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3.
J Med Imaging Radiat Oncol ; 64(5): 649-659, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33000560

RESUMO

To describe the chest CT features reported in children with confirmed COVID-19 infection, published in English literature. A systematic review was completed on PubMed, Embase and Scopus databases on the 1st of June 2020 using the PICO strategy. The NIH Quality Assessment Tool was used to assess the quality of the selected articles. The systematic review was evaluated by Case Series Studies and the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA). The extracted data were assessed and compared with those reported in the adult population. Seventy-two articles were retrieved from the database search and screened by the title, abstract and keywords. Eleven articles were deemed eligible for full-text assessment. Nine articles were included for the data extraction and in the final analysis. Chest CT features in children with COVID-19 differ from those in adults. 'Ground-grass opacities' (GGOs) are the most commonly described abnormalities, but closely followed by a combination of GGO and consolidation, not usual in adults. Children tend to have a more variable involvement than the subpleural and posterior and basal topography described in adults. Interlobular thickening and air bronchogram found in adults with COVID-19 are not frequent in children. Pulmonary embolism reported in up to 30% of adults has not been yet reported in children. Original articles describing chest CT features in children with COVID-19 in the English literature are limited to small populations of Chinese children. Chest CT imaging features are very diverse across the selected studies and globally different from those reported in adults. Data from children of different countries would provide a more comprehensive description of chest CT features in children with COVID-19.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Pneumopatias/virologia , Pneumonia Viral/diagnóstico por imagem , Radiografia Torácica/métodos , Tomografia Computadorizada por Raios X/métodos , Betacoronavirus , Criança , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Humanos , Pandemias , Pneumonia Viral/diagnóstico , Reação em Cadeia da Polimerase Via Transcriptase Reversa
4.
J Med Imaging Radiat Oncol ; 64(5): 668-670, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33001577

RESUMO

This case report describes our early radiological experiences of middle-aged patients with COVID-19 at Westmead Hospital, Sydney. We found limited relationship between initial CT imaging appearances and progression to severe disease. The most effective use of imaging in COVID-19 is yet to be determined.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Pneumopatias/virologia , Pneumonia Viral/diagnóstico por imagem , Radiografia Torácica , Tomografia Computadorizada por Raios X , Adulto , Austrália/epidemiologia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia
5.
BMJ Case Rep ; 13(10)2020 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-33122234

RESUMO

A 60-year-old man presented with sudden onset right-sided chest pain and gradually worsening shortness of breath on exertion. Eleven days earlier, he had an admission with COVID-19 pneumonitis requiring 8 days of continuous positive airway pressure. He was tachypnoeic with a respiratory rate of 24 breaths/min, oxygen saturations on room air of 91%. Examination revealed reduced air entry and a resonant percussion note over the right hemithorax. Chest radiograph suggested a complex right pneumothorax; however, a CT chest was notable for widespread right-sided bullous lung disease. After a day of observation on a COVID-19 ward (and a repeat radiograph with a stable appearance), he was discharged with a 2-week follow-up with the respiratory team, safety netting advice and ambulatory oxygen. This case suggests that bullous lung disease may be a complication of severe COVID-19 pneumonitis.


Assuntos
Infecções por Coronavirus/complicações , Infecções por Coronavirus/terapia , Pneumopatias/patologia , Pneumonia Viral/complicações , Pneumonia Viral/terapia , Pneumotórax/diagnóstico por imagem , Pneumotórax/etiologia , Síndrome Respiratória Aguda Grave/complicações , Dor no Peito/diagnóstico , Dor no Peito/etiologia , Técnicas de Laboratório Clínico/métodos , Pressão Positiva Contínua nas Vias Aéreas/métodos , Infecções por Coronavirus/diagnóstico , Diagnóstico Diferencial , Dispneia/diagnóstico , Dispneia/etiologia , Serviço Hospitalar de Emergência , Humanos , Pneumopatias/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Pneumotórax/terapia , Radiografia Torácica/métodos , Medição de Risco , Síndrome Respiratória Aguda Grave/diagnóstico , Síndrome Respiratória Aguda Grave/terapia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
6.
Medicine (Baltimore) ; 99(44): e23025, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33126388

