Mediastinal lymphadenopathy in patients with severe COVID-19

Valette, Xavier; Cheyron, Damien du; Goursaud, Suzanne

doi:10.1016/s1473-3099(20)30310-8

Cited by 49 publications

(43 citation statements)

References 5 publications

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“…This may suggest that lymphadenopathy could be an independent imaging biomarker of the disease, similar to what demonstrated for other infections (Chadburn et al 1989). Indeed, based on limited data, lymphadenopathy has been suggested as a prognostic marker of COVID-19 infection severity (Valette et al 2020) and a predictor of a worse outcome (Sardanelli et al 2020). In view of the grave clinical outcome of our patient, there may be an argument in support of a further prognostic role of higher SUVmax values of FDG positive nodal disease, as a biomarker which could herald a more severe case of the infection with the virus.…”

Section: Discussionsupporting

confidence: 52%

A twisted tale-radiological imaging features of COVID-19 on 18F-FDG PET/CT

O’Neill

Doran

Fraioli

et al. 2020

European J Hybrid Imaging

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The COVID-19 pandemic has had a major impact on health care systems across the globe in a short period of time. There is a growing body of evidence surrounding the findings on hybrid imaging with FDG-PET/CT, and this case highlights the importance of molecular imaging in better understanding of the biomarkers of the disease which ultimately determine the success in building a model to predict the disease severity and monitoring the response to treatment.

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Section: Discussionsupporting

confidence: 52%

A twisted tale-radiological imaging features of COVID-19 on 18F-FDG PET/CT

O’Neill

Doran

Fraioli

et al. 2020

European J Hybrid Imaging

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“…A large proportion of patients with COVID-19 were found to have enlarged intrathoracic lymph nodes, which is in distinction to the initial report from China suggesting only 6% incidence of lymph node enlargement in hospitalised patients. 41 Recent correspondence by French investigators 42 showed up to 66% incidence of lymph node enlargement in COVID-19 patients admitted to intensive care unit. This indicates controversy surrounding the issue of lymph node enlargement, which could be partly due to differences in study cohorts.…”

Section: Discussionmentioning

confidence: 99%

Extent of pulmonary thromboembolic disease in patients with COVID-19 on CT: relationship with pulmonary parenchymal disease

et al. 2020

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AIM To report the severity and extent of pulmonary thromboembolic disease (PTD) in COVID-19 patients undergoing computed tomography pulmonary angiography (CTPA) in a tertiary centre. MATERIALS AND METHODS This is a retrospective analysis of COVID-19 patients undergoing CTPA over a period of 27 days. The presence, extent, and severity of PTD were documented. Two observers scored the pattern and extent of lung parenchymal disease including potential fibrotic features, as well as lymph node enlargement and pleural effusions. Consensus was achieved via a third observer. Interobserver agreement was assessed using kappa statistics. Student's t -test, chi-squared, and Mann–Whitney U -tests were used to compare imaging features between PTD and non-PTD sub-groups. RESULTS During the study period, 100 patients with confirmed COVID-19 underwent CTPA imaging. Ninety-three studies were analysed, excluding indeterminate CTPA examinations. Overall incidence of PTD was 41/93 (44%) with 28/93 patients showing small vessel PTD (30%). D-dimer was elevated in 90/93 (96.8%) cases. A high Wells' score did not differentiate between PTD and non-PTD groups ( p= 0.801). The interobserver agreement was fair (kappa=0.659) for parenchymal patterns and excellent (kappa=0.816) for severity. Thirty-four of the 93 cases (36.6%) had lymph node enlargement; 29/34 (85.3%) showed no additional source of infection. Sixteen of the 93 (17.2%) cases had potential fibrotic features. CONCLUSION There is a high incidence of PTD in COVID-19 patients undergoing CTPA and lack of a risk stratification tool. The present data indicates a higher suspicion of PTD is needed in severe COVID-19 patients. The concomitant presence of possible fibrotic features on CT indicates the need for follow-up.

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“…(1) The thorax where the mediastinal lymphadenopathy if found with lymph node enlargement that can be potentially detected by CT imaging suggesting expression of the inflammatory response to the infection [46][47][48]. (2) In the gastrointestinal tract where distended fluidfilled small and large bowel loops and surrounding stranding are demonstrated on enhanced CT [30].…”

Section: Potentials Of Virtual Autopsy Findings In Extrapulmonary Manmentioning

confidence: 99%

Post-Mortem Investigation Through Virtual Autopsy Techniques: Proposal of a New Diagnostic Approach to Reduce the Risks of Operators During Emergencies

Malizia¹,

Filograna²,

Ryan³

et al. 2020

IJSSE

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Natural outbreaks of biological agents, causing local and global emergencies, have impacted human safety, social/political/economical activities, and the security of critical infrastructures. Lessons learned by previous emergencies have been used by decisionmakers not only to improve the phases of prevention, intervention, and recovery of normality but also to facilitate the dual-use of methods, instruments, and technologies. A crucial phase of emergency management is the investigation that in the past was based on questioning, suspicions, witnesses, and often unreliable evidence. Nowadays investigation is supported by technology and various types of forensics that are deeply involved. The authors in this paper consider the pandemic outbreak of SARS-COV-2 as a case study and propose virtual autopsy by postmortem CT (PMCT) as a technique to facilitate post-mortem examinations on ascertained or suspected SARS-COV-2 cases. This method reduces the risk of infection for the operators that have to conduct the particular investigations during the emergencies.

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Mediastinal lymphadenopathy in patients with severe COVID-19

Cited by 49 publications

References 5 publications

A twisted tale-radiological imaging features of COVID-19 on 18F-FDG PET/CT

A twisted tale-radiological imaging features of COVID-19 on 18F-FDG PET/CT

Extent of pulmonary thromboembolic disease in patients with COVID-19 on CT: relationship with pulmonary parenchymal disease

Post-Mortem Investigation Through Virtual Autopsy Techniques: Proposal of a New Diagnostic Approach to Reduce the Risks of Operators During Emergencies

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