Abbreviations (no more than 10): CT = Computed Tomography CXR = Chest radiograph RT-PCR = Reverse Transcription Polymerase Chain Reaction SARS = Severe acute respiratory syndrome Key Results: 1. Chest radiograph and CT findings of 21 patients with confirmed 2019 novel coronavirus infection in Shenzhen and Hong Kong are described and compared 2. A literature review and tabulation of the radiographic features in original publications are presented 3. One asymptomatic patient had evidence of consolidation on chest CT Abstract: Background: COVID-19 (formerly known as the 2019 novel coronavirus [2019-nCoV]) has rapidly spread in mainland China and into multiple countries worldwide. The radiographic profile of this infection continues to evolve as more cases present beyond the epicenter of Wuhan, China. Purpose: We present 21 COVID-19 cases from two Chinese centers with CT and chest radiograph (CXR) findings, as well as follow-up imaging in 5 cases. Materials and Methods: Retrospective study in Shenzhen and Hong Kong. Patients with COVID-19 infection were included. A systematic review of the published literature on COVID-19 infection's radiological features. Results: The predominant imaging pattern is of ground-glass opacification with occasional consolidation in the peripheries. Pleural effusions and lymphadenopathy were absent in all cases. Patients demonstrate evolution of the ground-glass opacities into consolidation, and subsequent resolution of the airspaces changes. Ground-glass and consolidative opacities visible on CT are sometimes undetectable on chest radiographs, suggesting that CT is a more sensitive imaging modality for investigation. The systematic review identified 4 other studies confirming the findings of bilateral and peripheral ground glass with or without consolidation as the predominant finding on CT chest examinations. Conclusion: The COVID-19 infection pulmonary manifestation is predominantly characterized by ground-glass opacification with occasional consolidation on CT. Radiographic findings in patients presenting in Shenzhen and Hong Kong are in keeping with 4 previous publications from other sites.
Key Points
NK/T-cell lymphomas failing L-asparaginse, generally fatal, showed a high CR rate to PD1 blockade with pembrolizumab. Comprehensive clinical, radiologic, pathologic, and molecular assessments showed different patterns of CRs and PRs.
Whole-body PET/CT scanning is accompanied by substantial radiation dose and cancer risk. Thus, examinations should be clinically justified, and measures should be taken to reduce the dose.
Comment 2 www.thelancet.com/infection Published online February 24, 2020 https://doi.org/10.1016/S1473-3099(20)30134-1 research is needed into the correlation of CT findings with clinical severity and progression, the predictive value of baseline CT or temporal changes for disease outcome, and the sequelae of acute lung injury induced by COVID-19. 1 Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497-506. 2 Lu R, Zhao X, Li J, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding.
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