RESUMO

RATIONALE: Pulmonary hemorrhage is a rare but fatal complication of Henoch-Schönlein purpura (HSP), and more easily ignored in children than in adults due to the absence of clinically evident hemoptysis. Moreover, despite being sporadically reported, given that pulmonary hemorrhage may develop after regression and even disappearance of skin rash, the asynchronous progression of skin and lung lesions poses escalating challenges in the timely diagnosis. We herein presented a delayed diagnosis of late-onset pulmonary hemorrhage in a child with HSP after regression of purpuric rash. PATIENT CONCERNS: A 6-year and 3-month child with a history of self-resolved purpuric rash three weeks ago, presented acutely with cough and dyspnea but without fever. DIAGNOSES: The decreased hemoglobin and diffuse ground-glass opacities of both lungs on CT scan weren't comprehensively evaluated. The child was initially misdiagnosed as pneumonia. INTERVENTIONS: Antibiotic treatment was initiated. However, no improvement of respiratory status was found following aggressive combination therapy. Bronchoscopy was subsequently performed. OUTCOMES: An diffuse alveolar hemorrhage with low inflammatory profile was noted after a bronchoscopy. Considering the history of HSP, the diagnosis of HSP-associated pulmonary hemorrhage was ultimately confirmed and the patient received corticosteroids with satisfactory results. LESSONS: Pulmonary hemorrhage could occur in children with HSP at late onset of disease after regression of skin rash. New-onset respiratory symptoms in patients with a history of HSP should heighten suspicion for pulmonary hemorrhage, particularly if presenting with lack of fever, sudden drop of hemoglobin, new pulmonary infiltrates and unresponsiveness to antibiotics therapy. Bronchoscopy should be performed early to confirm the diagnosis, specifically for children.


Assuntos
Exantema , Hemorragia/diagnóstico , Pneumopatias/diagnóstico , Púrpura de Schoenlein-Henoch , Criança , Tosse/etiologia , Diagnóstico Tardio , Hemorragia/complicações , Hemorragia/diagnóstico por imagem , Humanos , Pneumopatias/complicações , Pneumopatias/diagnóstico por imagem , Masculino , Tomografia Computadorizada por Raios X
7.
Monaldi Arch Chest Dis ; 90(4)2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32945644

RESUMO

The coronavirus disease 2019 (COVID-19) is a recent pandemic that affected more than 5 million people worldwide. Chest high resolution computed tomography (HRCT) is an essential tool in diagnosis and management of the disease. Pulmonary parenchymal opacity is a typical sign of the disease, but not the only one. Pneumothorax, pneumomediastinum, bronchiectasis and cysts are probably underrated complications of COVID-19 that can worsen prognosis, in terms of prolonged hospitalization and need of oxygen therapy. In our single center case series, we outline four different manifestations of pneumothorax, pneumomediastinum and cysts in hospitalized patients with COVID-19 pneumonia.


Assuntos
Bronquiectasia/diagnóstico por imagem , Infecções por Coronavirus/diagnóstico por imagem , Cistos/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Enfisema Mediastínico/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Pneumotórax/diagnóstico por imagem , Adulto , Betacoronavirus , Bronquiectasia/etiologia , Infecções por Coronavirus/complicações , Cistos/etiologia , Humanos , Itália , Pneumopatias/diagnóstico por imagem , Pneumopatias/etiologia , Masculino , Enfisema Mediastínico/etiologia , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Pneumotórax/etiologia , Enfisema Subcutâneo/diagnóstico por imagem , Enfisema Subcutâneo/etiologia , Tomografia Computadorizada por Raios X
8.
BMJ Case Rep ; 13(9)2020 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-32900753

RESUMO

Two 59-year-old male patients with COVID-19 pneumonia developed pulmonary cavitation with air-fluid level, accompanied by right-sided chest pain several weeks after first onset of symptoms. Considering a possible bacterial abscess formation, both patients were started on antibiotics. No microbiological pathogen was detected in further investigations (sputum analysis, bronchoscopy with bronchoalveolar lavage and CT-guided drainage of the cavitation). Histopathological analysis of the drained fluid was non-specific, and the aetiology remained not fully understood. We report pulmonary cavitation as a rare finding in late stage COVID-19 pneumonia. As both our patients presented with localised chest pain prior to detection of the lesions, new onset of this symptom should warrant further investigation.


