Purpose. The research goal comprises primary analysis of CT examinations results and their interpretation by comparing with the data already available in the literature.Material and methods. During the period from April 17, 2020 to May 18, 2020, 830 chest CT scans were performed and results of 123 CDs with CT scans made by other institutions were interpreted. Follow-up examinations were carried out every 3–4 days or when clinical presentation changed. At the primary stage, we have analysed in a more detail way a group of 69 patients, who were diagnosed with CT-3 or CT-4 volume of lung damage at least once during hospitalization. The patients underwent PCR analysis three times during hospitalization. Among 69 patients, 34 patients had a positive PCR test at least once, the remaining 35 patients had a clinic, corresponding with this disease.Results. At the initial examination, ground-glass opacity prevailed, as it was observed in 44 cases (64%), and lung tissue consolidation was observed in 25 cases (36%) in a group of 69 patients. When comparing the two groups, the average age of the patients with consolidation changes was statistically significantly lower than one of the group where ground-glass opacity prevailed – 51.7 and 59.4 years, respectively (p = 0.01) In the group of patients with pulmonary tissue consolidation, there were fewer concomitant diseases, fatal outcomes, positive PCR test results, a shorter hospitalization period, and fewer cases of tocilizumab administration were noted. At the initial examination the average percentage of pulmonary parenchyma involvement in the group of patients with lung tissue consolidation was higher (63.3%; p = 0.04), follow-up examinations showed c statistically significantly lower average values of the increase in the percentage of involvement of the parenchyma, which acquired negative values after the third CT scan (8.3 after the 2nd CT and −5.2 after the 3rd CT versus 18.5 and 3 in the GGO glass group; p = 0.02 and 0.03, respectively). No visible differences in CT between the period from the onset of the disease and the predominant symptom in CT were revealed. Meanwhile, on the 5th day (the day of the check-up CT examination) the largest number of patients was determined in both groups.Conclusion. An analysis of our experience during the first month of operation of Covid-19 Hospital is presented. According to our data, the appearance of consolidation at the initial CT examination is probably not related to the period, when the disease has been in progress, and may be associated with a more favorable course of the process.

Purpose. To assess changes in the degree of pulmonary injury in patients with Sars-CoV-2 after extracorporeal hemocorrection methods (ECHCM).Material and methods. 27 patients with Sars-CoV-2 underwent 48 ECHCM procedures - plasma separation, nonselective cytosorption hemoperfusion, dialysis-filtration techniques. After arriving in the hospital all patients underwent MSCT of the chest organs. The examination was conducted according to the standard protocol of MSCT of the chest organs and reconstruction of soft and high-resolution on a Philips Ingenuity CT 64 multi- detector computed tomograph. The following scanning parameters were used for the standard protocol: 64 × 0.625 collimation, 1 mm reconstruction, 0.5 mm increment. The patient was lying on his back with his arms thrown back behind his head during the procedure. A scan area including the chest was planned by the plan scan. Assessment of the scans was carried out in the Diсom-images viewing module of medical hardware- software complex “ArchiMed” (Med-Ray. Russia, 2004). The percentage of lung parenchyma lesions as well as the severity (CT-1–4) were evaluated according to the recommendations “Radiation diagnosis of coronavirus disease (COVID-19): organization, methodology, interpretation of the results”. CT examinations were compared not earlier than 4 days before ECHCM and not later than 5 days after.Result. With isolated plasmaseparation, the “ground glass” zones passed into the consolidation zones, the total volume of the lesion decreased and the pneumatization increased. In isolated hemoperfusion the dynamics is multidirectional: there are more consolidation zones, less ground glass zones in general, the process is stabilized and the zones of lung tissue damage are reduced. With isolated hemodiafiltration, the consolidation zones decreased, the pneumatization of the lung tissue increased, and subsequently the volume of the lesion and the consolidation zones increased significantly. By combined procedures there are multidirectional dynamics.Conclusion. The effect of ECMGC use on the degree and volume of lung tissue damage in patients with Sars- CoV-2 was not revealed.

