Pulmonary ct manifestations of COVID-19: changes within 2 weeks duration from presentation

Abstract

Background: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Chest computed tomography (CT) plays an essential role in the evaluation of COVID-19. This retrospective study aims to determine and compare the pulmonary changes in Iraqi patients with COVID-19 disease across the first two weeks after onset of symptoms using computerized tomography (CT) scan. Ninety-six patients with COVID-19 disease were enrolled in this study. Patients were divided into two groups according to the duration of symptoms (the first group has been scanned within the first week of presentation while the second group has been scanned in the second week). Results: The CT findings in the first and second group were as follows: ground glass opacity (GGO) were 94.3% vs. 88.5%, consolidation were 25.7% vs. 34.6%, broncho vascular thickening were 18.6% vs. 7.7%, crazy paving appearance were 15.7% vs. 3.8%, tree-in-bud appearance were 4.3% vs. 10.7%, pulmonary nodules were 5.1% vs. 7.7%, and bronchiectasis were 5.5% vs. 7.7%. Pleural effusion and cavitation were seen only in the first group (2.9% and 1.4% respectively). The distribution of CT changes across the two groups were as follows: bilateral changes were 85.7% vs. 100%; central distribution were 11.4% vs. 11.5%; peripheral distribution were 64.3% vs. 42.3%, and diffuse (central and peripheral) distribution were 24.3% vs. 46.2% while multilobar distribution were 70% vs. 80.8%. Conclusion: The type, extent, and distributions of pulmonary manifestations associated with COVID-19 infection are significantly different between the two groups who have been scanned in different stages of the disease.

Comparative evaluation of semi-quantitative CT-severity scoring versus serum lactate dehydrogenase as prognostic biomarkers for disease severity and clinical outcome of COVID-19 patients

“…The CT features of COVID-19 pneumonia in our study are compatible with that published in the literature [ 20 – 23 ]. Ground glass opacities were the most common CT chest radiological finding with bilateral peripheral/subpleural predilection.…”

Antibiotic misuse and compliance with infection control measures during COVID‐19 pandemic in community pharmacies in Egypt

“…The WHO and NICE recommendations support that only symptoms are enough to suspect infected cases, 5,10 so the majority of the pharmacists relied on patient symptoms to identify COVID‐19 presumptive cases, but the process of case identification and differentiating symptoms from common cold and flu or other respiratory diseases without the confirmation with the PCR swap may be very complex 14,18 . Moreover, patients with COVID‐19 may experience leucopenia, thrombocytopenia, and lymphopenia; however, high levels of serum C‐reactive protein (CRP), Erythrocyte sedimentation rate (ESR), lactate dehydrogenase (LDH), D‐dimer, and kidney function tests may be seen 18‐20 . Consequently, pharmacists ordered certain laboratory tests and chest CT scans to assess patient condition and define disease progression, which indicates that pharmacists can offer suitable guidance for patients and communicate proper clinical knowledge when possible.…”

Circulating microparticles and activated platelets as novel prognostic biomarkers in COVID-19; relation to cancer

“…Multislice CT chest has a sensitivity of 97% and 75% in PCR positive and negative cases respectively with 25% specificity for detection of COVID-19 infection, many studies have reported CT pulmonary changes with COVID-19 [ 27 , 33 ] which were combined in a prognostic score predicting the mortality in COVID-19 infected patients [ 34 ]. The most common observed CT changes were multiple bilateral peripheral GGO [ 35 ]. Many reports demonstrated a positive correlation between CT changes and abnormal blood coagulation parameters (based on measurements of platelets and D-dimer) [ 23 , 36 , 37 ], our results agreed with the previous studies where only patients with moderate GGO had a significantly higher D-dimer level compared with free CT, furthermore, our results in alignment with Zhang et al [ 23 ], demonstrated an association between CRP, and serum ferritin with the severity of CT changes.…”