Assuntos
Infecções por Coronavirus/complicações , Pneumopatias/virologia , Pneumonia Viral/complicações , Humanos , Pneumopatias/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Pandemias
9.
Medicine (Baltimore) ; 99(39): e21941, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32991402

RESUMO

INTRODUCTION: Diffuse pulmonary lymphangiomatosis (DPL) is a rare condition. Most patients with DPL present dyspnea, cough, expectoration, and hemoptysis. There are few reports of DPL accompanied by thrombocytopenia, whose cause remains unknown. PATIENT CONCERNS: An 18-year-old male patient presented with recurrent cough, expectoration, and dyspnea for 5 years, and thrombocytopenia was observed during a 2-month follow-up. DIAGNOSIS: Chest computed tomography showed diffuse patchy shadows in both lungs, and pleural and pericardial effusions. Immunohistochemical lung tissue staining showed lymphatic and vascular endothelial cells positive for D2-40, CD31 and CD34. Routine blood test revealed platelets at 62 × 10 cells/L during follow-up. Bone marrow biopsy was normal. Ultrasound revealed no hepatosplenomegaly. Finally, the patient was diagnosed with DPL accompanied by thrombocytopenia. INTERVENTIONS: He was treated by subtotal pericardial resection, thoracocentesis, and anti-infective therapy. Oral prednisone was administered for 2 months. OUTCOMES: The symptoms of cough and shortness of breath were improved, but thrombocytopenia persisted. We investigated the cause of thrombocytopenia. Whole-exome sequencing identified a mutation in exon 3 of the TNFRSF13B gene in this patient. CONCLUSION: DPL may present with thrombocytopenia and DIC. Patients with thrombocytopenia but not DIC and splenomegaly should be screened for gene mutations.


Assuntos
Pneumopatias/congênito , Linfangiectasia/congênito , Trombocitopenia/complicações , Adolescente , Criança , Humanos , Pneumopatias/complicações , Pneumopatias/diagnóstico por imagem , Pneumopatias/genética , Pneumopatias/patologia , Linfangiectasia/complicações , Linfangiectasia/diagnóstico por imagem , Linfangiectasia/genética , Linfangiectasia/patologia , Masculino , Mutação de Sentido Incorreto , Trombocitopenia/diagnóstico , Tomografia Computadorizada por Raios X , Proteína Transmembrana Ativadora e Interagente do CAML , Sequenciamento Completo do Exoma
10.
Medicine (Baltimore) ; 99(35): e22030, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871959

RESUMO

This study was designed to explore the safety, feasibility, and clinical efficacy of preoperative computed tomography (CT)-guided coil localization of sub-fissural lung nodules (LNs). A total of 105 LN patients underwent CT-guided coil localization followed by video-assisted thoracoscopic surgery (VATS)-guided wedge resection at our hospital from January 2016 to December 2019. Of these patients, 4 had sub-fissural LNs and were therefore subjected to trans-fissural coil localization procedures. We analyzed data pertaining to the coil localization and VATS procedures in these patients. A total of 4 coils were used to localize 4 LNs in 4 separate patients. One of these patients suffered from parenchymal hemorrhage around the needle path, while one other patient exhibited asymptomatic pneumothorax following coil localization. A thoracoscope was able to successfully visualize the coil tails in all of these patients. There were no instances of coils having been dislodged, and wedge resection was conducted with a 100% technical success rate in these patients. These 4 LNs were subsequently diagnosed as adenocarcinomas in situ (n = 3) and benign nodules (n = 1). CT-guided coil localization can be used to safely and easily localize sub-fissural LNs in patients scheduled to undergo VATS.


