Chest CT in the emergency department for suspected COVID-19 pneumonia

Palmisano, Anna; Scotti, Giulia Maria; Ippolito, Davide; Morelli, Marco J.; Vignale, Davide; Gandola, Davide; Sironi, Sandro; Cobelli, Francesco De; Ferrante, L; Spessot, Marzia; Tonon, Giovanni; Tacchetti, Carlo; Esposito, Antonio

doi:10.1007/s11547-020-01302-y

Cited by 38 publications

(36 citation statements)

References 13 publications

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“…According to our proposed algorithm, cardiac CT can be used to rule-out ACS when coronary obstruction is suspected, while CMR plays a key role in the differential diagnosis of myocardial injury with normal coronary arteries [ 76 ].…”

Section: Recommended Patient’s Workflow In Suspected Covid-19mentioning

confidence: 99%

Role of advanced imaging in COVID-19 cardiovascular complications

et al. 2021

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Clinical manifestations of COVID-19 patients are dominated by respiratory symptoms, but cardiac complications are commonly observed and associated with increased morbidity and mortality. Underlying pathological mechanisms of cardiac injury are still not entirely elucidated, likely depending on a combination of direct viral damage with an uncontrolled immune activation. Cardiac involvement in these patients ranges from a subtle myocardial injury to cardiogenic shock. Advanced cardiac imaging plays a key role in discriminating the broad spectrum of differential diagnoses. Present article aims to review the value of advanced multimodality imaging in patients with suspected SARS-CoV-2-related cardiovascular involvement and its essential role in risk stratification and tailored treatment strategies. Based on our experience, we also sought to suggest possible diagnostic algorithms for the rationale utilization of advanced imaging tools, such as cardiac CT and CMR, avoiding unnecessary examinations and diagnostic delays.

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Section: Recommended Patient’s Workflow In Suspected Covid-19mentioning

confidence: 99%

Role of advanced imaging in COVID-19 cardiovascular complications

et al. 2021

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“…Moreover, several data suggest a relevant role of cardiovascular comorbidities in determining COVID-19 patients’ outcome 3 , 4 , 5 , 6 Chest computed tomography (CT), already widely utilized for COVID-19 pneumonia diagnosis, might provide additional information beyond lung disease, such as coronary arteries calcium evaluation. 7 , 8 , 9 Coronary, thoracic aorta and aortic valve calcium burden can be quantitatively measured from a non-gated chest CT and are validated long-term predictors of cardiovascular events and all-cause mortality. 10 , 11 , 12 However, their prognostic role in the context of an acute and systemic inflammatory disease, such as…”

Section: Introductionmentioning

confidence: 99%

Coronary and total thoracic calcium scores predict mortality and provides pathophysiologic insights in COVID-19 patients

Giannini

Toselli

Palmisano

et al. 2021

Journal of Cardiovascular Computed Tomography

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Background Coronavirus disease 2019 (COVID-19) has spread worldwide determining dramatic impacts on healthcare systems. Early identification of high-risk parameters is required in order to provide the best therapeutic approach. Coronary, thoracic aorta and aortic valve calcium can be measured from a non-gated chest computer tomography (CT) and are validated predictors of cardiovascular events and all-cause mortality. However, their prognostic role in acute systemic inflammatory diseases, such as COVID-19, has not been investigated. Objectives The aim was to evaluate the association of coronary artery calcium and total thoracic calcium on in-hospital mortality in COVID-19 patients. Methods 1093 consecutive patients from 16 Italian hospitals with a positive swab for COVID-19 and an admission chest CT for pneumonia severity assessment were included. At CT, coronary, aortic valve and thoracic aorta calcium were qualitatively and quantitatively evaluated separately and combined together (total thoracic calcium) by a central Core-lab blinded to patients’ outcomes. Results Non-survivors compared to survivors had higher coronary artery [Agatston (467.76±570.92 vs 206.80±424.13 mm 2 , p<0.001); Volume (487.79±565.34 vs 207.77±406.81, p<0.001)], aortic valve [Volume (322.45±390.90 vs 98.27±250.74 mm2, p<0.001; Agatston 337.38±414.97 vs 111.70±282.15, p<0.001)] and thoracic aorta [Volume (3786.71±4225.57 vs 1487.63±2973.19 mm2, p<0.001); Agatston (4688.82±5363.72 vs 1834.90±3761.25, p<0.001)] calcium values. Coronary artery calcium (HR 1.308; 95% CI, 1.046 - 1.637, p=0.019) and total thoracic calcium (HR 1.975; 95% CI, 1.200 - 3.251, p=0.007) resulted to be independent predictors of in-hospital mortality. Conclusion Coronary, aortic valve and thoracic aortic calcium assessment on admission non-gated CT permits to stratify the COVID-19 patients in-hospital mortality risk.

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“…However, radiology research has also investigated the role of both imaging modalities as screening tools, to detect the infection, to monitor COVID-19 pneumonia, and to potentially predict clinical outcome. 20,[33][34][35][36][37] Indeed, as reported by the participants in our study, more than one-third of their radiology trials that started during the national lockdown were focused on COVID-19 imaging. Thus, this pandemic has been the driving force of new research lines in radiology.…”

Section: Discussionmentioning

confidence: 60%

Impact of coronavirus disease 2019 (COVID-19) outbreak on radiology research: An Italian survey

et al. 2021

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To understand how COVID-19 pandemic has changed radiology research in Italy. Methods: A questionnaire (n = 19 questions) was sent to all members of the Italian Society of Radiology two months after the first Italian national lockdown was lifted. Results: A total of 327 Italian radiologists took part in the survey (mean age: 49 ± 12 years). After national lockdown, the working-flow came back to normal in the vast majority of cases (285/327, 87.2%). Participants reported that a total of 462 radiological trials were recruiting patients at their institutions prior to COVID-19 outbreak, of which 332 (71.9%) were stopped during the emergency. On the other hand, 252 radiological trials have been started during the pandemic, of which 156 were non-COVID-19 trials (61.9%) and 96 were focused on COVID-19 patients (38.2%). The majority of radiologists surveyed (61.5%) do not conduct research. Of the radiologists who carried on research activities, participants reported a significant increase of the number of hours per week spent for research purposes during national lockdown (mean 4.5 ± 8.9 h during lockdown vs. 3.3 ± 6.8 h before lockdown; p = .046), followed by a significant drop after the lockdown was lifted (3.2 ± 6.5 h per week, p = .035). During national lockdown, 15.6% of participants started new review articles and completed old papers, 14.1% completed old works, and 8.9% started new review articles. Ninety-six surveyed radiologists (29.3%) declared to have submitted at least one article during COVID-19 emergency. Conclusion: This study shows the need to support radiology research in challenging scenarios like COVID-19 emergency.

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Chest CT in the emergency department for suspected COVID-19 pneumonia

Cited by 38 publications

References 13 publications

Role of advanced imaging in COVID-19 cardiovascular complications

Role of advanced imaging in COVID-19 cardiovascular complications

Coronary and total thoracic calcium scores predict mortality and provides pathophysiologic insights in COVID-19 patients

Impact of coronavirus disease 2019 (COVID-19) outbreak on radiology research: An Italian survey

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