Findings In Coronavirus Disease 2019 Patients Research Articles

Endoscopic Findings in Patients Infected With 2019 Novel Coronavirus in Lombardy, Italy

Coronavirus disease 2019 (COVID-19) is a major worldwide threat caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), rapidly spreading to a global pandemic. As of May 11, 2020, 4,176,346 cases have been reported worldwide, 219,814 in Italy, and of them, 81,871 occurred in the Lombardy region.1 Although the respiratory manifestations of COVID-19 have been widely described, the impact on the gastrointestinal (GI) system remains less clear. The reported prevalence of digestive symptoms ranges from 3% to 79%, depending on the setting,2-5 but data on GI endoscopic and histologic findings in COVID-19 patients are lacking. Therefore, the aim of this study is to describe the GI endoscopic and histologic findings in COVID-19 patients.

Coronavirus disease 2019(COVID-19) imaging reporting and data system (COVID-RADS) and common lexicon: a proposal based on the imaging data of 37 studies.

BackgroundIn the vast majority of the laboratory-confirmed coronavirus disease 2019 (COVID-19) patients, computed tomography (CT) examinations yield a typical pattern and the sensitivity of this modality has been reported to be 97% in a large-scale study. Structured reporting systems simplify the interpretation and reporting of imaging examinations, serve as a framework for consistent generation of recommendations, and improve the quality of patient care.PurposeTo compose a comprehensive lexicon for description of the imaging findings and propose a grading system and structured reporting format for CT findings in COVID-19.Material and methodsWe updated our published systematic review on imaging findings in COVID-19 to include 37 published studies pertaining to diagnostic features of COVID-19 in chest CT. Using the reported imaging findings of 3647 patients, we summarized the typical chest CT findings, atypical features, and temporal changes of COVID-19 in chest CT. Subsequently, we extracted a list of descriptive terms and mapped it to the terminology that is commonly used in imaging literature.ResultsWe composed a comprehensive lexicon that can be used for documentation and reporting of typical and atypical CT imaging findings in COVID-19 patients. Using the same data, we propose a grading system with five COVID-RADS categories. Each COVID-RADS grade corresponds to a low, moderate, or high level of suspicion for pulmonary involvement of COVID-19.ConclusionThe proposed COVID-RADS and common lexicon would improve the communication of findings to other healthcare providers, thus facilitating the diagnosis and management of COVID-19 patients.Key Points• Chest CT has high sensitivity in diagnosing the coronavirus disease 2019 (COVID-19).• Structured reporting systems simplify the interpretation and reporting of imaging examinations, serve as a framework for consistent generation of recommendations, and improve the quality of patient care.• The proposed COVID-RADS and common lexicon would improve the communication of findings to other healthcare providers, thus facilitating the diagnosis and management of COVID-19 patients.

Salivary Glands, Saliva and Oral Findings in COVID-19 Infection

The world is under the threat of the novel coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite several efforts to contain the disease spread, it still constitutes a public health emergency of international concern. Several published reports in the scientific literature called attention of the oral cavity as the potential route of infection, the implications for dental practice and the use of saliva in the diagnose of the COVID-19. The aim of this article is to provide an overview of the literature on the salivary glands and saliva in the context of SARS-CoV-2 infection. A brief discussion of taste disturbances and oral findings in COVID-19 patients is also presented. The literature shows that SARS-CoV-2 could infect the salivary glands. It is not possible, however, to make speculations regarding them as reservoirs for the SARS-CoV-2. In addition, patients with COVID-19 presented several oral repercussions, including hyposalivation and taste disturbances. A few reports showed oral ulcers and blisters associated with SARS-CoV-2 infection. However, it remains not fully understood and might lead to erroneous assumptions. Overall, further studies are necessary to understand the real role of salivary glands and saliva in the context of SARS-CoV-2 infection.

Utility of lung ultrasound in the management of COVID-19 respiratory infection

In the context of the coronavirus disease 2019 (COVID-19) pandemic, lung ultrasound has emerged as an accurate and reliable alternative for assessment of lung pathology. The main lung ultrasound findings in COVID-19 patients are interstitial syndrome, irregular and broken aspect of the pleural line, and sub-pleural consolidation. Consolidations are usually a late finding appearing during the second week since symptoms onset. Translating into the practice, lung ultrasound can improve diagnostic accuracy and contribute with relevant information to the triage of these patients. It can be used as part of the routinely assessment of patients admitted to the medical ward allowing early identification of disease progression. Among patients mechanically ventilated, it is useful evaluating response to prone position and/or recruiting maneuvers. Finally, in all the previous scenarios, lung ultrasound may also detect common complications seen in these patients such as cardiogenic pulmonary edema and pulmonary embolism. In this review, we have summarized the information available and suggest simple algorithm to incorporate lung ultrasound into the assessment of COVID-19 patients.