Assuntos
Pneumopatias/cirurgia , Radiografia Intervencionista/métodos , Cirurgia Torácica Vídeoassistida , Humanos , Pneumopatias/diagnóstico por imagem , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
12.
J Med Imaging Radiat Oncol ; 64(5): 671-673, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32945110

RESUMO

We report the case of who has been hospitalized complaining about fever in the last 4 days. Laboratory data revealed lymphocytopenia and leucopenia with an elevation of C-reactive protein and positive real-time reverse transcription-polymerase chain reaction (RT-PCR). Six days before this hospitalization, when the patient was asymptomatic, 18 F-FDG PET/CT images were performed for the therapeutic control of liver metastases of colorectal cancer. Lung abnormality findings at 18 F-FDG PET/CT images, unrelated to cancer metastases, but suspicious for viral infection, may suggest the presence of COVID-19 disease in its early phase before symptoms onset. Since PET/CT is more sensitive than CT scan in detecting host's reaction, the added value of this technique could be monitoring disease progression and could be used as a biomarker of lung disease activity and therefore as an important tool for a better understanding of the factors that contribute to the progression of lung disease.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Pneumopatias/virologia , Pneumonia Viral/diagnóstico por imagem , Betacoronavirus , Neoplasias Colorretais/patologia , Progressão da Doença , Fluordesoxiglucose F18 , Humanos , Achados Incidentais , Neoplasias Hepáticas/secundário , Pandemias , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos
13.
Artigo em Inglês | MEDLINE | ID: mdl-32970595

RESUMO

Ultrasound elastography (US-E) is a noninvasive, safe, cost-effective and reliable technique to assess the mechanical properties of soft tissue and provide imaging biomarkers for pathological processes. Many lung diseases such as acute respiratory distress syndrome, chronic obstructive pulmonary disease, and interstitial lung disease are associated with dramatic changes in mechanical properties of lung tissues. Nevertheless, US-E is rarely used to image the lung because it is filled with air. The large difference in acoustic impedance between air and lung tissue results in the reflection of the ultrasound wave at the lung surface and, consequently, the loss of most ultrasound energy. In recent years, there has been an increasing interest in US-E applications in evaluating lung diseases. This article provides a comprehensive review of the technological advances of US-E research on lung disease diagnosis. We introduce the basic principles and major techniques of US-E and provide information on various applications in lung disease assessment. Finally, the potential applications of US-E to the diagnosis of COVID-19 pneumonia is discussed.


Assuntos
Técnicas de Imagem por Elasticidade , Pneumopatias/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Betacoronavirus , Infecções por Coronavirus/diagnóstico por imagem , Humanos , Pandemias , Pneumonia Viral/diagnóstico por imagem
14.
Hell J Nucl Med ; 23 Suppl: 21-25, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32860392

RESUMO

On December 29, 2019, a hospital in the City of Wuhan, Hubei Province, in Central China, admitted four individuals with pneumonia. The hospital reported this occurrence to the local center for disease control (CDC), which lead Wuhan CDC staff to initiate a field investigation with a retrospective search for pneumonia patients. On December 31, 2019, the World Health Organization (WHO) was alerted by the Chinese authorities for several cases of pneumonia of unknown origin in the City of Wuhan. On January 7, 2020, a novel virus was identified as the causative agent, belonging to the Coronaviridae family (Severe Acute Respiratory Syndrome Coronavirus 2, SARS-CoV-2). Within the same month, the virus spread to other provinces of China, as well as a number of neighbouring countries. On February 11, 2020, the WHO announced that the SARS-CoV-2 - caused infection would be called coronavirus disease 2019 (COVID-19). On February 15, 2020, the first death due to COVID-19 in Europe was reported; a Chinese tourist who died in France. The first COVID-19 case was diagnosed in Greece on February 26th. The WHO declared COVID-19 a pandemic on 11 March 2020. On March 12th, movie theaters, gyms and courtrooms were closed in Greece and on March 13th, with 190 confirmed cases and 1 death, malls, cafés, restaurants, bars, beauty parlors, museums and archaeological sites were also closed. So far, COVID-19 pandemic has affected the way people live and work globally, and has resulted in extreme strain on the healthcare systems worldwide. Most of the nuclear medicine studies are performed on an out-patient basis. Therefore, without effective implementation of the required preventive measures, there is a significant risk for viral transmission when visiting nuclear medicine departments, particularly in periods of high community spread.


