Clinical Characteristics and Pulmonary Computerized Imaging Findings of Critically Ill Egyptian Patients with Multisystem Inflammatory Syndrome in Children

Ibrahim, Hanan; Mohammad, Asmaa Abdelsattar; Fouda, Eman; Ahmed, Khaled A; Habeeb, Neveen M; Rezk, Ahmed R.; Magdy, Sondos M; Allam, Ahmad M; Mahmoud, Sanaa

doi:10.1177/2333794x221085386

Cited by 4 publications

(6 citation statements)

References 29 publications

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“…We primarily explain this by the presence of a co-bacterial infection due to reduced immunity in most of our patients with other comorbidities, but there was no statistically significant difference in consolidation between patients with comorbidities or not. This could be explained that consolidative pattern was significantly higher in moderate and severe groups which represent one-third of our cases, this is consistent with a study done on 31 severe COVID-19 pediatric patients with consolidative patches were the most predominant CT feature [ 19 ].…”

Section: Discussionsupporting

confidence: 92%

Chest CT features of coronavirus disease 2019 (COVID-19) in pediatric patients and its correlation with the clinical condition

Gabr

Abdelhameed

Mohammad

et al. 2023

Egypt J Radiol Nucl Med

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Background All pediatric health organizations are concerned about the impact of coronavirus disease on children, especially on those with other comorbidities; fortunately, pediatric cases appear to be less severe than in adults (De Luca et al. in Pediatr Respir Rev 5:9–14, 2020). The purpose of this study is to characterize chest CT findings of children with and without comorbidities who had confirmed coronavirus disease (COVID-19) and to investigate the relation between chest CT findings and the clinical severity of COVID-19 pneumonia and their laboratory findings. Results The study was conducted on 36 patients, 72.2% of whom had associated comorbidities. Twenty-three patients (63.88%) had abnormal CT findings. Consolidative patches were the most common radiological sign (55.6%) followed by ground glass opacities (50%). The lesions were bilateral (58.3%), having predominantly peripheral distribution (38.9%) with predominant left lower lobe affection (25%). Cases with clinically severe chest conditions had significantly more prevalent consolidative patches (p = 0.026) which show a higher CT density (p = 0.01) and a significantly higher CT severity score (SS) compared to other groups (p = 0.029). The cutoff of severity score 4/20 had 100% sensitivity and 78.12% specificity in the diagnosis of severe cases. There were no statistically significant differences between patients with or without comorbidities regarding CT-SS or any radiological signs. Conclusions Consolidation was the most common radiological finding in children with COVID-19 and was more prevalent and denser in severe cases. The CT-SS may be used as a complementary tool for the evaluation of the severity of the chest condition. Chest CT-SS more than 4 can be used as an indicator of severe cases, yet no significant difference in CT-SS between patients with associated comorbidities or not.

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Section: Discussionsupporting

confidence: 92%

Chest CT features of coronavirus disease 2019 (COVID-19) in pediatric patients and its correlation with the clinical condition

Gabr

Abdelhameed

Mohammad

et al. 2023

Egypt J Radiol Nucl Med

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“…Their identification and the volumetric quantification may allow an easier classification in terms of gravity, extent and progression of the disease. Moreover, this may provide a high-impact tool to enhance awareness of the severity of COVID-19 pneumonia [ 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 ].…”

Section: Introductionmentioning

confidence: 99%

Imaging Severity COVID-19 Assessment in Vaccinated and Unvaccinated Patients: Comparison of the Different Variants in a High Volume Italian Reference Center

Granata

Fusco

Villanacci

et al. 2022

JPM

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Purpose: To analyze the vaccine effect by comparing five groups: unvaccinated patients with Alpha variant, unvaccinated patients with Delta variant, vaccinated patients with Delta variant, unvaccinated patients with Omicron variant, and vaccinated patients with Omicron variant, assessing the “gravity” of COVID-19 pulmonary involvement, based on CT findings in critically ill patients admitted to Intensive Care Unit (ICU). Methods: Patients were selected by ICU database considering the period from December 2021 to 23 March 2022, according to the following inclusion criteria: patients with proven Omicron variant COVID-19 infection with known COVID-19 vaccination with at least two doses and with chest Computed Tomography (CT) study during ICU hospitalization. Wee also evaluated the ICU database considering the period from March 2020 to December 2021, to select unvaccinated consecutive patients with Alpha variant, subjected to CT study, consecutive unvaccinated and vaccinated patients with Delta variant, subjected to CT study, and, consecutive unvaccinated patients with Omicron variant, subjected to CT study. CT images were evaluated qualitatively using a severity score scale of 5 levels (none involvement, mild: ≤25% of involvement, moderate: 26–50% of involvement, severe: 51–75% of involvement, and critical involvement: 76–100%) and quantitatively, using the Philips IntelliSpace Portal clinical application CT COPD computer tool. For each patient the lung volumetry was performed identifying the percentage value of aerated residual lung volume. Non-parametric tests for continuous and categorical variables were performed to assess statistically significant differences among groups. Results: The patient study group was composed of 13 vaccinated patients affected by the Omicron variant (Omicron V). As control groups we identified: 20 unvaccinated patients with Alpha variant (Alpha NV); 20 unvaccinated patients with Delta variant (Delta NV); 18 vaccinated patients with Delta variant (Delta V); and 20 unvaccinated patients affected by the Omicron variant (Omicron NV). No differences between the groups under examination were found (p value > 0.05 at Chi square test) in terms of risk factors (age, cardiovascular diseases, diabetes, immunosuppression, chronic kidney, cardiac, pulmonary, neurologic, and liver disease, etc.). A different median value of aerated residual lung volume was observed in the Delta variant groups: median value of aerated residual lung volume was 46.70% in unvaccinated patients compared to 67.10% in vaccinated patients. In addition, in patients with Delta variant every other extracted volume by automatic tool showed a statistically significant difference between vaccinated and unvaccinated group. Statistically significant differences were observed for each extracted volume by automatic tool between unvaccinated patients affected by Alpha variant and vaccinated patients affected by Delta variant of COVID-19. Good statistically significant correlations among volumes extracted by automatic tool for each lung lobe and overall radiological severity score were obtained (ICC range 0.71–0.86). GGO was the main sign of COVID-19 lesions on CT images found in 87 of the 91 (95.6%) patients. No statistically significant differences were observed in CT findings (ground glass opacities (GGO), consolidation or crazy paving sign) among patient groups. Conclusion: In our study, we showed that in critically ill patients no difference were observed in terms of severity of disease or exitus, between unvaccinated and vaccinated patients. The only statistically significant differences were observed, with regard to the severity of COVID-19 pulmonary parenchymal involvement, between unvaccinated patients affected by Alpha variant and vaccinated patients affected by Delta variant, and between unvaccinated patients with Delta variant and vaccinated patients with Delta variant.

