From Radiological Manifestations to Pulmonary Pathogenesis of COVID-19: A Bench to Bedside Review

Saburi, Amin; Schoepf, U. Joseph; Ulversoy, Kyle A; Jafari, Ramezan; Eghbal, Fatemeh; Ghanei, Mostafa

doi:10.1155/2020/8825761

Cited by 10 publications

(8 citation statements)

References 77 publications

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“…TCZ administration time was determined according to thorax CT imaging and duration of symptoms. If there was ground glass and duration of symptoms <7 days, it was defined as early period; if there was paving stone or fibrotic band and duration of symptoms >7 days, it was considered the late period 15 …”

Section: Methodsmentioning

confidence: 99%

Low‐dose tocilizumab is associated with improved outcome and a low risk of secondary infection in severe COVID‐19 pneumonia

Çelik

Eren

Toker

et al. 2021

Int J Clinical Practice

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Background Respiratory failure and death are the leading causes of severe Coronavirus disease 2019 (COVID‐19). Hyper‐inflammation and cytokine storm cause lung damage. This study aimed to compare the low‐dose and high‐dose effects of tocilizumab, an IL‐6 receptor antagonist. Method Patients with severe pneumonia and hyper‐inflammation signs because of COVID‐19 were included in this retrospective study. Patients receiving tocilizumab <200 mg intravenously were classified as the low‐dose group, and receiving ≥200 mg as the high‐dose group, and those not treated with tocilizumab as the control group. Demographic and clinical data of patients who died and survived in both low‐high dose and control patients were compared. According to symptom day and radiological infiltration, patients with tocilizumab were also evaluated in two groups as early and late periods at tocilizumab administration time. Results A total of 160 patients were included in the study; 70 were treated with a low dose and 50 with high‐dose tocilizumab. Forty patients were in the control group. Age, comorbidity and clinical features were similar in the control, low‐dose tocilizumab and high‐dose tocilizumab groups. The mortality rate (12.9%, 30.0%, 37.5, P = .008) was less in the low‐dose tocilizumab group. The secondary infection rate was higher in the high‐dose group than in the low‐dose tocilizumab and control groups (44.0%, 10.0%, 10.0%, P < .001). Distinguishing between those patients who died and survived, age (OR: 1.1589, P < .001), higher APACHE II scores (OR: 1.225, P = .001) and needs for non‐invasive mechanical ventilation (OR: 14.469, P < .001) were the most critical risk factors. Low‐dose tocilizumab was associated with a lower mortality rate (OR: 0.244, P = .012). Conclusion The use of tocilizumab at a low dose is associated with lower secondary infections and mortality.

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Section: Methodsmentioning

confidence: 99%

Low‐dose tocilizumab is associated with improved outcome and a low risk of secondary infection in severe COVID‐19 pneumonia

Çelik

Eren

Toker

et al. 2021

Int J Clinical Practice

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“…It has since rapidly spread throughout the world and was recognized as a global health emergency[ 1 , 2 ]. COVID-19 presents as a wide spectrum of clinical pictures, from asymptomatic or mild flu-like illness to severe respiratory infection and even death[ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Chest computed tomography (CT) also has an undeniable importance in the diagnostic management of COVID-19 due to its high sensitivity and widespread availability[ 5 ]. The most common radiologic findings of COVID-19 are bilateral, peripheral, multifocal ground-glass opacities (GGO) and consolidations, linear opacities, reversed halo sign, and crazy-paving pattern[ 4 , 6 ]. These findings are highly suggestive, but not specific, for the diagnosis of COVID-19 infection, as other viral pneumonias, like influenza, severe acute respiratory syndrome and middle east respiratory syndrome, may show similar imaging findings[ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

“Pulmonary target sign” as a diagnostic feature in chest computed tomography of COVID-19