Ïå÷åíü / Liver Цель. Оценить плотность печени при нативной КТ у больных COVID-19 в зависимости от степени поражения легочной паренхимы и назначенного лечения, сравнить данные с биохимическими показателями, а также продемонстрировать изменения плотности в динамике. Материал и методы. Ретроспективно анализировали данные КТ легких 200 пациентов с COVID-19. У всех пациентов измерили плотность печени, селезенки, подкожной жировой клетчатки (ПЖК) на вошедших в зону сканирования изображениях верхних отделов брюшной полости. Изучили отношение плотности печени к селезенке и к плотности ПЖК. Показатели сравнили между собой в двух группах поражения легочной ткани: КТ 1-2 и КТ 3-4. Детально рассмотрели группу КТ 3-4: плотность печени изучена в динамике, а ее связь с биохимическими показателями-при первичном исследовании. Также выполнено сравнение двух подгрупп: пациентов, принимавших тоцилизумаб, и без назначения тоцилизумаба. Результаты. Уменьшение плотности печени и коэффициента соотношения плотности печени к плотности селезенки отмечено у 35,5 и 47,5% пациентов соответственно. Плотность печени и коэффициент соотношения плотности печени к плотности селезенки были меньше в группе КТ 3-4, чем в группе КТ 1-2, и составляли 43,9 HU по сравнению с 49,3 HU (p < 0,008) и 0,9 по сравнению с КТ 1 соответственно (p < 0,014). При первичном исследовании была получена умеренная (r = −0,30; p < 0,05) и слабая (r = −0,26; p < 0,05) отрицательная корреляция плотности печени и коэффициента соотношения плотности печени к плотности селезенки с уровнем сывороточного альбумина. При оценке в динамике у пациентов в группе КТ 3-4 с каждым последующим исследованием отметили увеличение плотности паренхимы печени и коэффициента соотношения плотности печени к плотности селезенки. Разница между средними показателями плотности печени при первой и при четвертой КТ составила 11,85 HU. Плотностные показатели печени не зависели от лечения тоцилизумабом. Заключение. Значения плотности печени были меньше у больных COVID-19 при поражении легочной паренхимы КТ 3-4, увеличивались во время лечения и не зависели от назначения тоцилизумаба. Оценка плотности печени и изучение в динамике может стать полезным параметром в определении тяжести течения заболевания. Сильной взаимосвязи между плотностью при первичной КТ и биохимическими показателями не выявлено. Необходим более детальный анализ этих изменений в динамике, который, возможно, позволит предположить превалирующий механизм поражения печени при СOVID-19.

Purpose. Review and analysis of the available foreign literature about CT findings in patients with COVID-19 pneumonia after treatment with tocilizumab.Material and methods. 6 publications were analyzed that were available for the keywords “COVID-19”, “radiology”, “CT”, “tocilizumab”, “cytokine release syndrome”, “interleukin 6”, “IL-6”. Search was limited only to English language manuscripts with no time limit. The literature search was last done on 3rd June 2020.Results. There is a small number of studies on CT findings of COVID-19 pneumonia during the treatment of actemra (tocilizumab). At the request of “COVID-19”, “radiology”, “CT”, “tocilizumab”, “cytokine release syndrome”, “interleukin 6”, “IL-6” in the database of medical and biological publications “PubMed” on 03.06.2020 can be found only 8 publications that would satisfy the search query. At the time of writing this article we were able to locate only 1 full text articles in English which was the study of CT findings in patients with COVID-19 pneumonia after treatment with tocilizumab. It is important to note that new data is being shared regularly and so far, it consists mostly of pre-prints, case reports, small case series.Conclusion. After analyzing the available literature, it can be concluded that the majority of authors confirm the positive effect associated with taking tocilizumab, as evidenced by a very rapid improvement in the condition of patients, however, the CT-findings often does not correlate with the clinical course of the disease and does not always show improvement in lung tissue, which should not be regarded as negative dynamics, but as a natural regression of pathological changes in lung tissue.