Diagnostic role of chest computed tomography in coronavirus disease 2019

Stroszczynski

2020

AIM: Use of contrast enhanced ultrasound (CEUS) in severe cases of COVID-19 infection to assess pulmonary changes near the pleura. MATERIAL AND METHODS: Bedside examinations by an experienced intensive care unit examiner using a multifrequency probe (C1-6 MHz) with B-mode and CEUS to assess pleural-near changes in severe cases of COVID-19 infection with respiratory failure. CEUS with bolus delivery via a central venous catheter of 2.4 ml Sulphur hexafluoride microbubbles from the arterial phase (10-15 s) to the late phase of 5 min. Digital storage of cine sequences of the lung sound with abdomen for independent assessment with the subsequently performed contrast-enhanced dual-source CT. RESULTS: In 11 intubated and ventilated patients (arithmetic mean 62 years, 48 to 78 years, 3 women) with confirmed severe COVID-19 infections, a peripherally accentuated consolidation with irregular hyperemia was found in the CEUS and also in the CT examination. Of the 5 cases with pulmonary arterial embolisms, signs of right ventricular failure were found. In all cases, using CEUS low perfused areas of the pleura with adjacent hyperemia could be detected, while, with CT segmental contrast medium, gaps with subpleural compressions were found. Interstitial changes near the pleura led to B-lines and to ground glass opacities in the CT. Near the diaphragm a delayed arterial contrast of the liver was observed. In addition, in 2 cases partial atelectasis, in 3 cases marginal pleural effusions were found. CONCLUSION: CEUS opens up new possibilities for bedside monitoring of pleural reactive inflammatory or peripheral thrombus embolism in severe cases of COVID-19 infection.

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Contrast enhanced ultrasound (CEUS) to assess pleural pulmonal changes in severe COVID-19 infection: First results

Stroszczynski

2020

“…Computed tomography (CT) can be considered as an essential supplemental investigative tool for the detection of COVID-19 pneumonia in this pandemic context. In severe cases, CT plays an important role in identifying viral lung infection, examining the nature and extent of pulmonary lesions, and scrutinizing the disease severity [63]. Known features of COVID-19 on initial CT consist of bilateral multilobar with an usual of three lung segments, ground-glass opacification (GGO) with a peripheral or posterior distribution, principally in the lower lobes and some times inside the right middle lobe.…”

Section: Diagnosismentioning

confidence: 99%

The Pathophysiology, Diagnosis and Treatment of Corona Virus Disease 2019 (COVID-19)

Das

2020

Ind J Clin Biochem

Since the beginning of this century, beta coronaviruses (CoV) have caused three zoonotic outbreaks. However, little is currently known about the biology of the newly emerged SARS-CoV-2 in late 2019. There is a spectrum of clinical features from mild to severe life threatening disease with major complications like severe pneumonia, acute respiratory distress syndrome, acute cardiac injury and septic shock. The genome of SARS-CoV-2 encodes polyproteins, four structural proteins and six accessory proteins. SARS-CoV-2 tends to utilize Angiotensin-converting enzyme 2 (ACE2) of various mammals. The imbalance between ACE/Ang II/AT1R pathway and ACE2/Ang(1-7)/Mas receptor pathway in the renin-angiotensin system leads to multi-system inflammation. The early symptoms of COVID-19 pneumonia are low to midgrade fever, dry cough and fatigue. Vigilant screening is important. The diagnosis of COVID-19 should be based on imaging findings along with epidemiological history and nucleic acid detection. Isolation and quarantine of suspected cases is recommended. Management is primarily supportive, with newer antiviral drugs/vaccines under investigation. Keywords Angiotensin Á Angiotensin converting enzyme Á Chloroquine Á Corona virus Á COVID-19 Á Cytokine storm Á RNA-dependent Á RNA polymerase Á Spike protein Á SARS-CoV2

“…Another drawbacks of differential diagnosis can be expected for examination of infected children, who have either different or no manifestation than the adult patients and overall impact of COVID-19 on child ren is fortunately very mild (10). The differential diagnosis of COVID-19 can be further improved by instrumental techniques like computed tomography scan (11)(12)(13)(14). Though these instruments do not plausibly confi rm the particular disease, they make the diagnosis specifi c and they can also reveal related pathologies.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 molecular level laboratory diagnoses

Pohanka¹

2021

BLL

The Coronavirus Disease 2019 caused not only global pandemic, but it also pointed at unprepared health care systems and countermeasures were introduced under the pressure of urgent circumstances. This review is focused on discussion and critical evaluation of instrumental tools for COVID-19 diagnosis that were developed in the last months. METHODS: Survey of actual literature and scientifi c reports was made. The most substantial analytical and diagnostical methods were identifi ed and described. Principles and limitations of the methods are described, and actual papers are cited in this review. RESULTS: Analytical and diagnostical methods like Polymerase Chain Reaction (PCR), Loop-mediated isothermal Amplifi cation (LAMP), Lateral Flow Immunochromatography Assay (LFIA), Enzyme-Linked Immunosorbent Assay (ELISA), biosensors and ChemiLuminescence ImmunoAssay (CLIA) are discussed for assay of viral particles, antigens and specifi c host antibodies in blood, serum, plasma, nasopharyngeal swab and other samples in order to diagnose COVID-19. CONCLUSIONS: The Coronavirus Disease 2019 (COVID-19) is an emerging disease that has spread over the world since the end of year 2019. The global epidemic pointed at the necessity to introduce sensitive methods for instrumental diagnosis of COVID-19 and distinguishing it from the other viral diseases.