Jafari

Jonaidi-Jafari

Maghsoudi

et al. 2021

WJR

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BACKGROUND In chest computed tomography (CT) scan, bilateral peripheral multifocal ground-glass opacities, linear opacities, reversed halo sign, and crazy-paving pattern are suggestive for coronavirus disease 2019 (COVID-19) in clinically suspicious cases, but they are not specific for the diagnosis, as other viral pneumonias, like influenza and some viral pneumonia may show similar imaging findings. AIM To find a specific imaging feature of the disease would be a welcome guide in diagnosis and management of challenging cases. METHODS Chest CT imaging findings of 650 patients admitted to a university Hospital in Tehran, Iran between January 2020 and July 2020 with confirmed COVID-19 infection by RT-PCR were reviewed by two expert radiologists. In addition to common non-specific imaging findings of COVID-19 pneumonia, radiologic characteristics of “pulmonary target sign” (PTS) were assessed. PTS is defined as a circular appearance of non-involved pulmonary parenchyma, which encompass a central hyperdense dot surrounded by ground-glass or alveolar opacities. RESULTS PTS were presented in 32 cases (frequency 4.9%). The location of the lesions in 31 of the 32 cases (96.8%) was peripheral, while 4 of the 31 cases had lesions both peripherally and centrally. In 25 cases, the lesions were located near the pleural surface and considered pleural based and half of the lesions (at least one lesion) were in the lower segments and lobes of the lungs. 22 cases had multiple lesions with a > 68% frequency. More than 87% of cases had an adjacent bronchovascular bundle. Ground-glass opacities were detectable adjacent or close to the lesions in 30 cases (93%) and only in 7 cases (21%) was consolidation adjacent to the lesions. CONCLUSION Although it is not frequent in COVID-19, familiarity with this feature may help radiologists and physicians distinguish the disease from other viral and non-infectious pneumonias in challenging cases.

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“…3,6,7 However, some other specific symptoms, including loss of the sense of taste and smell, added to the common respiratory symptoms making the diagnosis more specific. [8][9][10] Some studies demonstrated specific factors as risk factors of developing COVID-19. These main risk factors include male gender, smoking, age over 65 years, and previous history of respiratory disease, malignancies, and cardiovascular diseases are considered factors that worsen the prognosis of COVID-19.…”

Section: Introductionmentioning

confidence: 99%

“…These main risk factors include male gender, smoking, age over 65 years, and previous history of respiratory disease, malignancies, and cardiovascular diseases are considered factors that worsen the prognosis of COVID-19. 9,11 Regardless of the clinical presentations and risk factors of COVID-19, the main challenging issue behind the novel coronavirus infection is the treatment strategy. 12 There are many conflicts in using various medications in COVID-19 cases, and it seems that an effective vaccine may be more helpful than routine medications.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Screening in Rheumatologic Diseases Cases; Special Look at Chloroquine Derivate Use

et al. 2021

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Background: Among suggested medications for the treatment of COVID-19, chloroquine derivates and angiotensin-converting– enzyme inhibitors (ACEIs)/angiotensin II type 1 receptor blockers (ARBs) are the two medications with conflicting effects on the development of the disease. Objectives: The present study aimed to evaluate COVID-19 in patients with rheumatic diseases receiving chloroquine derivate. Methods: Every patient with proven rheumatologic diseases registered in two referral centers in Tehran and Alborz, Iran was enrolled in the present descriptive cross-sectional study between May and June 2020. At first, the symptoms of COVID-19 were assessed, and if a case had suspicious symptoms, reverse transcription-polymerase chain reaction (RT-PCR) COVID-19 tests were done. Demographic and clinical data are documented for every patient. Then, the patients were grouped once according to their COVID-19 infection status and another time according to their hydroxychloroquine use. Results: 1159 patients enrolled in the study with a mean age of 49.39 years. Frequency of hypertension was 22.17 %, diabetics (9.49%) and 20 (1.7%) patients were positive for COVID-19 testing. The most common symptoms of the COVID-19 positive cases were cough (5.2%) and fever (4%). There was no significant difference in receiving ACEIs/ARBs or other medications between COVID-19 positive or negative patients. Among the patients receiving hydroxychloroquine, 15 patients (1.7%) had proved COVID-19 versus 5 patients (1.7%) who were not receiving these medications (P>0.999). Conclusion: The present study demonstrated that receiving ARBs or ACEIs was not different among patients with or without COVID-19. Moreover, receiving chloroquine derivate was not related to the development of COVID-19 in patients with rheumatologic disorders.

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From Radiological Manifestations to Pulmonary Pathogenesis of COVID-19: A Bench to Bedside Review

Cited by 10 publications

References 77 publications

Low‐dose tocilizumab is associated with improved outcome and a low risk of secondary infection in severe COVID‐19 pneumonia

Low‐dose tocilizumab is associated with improved outcome and a low risk of secondary infection in severe COVID‐19 pneumonia

“Pulmonary target sign” as a diagnostic feature in chest computed tomography of COVID-19

COVID-19 Screening in Rheumatologic Diseases Cases; Special Look at Chloroquine Derivate Use

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