Assuntos
Infecções por Coronavirus/transmissão , Controle de Infecções/métodos , Serviço Hospitalar de Medicina Nuclear/normas , Pneumonia Viral/transmissão , Guias de Prática Clínica como Assunto , Cintilografia/normas , Infecções por Coronavirus/epidemiologia , Prioridades em Saúde , Humanos , Controle de Infecções/normas , Pneumopatias/diagnóstico por imagem , Neoplasias/diagnóstico por imagem , Serviço Hospitalar de Medicina Nuclear/organização & administração , Pandemias , Pneumonia Viral/epidemiologia , Cintilografia/métodos
15.
PLoS One ; 15(8): e0237071, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32760104

RESUMO

BACKGROUND AND OBJECTIVES: The number of patients with pulmonary Mycobacterium avium complex (MAC) disease is increasing worldwide, especially among middle-aged women and never-smokers. However, little is known about the factors causing exacerbations of pulmonary MAC disease in untreated patients. The aim of the present study was to identify the predictors of radiological aggravations of pulmonary MAC disease. METHODS: From April 2011 to December 2018, 238 MAC patients at our institute were newly diagnosed with pulmonary MAC disease according to the 2007 American Thoracic Society/Infectious Disease Society guideline. Their medical records were examined retrospectively for their clinical findings. The radiological findings at the time of the diagnosis and 1 year later were evaluated. To identify the predictors of radiological aggravation, multivariable analysis was performed with the data of 167 treatment-naïve patients. RESULTS: Female, never-smoker, and nodular/bronchiectatic (NB) type were predominant in patients with pulmonary MAC disease. Univariate analysis of data from treatment-naïve subjects showed that no lung diseases other than MAC, extensive radiological findings, and a positive acid-fast bacilli (AFB) smear were significantly associated with radiological aggravations. On multivariate analysis, the radiological factor (larger affected area) and absence of other lung disease were significantly associated with radiological aggravations. In particular, the presence of abnormal shadows in more than 3 lobes was significantly associated with radiological aggravations. CONCLUSIONS: In this study, the presence of extensive radiological findings and the absence of lung diseases other than MAC were predictors of radiological aggravations of treatment-naïve pulmonary MAC disease. In particular, the presence of abnormal shadows in more than 3 lobes was significantly associated with radiological aggravations.


Assuntos
Pneumopatias/diagnóstico por imagem , Infecção por Mycobacterium avium-intracellulare/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Feminino , Humanos , Pneumopatias/etiologia , Pneumopatias/microbiologia , Masculino , Análise Multivariada , Infecção por Mycobacterium avium-intracellulare/etiologia , Infecção por Mycobacterium avium-intracellulare/microbiologia , Estudos Retrospectivos , Fatores de Tempo
16.
Dermatol Online J ; 26(3)2020 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-32609450

RESUMO

We report a patient with Sweet syndrome involving the pulmonary system in the context of myelodysplastic syndrome. Although Sweet syndrome may involve a variety of organ systems, the pulmonary system is rarely affected and can result in poor clinical outcomes, including acute respiratory distress syndrome. Both cutaneous and pulmonary symptoms respond well to systemic corticosteroid therapy and early diagnosis and treatment can improve the prognosis. Our case highlights the importance of collaboration between hematologists, dermatologists, and pulmonologists to facilitate effective diagnosis, triage, and treatment of these patients.


Assuntos
Síndromes Mielodisplásicas/complicações , Síndrome de Sweet/diagnóstico , Diagnóstico Diferencial , Feminino , Glucocorticoides/uso terapêutico , Histona-Lisina N-Metiltransferase/genética , Humanos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Pneumopatias/diagnóstico por imagem , Pneumopatias/patologia , Metilprednisolona/uso terapêutico , Pessoa de Meia-Idade , Proteína de Leucina Linfoide-Mieloide/genética , Pancitopenia/complicações , Síndrome de Sweet/tratamento farmacológico , Síndrome de Sweet/patologia , Tomografia Computadorizada por Raios X
17.
Medicine (Baltimore) ; 99(29): e21239, 2020 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-32702901

RESUMO

To investigate the computed tomography (CT) imaging and pathological basis of the linear shadows connecting pulmonary segmental arteries to horizontal fissure (hereinafter referred to as "linear shadow") on thin-slice CT.Collect 127 clinical cases to analyze the display and morphology of linear shadows on the thin-slice CT and to measure their length, thickness, and angle. Collect 11 autopsy specimens of coal worker's pneumoconiosis to conduct an imaging and pathology basis control study for the linear shadows.There is no correlation between the linear shadow and gender, age, and smoking history. Linear shadows are observed in 54.33% of patients. 93.33% of those linear shadows are straight lines. Generally, the lengths are less than 10 mm, the thicknesses are around 1 mm, and the scopes of angles are wide, range from acute angles to obtuse angles. The linear shadow is a banded structure consisting of loose connective tissue, small blood vessels, and small lymphatic vessels due to the visceral pleura recessed and fused into the lung.Linear shadows are intrinsic to the lung. The linear shadows consist of loose connective tissue, small blood vessels, and small lymphatic vessels.


