemiologia , Humanos , Itália/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Radiologistas , Tomografia Computadorizada por Raios X
13.
BMC Pediatr ; 20(1): 227, 2020 05 18.
Artigo em Inglês | MEDLINE | ID: mdl-32423435

RESUMO

BACKGROUND: Recently, the World Health Organization has declared the coronavirus disease 2019 (COVID-19) outbreak a public health emergency of international concern. So far, however, limited data are available for children. Therefore, we aimed to investigate the clinical and chest CT imaging characteristics of COVID-19 in preschool children. METHODS: From January 26, 2020 to February 20, 2020, the clinical and initial chest CT imaging data of eight preschool children with laboratory-confirmed COVID-19 from two hospitals were retrospectively collected. The chest CT imaging characteristics, including the distribution, shape, and density of lesions, and the pleural effusion, pleural changes, and enlarged lymph nodes were evaluated. RESULTS: Two cases (25%) were classified as mild type, and they showed no obvious abnormal CT findings or minimal pleural thickening on the right side. Five cases (62.5%) were classified as moderate type. Among these patients, one case showed consolidation located in the subpleural region of the right upper lobe, with thickening in the adjacent pleura; one case showed multiple consolidation and ground-glass opacities with blurry margins; one case displayed bronchial pneumonia-like changes in the left upper lobe; and two cases displayed asthmatic bronchitis-like changes. One case (12.5%) was classified as critical type and showed bronchial pneumonia-like changes in the bilateral lungs, presenting blurred and messy bilateral lung markings and multiple patchy shadows scattered along the lung markings with blurry margins. CONCLUSIONS: The chest CT findings of COVID-19 in preschool children are atypical and various. Accurate diagnosis requires a comprehensive evaluation of epidemiological, clinical, laboratory and CT imaging data.


Assuntos
Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico por imagem , Coronavirus , Pulmão/diagnóstico por imagem , Tomografia Computadorizada Multidetectores/métodos , Pneumonia Viral/diagnóstico por imagem , Betacoronavirus , Criança , Pré-Escolar , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Surtos de Doenças/prevenção & controle , Feminino , Humanos , Masculino , Pandemias , Derrame Pleural , Pneumonia Viral/epidemiologia , Estudos Retrospectivos , Tórax
14.
J Immunother Cancer ; 8(1)2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32434789

RESUMO

BACKGROUND: Immune checkpoint inhibitors (ICIs) can produce specific immune-related adverse events including pneumonitis. The impact of ICI therapy on the severity of acute coronavirus infection symptomatology warrants further exploration. CASE PRESENTATION: We report a 65-year-old man diagnosed with stage IV melanoma who developed pulmonary and brain metastases and was treated with bilateral craniotomies followed by combined nivolumab and ipilimumab immunotherapy. He developed early-onset severe dyspnea associated with acute coronavirus HKU1 (non-COVID-19) infection, with diffuse pneumonitis evidenced by ground glass opacification on CT scan. He was treated with steroids leading to resolution of pneumonitis on repeat imaging, suggesting an exacerbated immune-mediated toxicity. CONCLUSION: We report the first case of a patient with melanoma with severe and reversible diffuse pneumonitis in association with coronavirus HKU1 following combined nivolumab and ipilimumab immunotherapy. Although we do not have data on the impact of ICI therapy on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) symptomatology, a possible interaction should be considered when deciding on dosing in patients with possible SARS-CoV-2 exposure or when evaluating patients with presumed ICI-related pneumonitis during the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus/tratamento farmacológico , Melanoma/tratamento farmacológico , Pneumonia Viral/tratamento farmacológico , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Coronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico por imagem , Humanos , Imunoterapia , Ipilimumab/administração & dosagem , Masculino , Melanoma/virologia , Nivolumabe/administração & dosagem , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/virologia , Esteroides/uso terapêutico
15.
Respir Med ; 167: 105951, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32421539

