Crazy-Paving: A Computed Tomographic Finding of Coronavirus Disease 2019

Gillespie, Megan; Flannery, Patrick; Schumann, Jessica A; Dincher, Nathan; Mills, Rebecca; Can, Argun

doi:10.5811/cpcem.2020.5.47998

Cited by 6 publications

(3 citation statements)

References 4 publications

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“…The crazy-paving pattern is defined by multiple, patchy ground-glass opacities with reticular, and interlobular septal thickening and intralobular lines. It is pathognomonic in COVID-19 progressive disease, which may present in the inflammatory and hyperinflammatory state [16]. This is in line with these cases, in which Chest CT was performed after the 25 th day when the patient was under cytokine storm period.…”

Section: Discussionsupporting

confidence: 74%

Spontaneous Pneumomediastinum in COVID-19 Unrelated to Mechanical Ventilation: A Case Report

Soeroso

Soliha²,

Ghanie³

et al. 2022

Open Access Maced J Med Sci

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Background: Pneumo-mediastinum is a rare disease associated with barotrauma and uncommonly occurs in viral pneumonia. Although the underlying mechanism of the incidence of pneumo-mediastinum in COVID-19 patients is not fully understood, barotrauma is the most probable cause. Case Report: We reported a case of a 27-years-old woman with the chief complaint was shortness of breath and diagnosed with COVID19 based on RT-PCR examination. On the sixth day after being admitted to the hospital, suddenly, the intensity of dyspnea was increased with the decrease of oxygen saturation. CT of the chest confirmed pneumomediastinum and pneumonia COVID -19. There was no improvement of symptoms after oxygen and steroid administration. Emergency thoracotomy was not performed yet, and the patient has died. Conclusions: Although pneumomediastinum is benign disease and self-limited disease, the presents of pneumomediastinum may relate to worse outcomes in COVID19 infections.

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Section: Discussionsupporting

confidence: 74%

Spontaneous Pneumomediastinum in COVID-19 Unrelated to Mechanical Ventilation: A Case Report

Soeroso

Soliha²,

Ghanie³

et al. 2022

Open Access Maced J Med Sci

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“…A characteristic feature is the computed tomographic finding of interlobular septal thickening in a 'crazy paving' pattern [54]. This finding is also characteristic of COVID-19 [55]. Although the mechanisms responsible may be different, the net result in both cases is the increased deposition of surfactant on pulmonary epithelium.…”

Section: Discussionmentioning

confidence: 97%

The Role of Surface in the Pathogenesis and Treatment of COVID-19

Retzinger

2021

COVID

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Recently, an inverse relationship between incidence of COVID-19 and seasonal aerosolization of mold spores was demonstrated. Analyses of that relationship suggested mold spores compete with SARS-CoV-2 virions for a receptor on the pulmonary epithelial surface. By inference, the operative receptor was proposed to be Toll-like receptor 4, with surface-localized virions being responsible for symptomatology. In this report, the pathogenesis of COVID-19 is further developed, with a focus on a role for surfactant protein D in the process. This developed proposal provides both mechanistic understanding and suggested treatments of COVID-19.

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“…The crazy paving sign is presumed to reflect alveolar edema and interstitial inflammation, relatively a specific sign of COVID 19 pneumonia and reported in as high as 92% of cases [ 46 , 47 ]. The initial reports suggested that crazy paving pattern is a sign of progressive disease [ 48 , 49 ]. Zahan et al [ 44 ], reported the incidence of localized crazy paving sign in 65% of patients with mild pneumonia cases and in 23.4% of the severe cases ( P < 0.001).…”

Section: Discussionmentioning

confidence: 99%

Correlation between the initial CT chest findings and short-term prognosis in Egyptian patients with COVID-19 pneumonia

Hefeda

Elsharawy

Dawoud

2022

Egypt J Radiol Nucl Med

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Background The recent pandemic of COVID‐19 has thrown the world into chaos due to its high rate of transmissions. This study aimed to highlight the encountered CT findings in 910 patients with COVID-19 pneumonia in Egypt including the mean severity score and also correlation between the initial CT finding and the short-term prognosis in 320 patients. Results All patients had confirmed COVID-19 infection. Non-contrast CT chest was performed for all cases; in addition, the correlation between each CT finding and disease severity or the short-term prognosis was reported. The mean age was higher for patients with unfavorable prognosis (P < 0.01). The patchy pattern was the most common, found in 532/910 patients (58.4%), the nodular pattern was the least common 123/910 (13.5%). The diffuse pattern was reported in 124 (13.6%). The ground glass density was the most common reported density in the study 512/910 (56.2%). The crazy pavement sign was reported more frequently in patients required hospitalization or ICU and was reported in 53 (56.9%) of patients required hospitalization and in 29 (40.2%) patients needed ICU, and it was reported in 11 (39.2%) deceased patients. Air bronchogram was reported more frequently in patients with poor prognosis than patients with good prognosis (16/100; 26% Vs 12/220; 5.4%). The mean CT severity score for patients with poor prognosis was 15.2. The mean CT severity score for patients with good prognosis 8.7., with statistically significant difference (P = 0.001). Conclusion Our results confirm the important role of the initial CT findings in the prediction of clinical outcome and short-term prognosis. Some signs like subpleural lines, halo sign, reversed halo sign and nodular shape of the lesions predict mild disease and favorable prognosis. The crazy paving sign, dense vessel sign, consolidation, diffuse shape and high severity score predict more severe disease and probably warrant early hospitalization. The high severity score is most important in prediction of unfavorable prognosis. The nodular shape of the lesions is the most important predictor of good prognosis.

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Crazy-Paving: A Computed Tomographic Finding of Coronavirus Disease 2019

Cited by 6 publications

References 4 publications

Spontaneous Pneumomediastinum in COVID-19 Unrelated to Mechanical Ventilation: A Case Report

Spontaneous Pneumomediastinum in COVID-19 Unrelated to Mechanical Ventilation: A Case Report

The Role of Surface in the Pathogenesis and Treatment of COVID-19

Correlation between the initial CT chest findings and short-term prognosis in Egyptian patients with COVID-19 pneumonia

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