The Role of Repeat Chest CT Scan in the COVID-19 Pandemic

Mahdavi, Ali; Haseli, Sara; Mahdavi, Arash; Bakhshayeshkaram, Mehrdad; Foroumandi, Morteza; Nekooghadam, Sayyed Mojtaba; Raoufi, Masoomeh; Taheri, Morteza Sanei

doi:10.1016/j.acra.2020.04.031

Cited by 16 publications

(11 citation statements)

References 9 publications

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“…These recommendations are echoed by the World Health Organization (WHO) consensus guidelines, which recommend the use of reverse-transcription polymerase chain reaction (RT-PCR) over chest imaging for the diagnosis of COVID-19 [12]. Local Iranian practices reiterate this sentiment, advocating the use of repeat chest CT in high-risk hospitalized patients to assess treatment response and to address clinical conundrums [13]. When obtained, common findings on chest CT range from normal to peripheral ground-glass opacities to more diffuse parenchymal opacities [14].…”

Section: Introductionmentioning

confidence: 99%

Clinical and imaging features predict mortality in COVID-19 infection in Iran

et al. 2020

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The new coronavirus disease 2019 (COVID-19) pandemic has challenged many healthcare systems around the world. While most of the current understanding of the clinical features of COVID-19 is derived from Chinese studies, there is a relative paucity of reports from the remaining global health community. In this study, we analyze the clinical and radiologic factors that correlate with mortality odds in COVID-19 positive patients from a tertiary care center in Tehran, Iran. A retrospective cohort study of 90 patients with reverse transcriptasepolymerase chain reaction (RT-PCR) positive COVID-19 infection was conducted, analyzing demographics, co-morbidities, presenting symptoms, vital signs, laboratory values, chest radiograph findings, and chest CT features based on mortality. Chest radiograph was assessed using the Radiographic Assessment of Lung Edema (RALE) scoring system. Chest CTs were assessed according to the opacification pattern, distribution, and standardized severity score. Initial and follow-up Chest CTs were compared if available. Multiple logistic regression was used to generate a prediction model for mortality. The 90 patients included 59 men and 31 women (59.4 ± 16.6 years), including 21 deceased and 69 surviving patients. Among clinical features, advanced age (p = 0.02), low oxygenation saturation (p<0.001), leukocytosis (p = 0.02), low lymphocyte fraction (p = 0.03), and low platelet count (p = 0.048) were associated with increased mortality. High RALE score on initial chest radiograph (p = 0.002), presence of pleural effusions on initial CT chest (p = 0.005), development of pleural effusions on follow-up CT chest (p = 0.04), and worsening lung severity score on follow-up CT Chest (p = 0.03) were associated with mortality. A two-factor logistic model using patient age and oxygen saturation was created, which demonstrates 89% accuracy and area under the ROC curve of 0.86 (p<0.0001). Specific demographic, clinical, and imaging features are associated with increased mortality in COVID-19 infections. Attention to these features can help optimize patient management.

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Section: Introductionmentioning

confidence: 99%

Clinical and imaging features predict mortality in COVID-19 infection in Iran

et al. 2020

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“…Therefore, PCR analysis during hospitalization before brain death may be necessary for harvesting of allograft bone from brain-death donor. In contrast, previous studies reported that COVID-19 infection was observed in trauma patients (Mahdavi et al 2020 ; Khazaei et al 2020 ). Donor assessment when considering harvesting from cardiac-death donors will need to be performed rapidly, and will require rapid and exact detection tools in order to prevent infection of coordinators and medical staff.…”

Section: The Aftermath Of a Pandemic In Tissue Bankingmentioning

confidence: 75%

Management of regional bone bank during declaration of a state of emergency concerning the COVID-19 in Japan

et al. 2021

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Bone banks are necessary for providing biological allografts for a series of orthopedic procedures. As nations cope with new realities driven by the 2019 coronavirus disease (COVID-19) pandemic, health-care providers, institutions, and patients share a particular concern about the effect of COVID-19 on organ donation and transplantation. Here, we describe the management of the Kitasato University Bone Bank during the state of emergency declared in response to COVID-19. Living donors received pre-operative screening by PCR, and allograft bone from COVID-19-negative donors was cryopreserved as transplantable tissues. The weekly rate of infection gradually increased from February 2–9 to April 5–11 in the dead donor-derived allograft bone-harvesting region covered by the Bank. It is becoming clear that the virus can be transmitted by asymptomatic patients, and that this route may have facilitated the spread of COVID-19. Therefore, the Bank stopped dead donor donation to consider the safety of medical staff. Three recipients received bone allografts following pre-operative COVID-19 screening by PCR. All patients were asymptomatic after bone allograft. Our experience may provide helpful information for the management of tissue banks.

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“…High resolution CT for chest is more sensitive than conventional chest x-ray which can show early abnormal changes in the lung. Hence HRCT became the main supporting modality for the (7) diagnosis of Covid-19 infection .…”

Section: Discussionmentioning

confidence: 99%

Radiological Evaluation and Correlation of Ct Severity Scoring With the Clinical Outcome in Rt-PCR Confirmed Covid-19 Infected Patients

Parthasarathy

Anand

2021

ijsr

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Background Radiological evaluation of the severity of lung inflammation in Covid-19 patients could provide an objective approach to rapidly identify the treatment modalities and to calculate the duration of hospitalization, need for intubation and ICU stay thereby analyzing and managing the clinical outcome of the patient. Purpose To identify the significant relationship between CT severity score and clinical outcome among RT-PCR confirmed Covid-19 infected patients Materials and Methods Inclusion of 40 patients with COVID-19 confirmed by positive real-time reverse transcriptase polymerase chain reaction on throat swabs underwent High resolution chest CT (7 men and 33 women).The CT-SS was defined by summing up individual scores from 20 lung regions; scores of 0, 1, and 2 were respectively assigned for each region if parenchymal opacification involved 0%, less than 50%, or equal or more than 50% of each region (theoretical range of CT-SS from 0 to 40). The clinical and laboratory data were collected and analyzed. Results All patients (n=16) who underwent intubation died invariably. The lung findings in all patients who died consist of co-existence of Consolidation and ground glass opacities in periphery and central region of lungs. Age is a predominant determinant factor for the course and outcome of disease as 17 patients with a mean age of 62 died when compared to 23 patients alive with a mean age of 47. This implies that mortality has a direct relationship with age. Out of 19 patients who had a CT –Severity score of >19 (Severe), 17 were shifted to ICU and 15 patients died. Only 4 patients recovered. Out of 5 patients whose CT-SS score were < 19, 5 patients were shifted to ICU and 2 cases died. 95 % of Covid-19 positive patients had Fever as their predominant complaint. The results are statistically significant with a p value of <0.01 and specificity of 82.6% and sensitivity of 88.2% Conclusion Along with RT-PCR, CT severity scoring is invariably a valuable modality for the management and planning of treatment for the patients by predicting the prognosis. Summary The chest CT severity score could be used to rapidly identify patients with severe forms of COVID-19 and clearly impacts the outcome of the patients.

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The Role of Repeat Chest CT Scan in the COVID-19 Pandemic

Cited by 16 publications

References 9 publications

Clinical and imaging features predict mortality in COVID-19 infection in Iran

Clinical and imaging features predict mortality in COVID-19 infection in Iran

Management of regional bone bank during declaration of a state of emergency concerning the COVID-19 in Japan

Radiological Evaluation and Correlation of Ct Severity Scoring With the Clinical Outcome in Rt-PCR Confirmed Covid-19 Infected Patients

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