Ground-glass opacity (GGO): a review of the differential diagnosis in the era of COVID-19

Cozzi, Diletta; Cavigli, Edoardo; Moroni, Chiara; Smorchkova, Olga; Zantonelli, Giulia; Pradella, Silvia; Miele, Vittorio

doi:10.1007/s11604-021-01120-w

Cited by 54 publications

(43 citation statements)

References 97 publications

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“…'Ground-glass' opacities in COVID and long COVID One of the early hallmarks of acute COVID-19 was the observation of extensive, diffuse opacities in highresolution computed tomography (HRCT) scans of the lungs of patients, consistent with the breathing difficulties widely observed. These opacities resembled ground glass [126], and indeed are commonly referred to as 'ground-glass opacities' (GGO) [127][128][129][130][131][132]. They are largely formed of fibrin, though we are not aware that anyone has yet stained them for amyloid structures (which is what we believe they must be, and there is ample precedent for this in other diseases (e.g.…”

Section: Amyloid Fibrin Microclots (Fibrinaloids) In Covid-19 and Lon...mentioning

confidence: 93%

A central role for amyloid fibrin microclots in long COVID/PASC: origins and therapeutic implications

Kell

Laubscher

Pretorius

2022

Biochemical Journal

157

212

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Post-acute sequelae of COVID (PASC), usually referred to as ‘Long COVID’ (a phenotype of COVID-19), is a relatively frequent consequence of SARS-CoV-2 infection, in which symptoms such as breathlessness, fatigue, ‘brain fog’, tissue damage, inflammation, and coagulopathies (dysfunctions of the blood coagulation system) persist long after the initial infection. It bears similarities to other post-viral syndromes, and to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Many regulatory health bodies still do not recognize this syndrome as a separate disease entity, and refer to it under the broad terminology of ‘COVID’, although its demographics are quite different from those of acute COVID-19. A few years ago, we discovered that fibrinogen in blood can clot into an anomalous ‘amyloid’ form of fibrin that (like other β-rich amyloids and prions) is relatively resistant to proteolysis (fibrinolysis). The result, as is strongly manifested in platelet-poor plasma (PPP) of individuals with Long COVID, is extensive fibrin amyloid microclots that can persist, can entrap other proteins, and that may lead to the production of various autoantibodies. These microclots are more-or-less easily measured in PPP with the stain thioflavin T and a simple fluorescence microscope. Although the symptoms of Long COVID are multifarious, we here argue that the ability of these fibrin amyloid microclots (fibrinaloids) to block up capillaries, and thus to limit the passage of red blood cells and hence O2 exchange, can actually underpin the majority of these symptoms. Consistent with this, in a preliminary report, it has been shown that suitable and closely monitored ‘triple’ anticoagulant therapy that leads to the removal of the microclots also removes the other symptoms. Fibrin amyloid microclots represent a novel and potentially important target for both the understanding and treatment of Long COVID and related disorders.

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Section: Amyloid Fibrin Microclots (Fibrinaloids) In Covid-19 and Lon...mentioning

confidence: 93%

A central role for amyloid fibrin microclots in long COVID/PASC: origins and therapeutic implications

Kell

Laubscher

Pretorius

2022

Biochemical Journal

157

212

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“…Ground glass opacity (GGO) in CT images is considered to be a sign of COVID-19, and GGO in CT images takes on a fuzzy appearance, with opaque cerebral lesions being either uni-partite, bilateral, cortical, or distributed invasive lesions. The immediate diagnosis of COVID-19 was initially pivotal in controlling the spread of disease [ 8 ]. Manual assessment and analysis of CT scans by expert radiologists are time-consuming procedures while the severity and spreading rate demand automatic segmentation and detection in a fast pace environment [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Automatic COVID-19 Lung Infection Segmentation through Modified Unet Model

