Background The aim of this study was to evaluate the value of chest computed tomography (CT) severity score in the assessment of coronavirus disease 2019 (COVID‑19) severity and short-term prognosis. Methods In this cross-sectional study, we evaluated all patients who were referred to our university hospital, from 21 May 2020 to 22 June 2020 with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) test. The patients suspected of having other respiratory diseases including influenza, according to an infectious disease specialist, and those without chest CT scan were excluded. A chest CT was obtained for all patients between days 4 and 7 days after symptom onset. Chest CT severity score was also calculated based on the degree of involvement of the lung lobes as 0%, (0 points), 1–25% (1 point), 26–50% (2 points), 51–75% (3 points), and 76–100% (4 points). The CT severity score was quantified by summing the 5 lobe indices (range 0–20). The ROC curve analysis was performed for the clinical value of CT scores in distinguishing the patients based on the severity of disease (mild/moderate group versus severe group), ICU admission, intubation requirement, and mortality. Results Of the 148 patients included, 93 patients recovered, while 55 patients died (mortality rate 37%). The area under the curve of CT score for discriminating of recovered patients from deceased individuals was 0.726, and the optimal CT score threshold was 15.5 with 61.8% sensitivity and 76.3% specificity. The best CT score cut-off for discriminating of patients based on the severity of disease was 12.5 with 68.3% sensitivity and 72.7% specificity. In addition, with CT score cut-off of 15.5, sensitivities of 70.8% and 51.6% and specificities of 78% and 72.6% were observed for intubation and ICU admission, respectively. Conclusion CT scan and semiquantitative scoring method could be beneficial and applicable in predicting the patient’s condition.
The outbreak of coronavirus disease 2019 (COVID-19) in late 2019 rapidly turned into a global pandemic. Although the symptoms of COVID-19 are mainly respiratory ones, the infection is associated with a wide range of clinical signs and symptoms. The main imaging modality in COVID-19 is lung computed tomography (CT) scanning, but the diagnosis of the vast spectrum of complications needs the application of various imaging modalities. Owing to the novelty of the disease and its presentations, its complications—particularly uncommon ones—can be easily missed. In this study, we describe some uncommon presentations of COVID-19 diagnosed by various imaging modalities. The first case presented herein was a man with respiratory distress, who transpired to suffer from pneumothorax and pneumomediastinum in addition to the usual pneumonia of COVID-19. The second patient was a hospitalized COVID-19 case, whose clinical condition suddenly deteriorated with the development of abdominal symptoms diagnosed as mesenteric ischemia by abdominal CT angiography. The third patient was a case of cardiac involvement in the COVID-19 course, detected as myocarditis by cardiac magnetic resonance imaging (MRI). The fourth and fifth cases were COVID-19-associated encephalitis whose diagnoses were established by brain MRI. COVID-19 is a multisystem disorder with a wide range of complications such as pneumothorax, pneumomediastinum, mesenteric ischemia, myocarditis, and encephalitis. Prompt diagnosis with appropriate imaging modalities can lead to adequate treatment and better survival.
Objectives The cervical vertebrae are more durable than other skeletal components, and therefore may be the only remnants of a dead body. The present study aims to investigate the role of several linear dimensions of the second cervical vertebrae measured by Three-Dimensional Computed Tomographic Scanning (3D CT Scan) in height estimation of Iranian adult population. In this cross-sectional study, height determination was performed by measuring 15 indexes of the second cervical vertebrae. Indexes were obtained by screening cervical CT scan of 66 patients (33 males and 33 females) aged ≥ 18 years at Rasoul Hospital. Chi square, T student and logistic regression tests were used for statistical analysis. The significance level was considered to be < 0.05. Result In the total population, among the indexes for the second cervical vertebrae, the Max height of the axis (AMA) (r = 0.470, P = 0.0001), Max length of the axis (CMA) (r = 0.320, P = 0.007), and Sagittal max body diameter (DSMC) (r = 0.281, P = 0.019) had a strong and positive correlation with height. The results of this study showed the accuracy of linear dimensions of cervical vertebrae in determining the body height of the Iranian adult population.
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