CT chest for COVID-19, a multicenter study—experience with 220 Egyptian patients

Sabri, Youssriah Yahia; Nassef, Ashraf O.; Ibrahim, Iman Mohamed Hamdy; Mageed, Mohammed Raafat Abd El; Khairy, Mostafa Ahmed

doi:10.1186/s43055-020-00263-6

Cited by 14 publications

(18 citation statements)

References 14 publications

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“…Regarding the distribution of lung manifestations, unilateral lung affection was only observed in 24/200 [12%] while bilaterally was seen in 176/200 [88%], and that was in agreement with almost all previous publications [ 7 – 9 , 16 , 17 ].…”

Section: Discussionsupporting

confidence: 90%

“…It is a highly contagious disease, and by March 2020, the World Health Organization declared it as a pandemic causing a global health emergency [2] making early diagnosis mandatory for proper management of the patients and rapid detection of contacts for quarantine purpose; real-time reverse transcriptasepolymerase chain reaction of the viral nucleic acid (RT-PCR) within body specimens mainly nasopharyngeal or oro-phangeal swab is the gold standard for diagnosis [3]. Many publications appeared mainly focusing on the diagnosis of the disease either comparing chest CT findings with RT-PCR results [4][5][6] or describing the disease imaging features mainly chest CT [7][8][9] with paucity of articles investigating the role of chest CT in disease prognosis regarding helping the physician to speed up the diagnostic work flow by properly selecting patients in need of intensive medical care, or only hospital ward care or just home quarantine. The purpose of the study was to investigate the role of chest CT findings and CT scores along with serum biomarkers namely serum ferritin and lactate dehydrogenase (LDH) in the proper effective management of COVID-19 patients.…”

Section: Introductionmentioning

confidence: 99%

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Chest CT manifestations with emphasis on the role of CT scoring and serum ferritin/lactate dehydrogenase in prognosis of coronavirus disease 2019 (COVID-19)

Bakry

Sayed

2021

Egypt J Radiol Nucl Med

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Background In March 2020, the World Health Organization announced coronavirus disease 2019 (COVID-19) a pandemic, and because of the primary pulmonary manifestations of the disease, chest CT is essential in the evaluation of those patients. The aim of the study was to evaluate the role of chest CT findings and chest CT scoring along with serum ferritin and LDH in the prognosis of COVID-19 patients in a cohort of the Egyptian population. Results This retrospective study included 250 patients with positive RT-PCR for COVID-19, 138 males [55.2%] and 112 females [44.8%], age range 17–82 years with median 49.5. Two hundred patients had a positive significant correlation between age, serum ferritin, serum LDH, and CT score. Bilateral affection was 88% while unilaterality was 12%, and peripheral chest CT findings were stratified as follows: mild [score from 1 to 10], 114 patients [57%]; moderate [score from 11 to 19], 65 patients [32.5%]; and severe [score from 20 to 25], 21 patients [10.5%]. In severe cases, males constitute 85.7% while females were only 14.3%. Statistical and central distribution was 67%, peripheral was 31%, and central was 2%. Ground glass opacity (GGO) was the highest pattern 39.2%, consolidation 31.2%, fibrosis 15.2%, and CP 13.7%, with lymph nodes only 0.6%. Fifteen cases [6%] were critical; all showed severe scores ranging from 21 to 23 with three times increase in serum ferritin and four times increase in LDH. A follow-up study done to 8 cases [3.2%] showed an increase in CT scoring, serum ferritin, and serum LDH. Conclusion Chest CT findings are crucial for early diagnosis of COVID-19 disease especially for asymptomatic patients with old age and male sex considered risk factors for poor prognosis. Chest CT score, serum ferritin, and serum LDH help in predicting the short-term outcome of the patients aiming to decrease both morbidity and mortality.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Chest CT manifestations with emphasis on the role of CT scoring and serum ferritin/lactate dehydrogenase in prognosis of coronavirus disease 2019 (COVID-19)

Bakry

Sayed

2021

Egypt J Radiol Nucl Med

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“…Each lobe was assessed for affection, score 0 = 0% involvement; score 1 if < 5% involvement; score 2 if 5% to < 25% involvement; score 3 if 25 to < 50% involvement; score 4 if 50 to < 75% involvement; and score 5 if ≥ 75% involvement. Then, calculation of the total score that ranged from 0 to 25 [11,12].…”