RESUMO

Patients with Coronavirus Disease 2019 (COVID-19) often have clinical characteristics, such as chest tightness and dyspnea. Continuous, unresolved dyspnea often indicates the progression of lung lesions. The mechanism that underlies the chest distress and dyspnea in patients with COVID-19 is still unclear. Chest CT has a higher sensitivity and can play an essential role in the diagnosis and treatment of the disease. However, our clinical observations showed that although some patients had significant chest distress and dyspnea, the lesions that were observed in the lungs during computed tomography were milder and not completely consistent with clinical symptoms. We analyzed the clinical characteristics, laboratory test results, and imaging findings of these patients. We found that extensive inflammation of the bilateral and respiratory bronchioles in patients with COVID-19 due to excessive activation of proinflammatory cytokines and chemotactic aggregation of T-lymphocytes at the site of inflammation are possible mechanisms underlying chest distress and dyspnea in patients with COVID-19. Short-time and lose-dose use of corticosteroid may be helpful to treat chest tightness and dyspnea in mild COVID-19 patients. Through this study, we aimed to improve our understanding of the pathogenesis of COVID-19.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Dispneia/diagnóstico por imagem , Dispneia/virologia , Pneumonia Viral/diagnóstico por imagem , Adulto , Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/virologia , Feminino , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/virologia , Radiografia Torácica/métodos , Tomografia Computadorizada por Raios X/métodos
16.
Dan Med J ; 67(6)2020 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-32448405

RESUMO

INTRODUCTION: The first case of coronavirus disease 2019 (COVID-19) disease caused by severe acute respiratory syndrome coronavirus-2 occurred in Denmark on 27 February 2020. On 10 March, the first case of COVID-19 pneumonia was admitted to Hvidovre Hospital. METHODS: Retrospective case review of individuals 18 years or older who were admitted consecutively to Hvidovre Hospital from 10 March through 23 April 2020. RESULTS: A total of 175 individuals were admitted with COVID-19 pneumonia. The median age was 71 years, 48.6% were male and 71% had at least one co-morbidity. The most commonly presenting symptoms were dyspnoea, dry cough, and fever. The majority of patients had lymphopenia, elevated liver function tests and C-reactive protein. Nearly two in three presented with multilobar infiltration by chest X-ray. Respiratory failure leading to invasive mechanical ventilation developed in 27 patients (15.4%). By 20 April, 23 of 175 (13.1%) patients remained hospitalised, 43 (24.6%) had died and 109 (62.3%) had been discharged. CONCLUSIONS: The manifestations of COVID-19 at presentation were similar to those seen in other reports. Our population was older, slightly overrepresented by women and had a high level of co-morbidity. COVID-19 admittance was associated with frequent need of intensive care and mechanical ventilation that was associated with a very high mortality. FUNDING: none. TRIAL REGISTRATION: not relevant.


Assuntos
Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/etiologia , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/terapia , Dinamarca , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/epidemiologia , Pneumonia Viral/mortalidade , Pneumonia Viral/terapia , Radiografia Torácica , Respiração Artificial , Insuficiência Respiratória/etiologia , Estudos Retrospectivos
17.
Med Sci Monit ; 26: e924403, 2020 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-32367888

RESUMO

BACKGROUND Chest CT has an essential role in the detection and evaluation of novel coronary pneumonia (COVID-19) and has be regarded as a critical supplement for RT-PCR. This study explored the dynamic CT manifestations of COVID-19 at different times and the value of some laboratory indicators for clinical guidance. MATERIAL AND METHODS This retrospective review included 44 patients who were infected with COVID-19. The dynamic chest CT and laboratory findings were obtained from electronic medical records. The intervals between onset and CT scans and the dynamic changes of the lesions were recorded. The above data were reviewed, sorted, and analyzed by using SPSS 21.0 software. RESULTS From the time of onset, the dynamic image of the lungs became more complete. Fibrous cord shadow absorption in the lungs were observed. Experimental indicators, biochemical indicators of lymphocytes, and protein series were decreased to varying degrees, while erythrocyte sedimentation, fibrinogen, and D-dimer were increased to varying degrees. CONCLUSIONS The dynamic changes of CT images of lungs of COVID-19 patients, combined with the clinical manifestations and laboratory indicators of patients, can help guide clinical diagnosis and treatment.


Assuntos
Betacoronavirus , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Biomarcadores , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/patologia , Infecções por Coronavirus/fisiopatologia , Humanos , Processamento de Imagem Assistida por Computador , Pulmão/diagnóstico por imagem , Pandemias , Pneumonia Viral/patologia , Pneumonia Viral/fisiopatologia , Estudos Retrospectivos , Software
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