Shamim

Awan

Zain

et al. 2022

Journal of Healthcare Engineering

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The coronavirus (COVID-19) pandemic has had a terrible impact on human lives globally, with far-reaching consequences for the health and well-being of many people around the world. Statistically, 305.9 million people worldwide tested positive for COVID-19, and 5.48 million people died due to COVID-19 up to 10 January 2022. CT scans can be used as an alternative to time-consuming RT-PCR testing for COVID-19. This research work proposes a segmentation approach to identifying ground glass opacity or ROI in CT images developed by coronavirus, with a modified structure of the Unet model having been used to classify the region of interest at the pixel level. The problem with segmentation is that the GGO often appears indistinguishable from a healthy lung in the initial stages of COVID-19, and so, to cope with this, the increased set of weights in contracting and expanding the Unet path and an improved convolutional module is added in order to establish the connection between the encoder and decoder pipeline. This has a major capacity to segment the GGO in the case of COVID-19, with the proposed model being referred to as “convUnet.” The experiment was performed on the Medseg1 dataset, and the addition of a set of weights at each layer of the model and modification in the connected module in Unet led to an improvement in overall segmentation results. The quantitative results obtained using accuracy, recall, precision, dice-coefficient, F1score, and IOU were 93.29%, 93.01%, 93.67%, 92.46%, 93.34%, 86.96%, respectively, which is better than that obtained using Unet and other state-of-the-art models. Therefore, this segmentation approach proved to be more accurate, fast, and reliable in helping doctors to diagnose COVID-19 quickly and efficiently.

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“…Takip sürecinde klinik ve radyolojik iyileşme beklenenden uzun sürebilmektedir, klinik iyileşme sağlansa dahi toraks BT'de rezidü buzlu cam dansiteleri ve subplevral bantlar görülebilir (25). COVİD-19 pnömonisinde görüntüleme bulguları görece spesifik olmadığından BT'de görülen bulgular, viral/atipik pnömoniler gibi diğer enfeksiyonlar, hemorajiler, akciğer ödemi, interstisyel akciğer hastalığı alevlenmesi gibi alveolar patolojilerle karışabilir (26,27). Bu durumda hastanın öyküsü ve ek BT bulguları ayırıcı tanıya yardımcı olur.…”

Section: öZunclassified

COVİD-19 Pandemisinde Radyolojik Değerlendirme

Batur

Düzgün

Erbil

et al. 2021

Anatolian Journal of Emergency Medicine

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Since the beginning of the COVID-19 pandemic, there have been differences in the use of imaging methods due to variables such as the difficulty of accessing health services, the planning made for the efficient use of resources, the significant increase in the number of admissions, high rates of contagiousness, cost, and duration of decontamination. Especially at the beginning of the COVID-19 pandemic, the American Society of Radiology (ACR) declared in its statement that the decontamination process, especially after the application of computed tomography, would cause disruptions in the delivery of radiological services, increase the risk of cross-infection and the possibility of transmission. For this reason, in the first months of the Pandemic, ACR recommended that COVID-19 patients be evaluated with portable direct chest radiographs. However, in the following period, the frequency of use of thorax CT increased due to its high sensitivity in diagnosis.Typical findings of COVID-19 pneumonia are subpleural groundglass densities, a "cobblestone" sign caused by intra/interlobular septal thickenings superposed to ground glass densities, and consolidations, predominantly in the basal and posterior segments. In addition, air bronchograms and signs of vascular enlargement may accompany. These findings can be evaluated by X-ray, ultrasonography, and computed tomography.As a result, imaging methods used in the management of COVID-19 pneumonia differed due to variables such as service delivery conditions, number of patients, cost, technical competence, and patient management plans. Currently, there is no imaging method that leads to a definitive diagnosis for COVID-19 cases. Available imaging methods will vary according to the characteristics of the institution and the patients. It would be appropriate to choose imaging methods suitable for these variables.

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Ground-glass opacity (GGO): a review of the differential diagnosis in the era of COVID-19

Cited by 54 publications

References 97 publications

A central role for amyloid fibrin microclots in long COVID/PASC: origins and therapeutic implications

A central role for amyloid fibrin microclots in long COVID/PASC: origins and therapeutic implications

Automatic COVID-19 Lung Infection Segmentation through Modified Unet Model

COVİD-19 Pandemisinde Radyolojik Değerlendirme

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