Section: Image Acquisition and Analysismentioning

confidence: 99%

COVID-19 infection: epidemiological, clinical, and radiological expression among adult population

Ragab

Mahrous

Sheikh

2020

Egypt J Radiol Nucl Med

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Background High-resolution computed tomography (HRCT) has proved to be an important diagnostic tool throughout the COVID-19 pandemic outbreaks. Increasing number of the infected personnel and shortage of real-time transcriptase polymerase chain reaction (RT-PCR) as well as its lower sensitivity made the CT a backbone in diagnosis, assessment of severity, and follow-up of the cases. Results Two hundred forty patients were evaluated retrospectively for clinical, laboratory, and radiological expression in COVID-19 infection. One hundred eighty-six non-severe cases with home isolation and outpatient treatment and 54 severe cases needed hospitalization and oxygen support. Significant difference between both groups was encountered regarding the age, male gender, > 38° fever, dyspnea, chest pain, hypertension, ≤ 93 oxygen saturation, intensive care unit (ICU) admission, elevated D-dimer, high serum ferritin and troponin levels, and high CT-severity score (CT-SS) of the severe group. CT-SS showed a negative correlation with O2 saturation and patients’ outcome (r − 0.73/p 0.001 and r − 0.56/p 0.001, respectively). Bilateral peripherally distributed ground glass opacities (GGOs) were the commonest imaging feature similar to the literature. Conclusion Older age, male gender, smoking, hypertension, low O2 saturation, increased CT score, high serum ferritin, and high D-dimer level are the most significant risk factors for severe COVID-19 pneumonia. Follow-up of the recovered severe cases is recommended to depict possible post COVID-19 lung fibrosis.

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“…Intensive care unit (ICU) cases on admittance often presented with bilateral multi-lobar and sub-segmental consolidations, compared with the non-severe cases who presented with bilateral GGOs and consolidation (3) . Chest CT might be Page 12 of 17 used as a monitor to detect the evolution of the coronavirus disease as patients with severe illness most commonly report bilateral and multi-lobar affection (12,19,22,23, 24) .…”

Section: Discussionmentioning

confidence: 99%

Is There a Correlation Between Pulmonary Inflammation Index With COVID-19 Disease Severity And Outcome?

Mohamed-Hussein

Sayed²,

Mmar³

et al. 2020

Preprint

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Rational: the radiologic pulmonary inflammatory index (PII) may be used as early predictor of inflammation as laboratory assessments in COVID-19. The purpose of this study was to compare the clinical and radiological features between the cases of COVID-19 necessitating ICU and those who did not, and to correlate the PII with other inflammatory markers and outcome. Patients and methods: This study included 72 patients with confirmed COVID-19. Their electronic records of were retrospectively revised and the demographic, clinical, laboratory, HRCT data, PII and the outcomes of the patients were analyzed. Results: They were 50/50% males/females, mean age was 47.1 (16.8). During their stay, 15.3% necessitated ICU admittance, 68% cured, 9 cases referred and five cases (6.9%) died. The baseline lesions identified were ground glass opacification in (93%), higher PII and >3 lobes affection were considerably recorded in those who required ICU (P= 0.041 and 0.013). There were correlations between PII with age (r=0.264, P=0.031), ferritin (r=0.225, P=0.048) and D Dimer (r=0.271, P=0.043). Conclusions: The use of PII together with clinical and laboratory data may be valuable in defining the inflammatory state of COVID-19. It was correlated with other inflammatory indices as D dimer, ferritin even before clinical deterioration.

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CT chest for COVID-19, a multicenter study—experience with 220 Egyptian patients

Cited by 14 publications

References 14 publications

Chest CT manifestations with emphasis on the role of CT scoring and serum ferritin/lactate dehydrogenase in prognosis of coronavirus disease 2019 (COVID-19)

Chest CT manifestations with emphasis on the role of CT scoring and serum ferritin/lactate dehydrogenase in prognosis of coronavirus disease 2019 (COVID-19)

COVID-19 infection: epidemiological, clinical, and radiological expression among adult population

Is There a Correlation Between Pulmonary Inflammation Index With COVID-19 Disease Severity And Outcome?

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