Assuntos
Antracose , Pneumopatias/diagnóstico por imagem , Pleura/diagnóstico por imagem , Artéria Pulmonar/diagnóstico por imagem , Adulto , Autopsia , Feminino , Humanos , Pneumopatias/patologia , Masculino , Pleura/patologia , Artéria Pulmonar/patologia , Tomografia Computadorizada por Raios X
18.
Aging (Albany NY) ; 12(14): 13860-13868, 2020 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-32688346

RESUMO

OBJECTIVE: To investigate the clinical, laboratory, and radiological characteristics of patients with coronavirus disease-2019 (COVID-19) in Heilongjiang Province. RESULTS: Patients in the ICU group were older and their incidence of cardiovascular disease was higher than those in the non-ICU group. Lymphocyte levels were lower and neutrophil and D-dimer levels were higher in the ICU than that in the non-ICU group. Compared to the non-ICU group, the incidence of pulmonary consolidation and ground-glass opacity with consolidation was significantly higher in the ICU group, all lung lobes were more likely to be involved, with higher number of lung lobes and areas surrounding the bronchi. Of the 59 patients with COVID-19 in this group, 15 received mechanical ventilation. All intubated patients involved lung lobes, and a large number of lesions were observed in the area around the bronchial vessels. CONCLUSION: Significant differences were observed in clinical symptoms, laboratory tests, and computed tomography features between the ICU and non-ICU groups. METHODS: A total of 59 patients with COVID-19, comprising 44 patients in the intensive care unit (ICU) and 15 in the non-ICU, were retrospectively analyzed. Characteristics of the two groups of patients were compared.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/patologia , Pneumopatias/diagnóstico por imagem , Pneumopatias/patologia , Pneumopatias/virologia , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/patologia , Idoso , Betacoronavirus , China , Feminino , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
20.
Clin Radiol ; 75(10): 780-788, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32684301

RESUMO

AIM: To report the severity and extent of pulmonary thromboembolic disease (PTD) in COVID-19 patients undergoing computed tomography pulmonary angiography (CTPA) in a tertiary centre. MATERIALS AND METHODS: This is a retrospective analysis of COVID-19 patients undergoing CTPA over a period of 27 days. The presence, extent, and severity of PTD were documented. Two observers scored the pattern and extent of lung parenchymal disease including potential fibrotic features, as well as lymph node enlargement and pleural effusions. Consensus was achieved via a third observer. Interobserver agreement was assessed using kappa statistics. Student's t-test, chi-squared, and Mann-Whitney U-tests were used to compare imaging features between PTD and non-PTD sub-groups. RESULTS: During the study period, 100 patients with confirmed COVID-19 underwent CTPA imaging. Ninety-three studies were analysed, excluding indeterminate CTPA examinations. Overall incidence of PTD was 41/93 (44%) with 28/93 patients showing small vessel PTD (30%). D-dimer was elevated in 90/93 (96.8%) cases. A high Wells' score did not differentiate between PTD and non-PTD groups (p=0.801). The interobserver agreement was fair (kappa=0.659) for parenchymal patterns and excellent (kappa=0.816) for severity. Thirty-four of the 93 cases (36.6%) had lymph node enlargement; 29/34 (85.3%) showed no additional source of infection. Sixteen of the 93 (17.2%) cases had potential fibrotic features. CONCLUSION: There is a high incidence of PTD in COVID-19 patients undergoing CTPA and lack of a risk stratification tool. The present data indicates a higher suspicion of PTD is needed in severe COVID-19 patients. The concomitant presence of possible fibrotic features on CT indicates the need for follow-up.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Embolia Pulmonar/diagnóstico por imagem , Embolia Pulmonar/etiologia , Tomografia Computadorizada por Raios X/métodos , Idoso , Feminino , Humanos , Pulmão/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , Índice de Gravidade de Doença
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