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“…Figure 3 represents 47.5% (115/242) of MIS‐C and MIS‐A cases reported in nine published African studies. MIS was more common in men between the ages of 2.3 and 51 years 25–27,67–81 . Polymorphous maculopapular eruptions on the trunk and flexural areas, acral erythema, extremity swelling, desquamation, mucositis, and fissured lips are all examples of MIS dermatological lesions 25–27,67–81 .…”

Section: Clinical Manifestations Of Covid‐19‐related Cutaneous Manife...mentioning

confidence: 99%

“…Several studies in African populations have reported MIS-C and MIS-A or Kawasaki-like disease. [25][26][27][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81] published African studies. MIS was more common in men between the ages of 2.3 and 51 years.…”

Section: Clinical Manifestations Of Covid-19-related Cutaneous Manife...mentioning

confidence: 99%

“…[25][26][27][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81] Polymorphous maculopapular eruptions on the trunk and flexural areas, acral erythema, extremity swelling, desquamation, mucositis, and fissured lips are all examples of MIS dermatological lesions. [25][26][27][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81] MIS lesions were mostly generalized or on the face, upper limbs, trunks, oral, hands, feet, palmar, and plantar surfaces in African populations (Table 1). Cases of MIS-C have been described as occurring after the peak of the epidemic and resembling both Kawasaki disease and toxic shock.…”

Section: Clinical Manifestations Of Covid-19-related Cutaneous Manife...mentioning

confidence: 99%

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Epidemiology, clinical profiles, and prognostic value of COVID‐19‐related cutaneous manifestations in African populations: a rapid narrative review

Nyasulu,

Tamuzi

2023

Int J Dermatology

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BackgroundSkin manifestations’ true prognostic value, and clinical and epidemiological pictures in SARS‐CoV‐2 infection in African populations are poorly described and understudied. More familiarity with COVID‐19 cutaneous manifestations may aid in early clinical diagnosis or guide prognosis.MethodsIn this literature review, we looked for potential studies published from December 2019 to March 2023 on COVID‐19 cutaneous lesions in African populations. Our key questions were focused on the prognostic values of cutaneous manifestations related to COVID‐19.ResultsOur findings show that cutaneous manifestations of COVID‐19 vary by country and severity of COVID‐19, primarily multisystem inflammatory syndrome (MIS). Significant differences were also found between various dermatological lesions, primarily MIS, erythema multiforme‐like, livedoid, vesicular, or varicella‐like rashes, urticarial, maculopapular or morbilliform rashes, and chilblain‐like or pernio‐like rashes. There were 47.5% (115/242) of MIS cases reported in nine published African studies. Our findings also revealed that MIS may be diagnosed in 2–7 days due to early onset rash. Advanced age, obesity, diabetes, cardiovascular disease, HIV, tuberculosis, asthma, atopic disease, underweight, malnutrition, and malignancy were found to be associated with COVID‐19 cutaneous manifestations in African populations.ConclusionsCOVID‐19‐related skin manifestations in African populations are important as a driving force in COVID‐19 prognosis.

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Clinical Characteristics and Pulmonary Computerized Imaging Findings of Critically Ill Egyptian Patients with Multisystem Inflammatory Syndrome in Children

Cited by 4 publications

References 29 publications

Chest CT features of coronavirus disease 2019 (COVID-19) in pediatric patients and its correlation with the clinical condition

Chest CT features of coronavirus disease 2019 (COVID-19) in pediatric patients and its correlation with the clinical condition

Imaging Severity COVID-19 Assessment in Vaccinated and Unvaccinated Patients: Comparison of the Different Variants in a High Volume Italian Reference Center

Epidemiology, clinical profiles, and prognostic value of COVID‐19‐related cutaneous manifestations in African populations: a rapid narrative review

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