High-Resolution Computed Tomography Is Useful for Early Diagnosis of Severe Acute Respiratory Syndrome–Associated Coronavirus Pneumonia in Patients with Normal Chest Radiographs

Hui, Joyce Y. H.; Hon, Timothy Yu Wai; Yang, Michael K. W.; Cho, Danny Hing Yan; Luk, Wing Hang; Chan, Ronee Yun Yee; Chan, K. S.; Loke, Tkl; Chan, John

doi:10.1097/00004728-200401000-00001

Cited by 18 publications

(20 citation statements)

References 11 publications

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“…The superiority of CT to CR for related diagnoses was previously shown in patients with diffuse infiltrative lung disease (10) and severe acute respiratory syndrome (SARS) (11)(12)(13). The reported sensitivity of CT for the diagnosis of SARS was 100%, whereas that of CR was only 57.5-66.7% (11)(12)(13).…”

Section: Discussionmentioning

confidence: 95%

“…The reported sensitivity of CT for the diagnosis of SARS was 100%, whereas that of CR was only 57.5-66.7% (11)(12)(13). Several reasons have been proposed for overlooking pneumonic infiltration on CR films: 1) the shadow is localized and/or too light (11); 2) anatomic structures, such as the diaphragm and heart, may be superimposed so as to impair the diagnostic accuracy of CR (12); 3) the anterior-posterior view is less diagnostically accurate than the posterior-anterior view.…”

Section: Discussionmentioning

confidence: 99%

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Computed Tomography for the Diagnosis and Evaluation of the Severity of Community-acquired Pneumonia in the Elderly

et al. 2016

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Objective We herein assessed the utility of computed tomography (CT) for the diagnosis and ascertainment of the severity of community-acquired pneumonia (CAP) in the elderly. Methods The utility of CT compared with chest radiography (CR) for the diagnosis of CAP was prospectively studied among elderly inpatients with clinical symptoms and signs indicative of CAP at the Department of Respiratory Medicine in Nissan Tamagawa Hospital during the one-year period from January 2013 to December 2013. Additionally, we evaluated whether the findings of CT were useful as predictive factors related to the mortality rate associated with CAP. Results One hundred and forty-two patients, 65 years of age or older, were surveyed upon hospital admission for suspected CAP. Of the 142 patients included, 127 (89.4%) had pneumonic infiltration diagnosed by CT, however, CR could not recognize pneumonic infiltration in 9.4% (12/127) of these patients. In 127 CAPpositive patients, bilateral pneumonic infiltration was more frequently detected by CT in non-survivors than survivors (79.0% vs. 53.7%; p <0.05). By a multivariable analysis to determine the prognostic factors related to mortality from CAP, oxygen desaturation showed the greatest odds ratio among the other predictive factors, followed by comorbid neoplastic disease, blood urea nitrogen ! 21 mg/dL, male gender, and bilateral pneumonic infiltration diagnosed by CT. Conclusion We herein demonstrated that CT was superior to CR for diagnosing and evaluating the severity of CAP in elderly patients.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Computed Tomography for the Diagnosis and Evaluation of the Severity of Community-acquired Pneumonia in the Elderly

et al. 2016

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“…In addition, SARS-CoV contains eight encoded accessory genes interspersed amongst the viral structural genes [22,25,126], the most of the known CoVs. Interestingly, these accessory genes are present in SARS-CoVs isolated from bats, civet cats, raccoon dogs, and humans, suggesting important accessory functions in a variety of hosts [55,127,128]. Evidence confirms that these accessory proteins are indeed expressed during SARS-CoV infection, but for many, their functions are yet to be determined.…”

Section: Discussionmentioning

confidence: 99%

The Role of Severe Acute Respiratory Syndrome (SARS)-Coronavirus Accessory Proteins in Virus Pathogenesis

McBride

Fielding

2012

Viruses

137

150

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A respiratory disease caused by a novel coronavirus, termed the severe acute respiratory syndrome coronavirus (SARS-CoV), was first reported in China in late 2002. The subsequent efficient human-to-human transmission of this virus eventually affected more than 30 countries worldwide, resulting in a mortality rate of ~10% of infected individuals. The spread of the virus was ultimately controlled by isolation of infected individuals and there has been no infections reported since April 2004. However, the natural reservoir of the virus was never identified and it is not known if this virus will re-emerge and, therefore, research on this virus continues. The SARS-CoV genome is about 30 kb in length and is predicted to contain 14 functional open reading frames (ORFs). The genome encodes for proteins that are homologous to known coronavirus proteins, such as the replicase proteins (ORFs 1a and 1b) and the four major structural proteins: nucleocapsid (N), spike (S), membrane (M) and envelope (E). SARS-CoV also encodes for eight unique proteins, called accessory proteins, with no known homologues. This review will summarize the current knowledge on SARS-CoV accessory proteins and will include: (i) expression and processing; (ii) the effects on cellular processes; and (iii) functional studies.

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“…Hui et al 19 suggest that high-resolution chest CT is useful for early diagnosis of SARS in patients with negative radiographs.…”

Section: Severe Acute Respiratory Syndromementioning

confidence: 99%

ACR Appropriateness Criteria® Acute Respiratory Illness in Immunocompetent Patients

Kirsch

Ramírez²,

Mohammed³

et al. 2011

Journal of Thoracic Imaging

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Acute respiratory illness is defined as one or more of the following: cough, sputum production, chest pain, or dyspnea (with or without fever). The workup of these patients depends on many factors, including clinical presentation and the suspected etiology. This study reviews the literature on the indications and usefulness of radiologic studies for the evaluation of acute respiratory illness in the immunocompetent patient. The following recommendations are the result of evidence-based consensus by the American College of Radiology Appropriateness Criteria Expert Panel on Thoracic Radiology. Chest radiographs are usually appropriate in (1) patients with positive physical examination or risk factors for pneumonia, (2) for the assessment of complicated pneumonia, or (3) in cases of emerging infections and biological warfare agents such as severe acute respiratory syndrome, H1N1, and anthrax. Computed tomography, although having a more limited role, is usually appropriate (1) in the assessment of complicated pneumonia and (2) in patients with suspected severe acute respiratory syndrome, H1N1, or anthrax and a normal radiograph.

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High-Resolution Computed Tomography Is Useful for Early Diagnosis of Severe Acute Respiratory Syndrome–Associated Coronavirus Pneumonia in Patients with Normal Chest Radiographs

Abstract: HRCT is useful for early diagnosis of SARS-associated coronavirus pneumonia in patients with normal chest radiographs. HRCT findings in these patients predict potentially severe disease.

Cited by 18 publications

References 11 publications

Computed Tomography for the Diagnosis and Evaluation of the Severity of Community-acquired Pneumonia in the Elderly

Computed Tomography for the Diagnosis and Evaluation of the Severity of Community-acquired Pneumonia in the Elderly

The Role of Severe Acute Respiratory Syndrome (SARS)-Coronavirus Accessory Proteins in Virus Pathogenesis

ACR Appropriateness Criteria® Acute Respiratory Illness in Immunocompetent Patients

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