Findings In COVID-19 Patients Research Articles

Mortality Predictors using Chest Computed Tomography Findings in COVID-19 Patients

Mortality Predictors using Chest Computed Tomography Findings in COVID-19 Patients

Cardiac Muscle Injury and Echocardiographic Plus Electrocardiographic Findings in Patients With 2019 Novel Coronavirus (COVID-19): A Retrospective Cohort Study

BackgroundMyocardial injury has been described in coronavirus-2019 (COVID-19). Few studies have reported cardiovascular imaging data with transthoracic echocardiography (TTE) and electrocardiography (ECG) findings in COVID-19 patients, and their correlation with mortality. MethodsWe conducted a retrospective cohort study that included COVID-19 patients from March 2020 through February 2021 who had TTE and ECG during hospital admission. Myocardial injury was defined by an elevated high-sensitivity troponin T level > 20 ng/L. Bivariate analysis was used to compare patients with myocardial injury and those without. Multivariate logistic regression analysis was performed to identify the variables associated with mortality. ResultsA total of 438 patients were included. The mean age was 62.1 ± 14.9 years, and 58.9% were male. A total of 149 patients died, with a mortality rate of 34%. A total of 260 patients (59.4%) had myocardial injury. The average left ventricular ejection fraction was 59.8% ± 11.2%, with 30 patients (6.8%) having an ejection fraction of < 40%. Patients with myocardial injury had higher mortality than those without (P < 0.05, χ2 test). A multiple regression analysis model indicated that age, race and/or ethnicity, the development of acute respiratory distress syndrome, shock, the need for vasopressors, mechanical ventilation, and hemodialysis were the variables significantly associated with mortality. ConclusionCOVID-19 patients with myocardial injury had higher mortality than those without. Age, race and/or ethnicity, acute respiratory distress syndrome, shock, the need for vasopressors, mechanical ventilation, and hemodialysis were the clinical variables associated with mortality. The TEE and ECG variables studied were not significantly associated with mortality.

A Retrospective Cohort Study Characteristics of Chest X-Ray Findings in COVID-19 Patients that Presented to a Tertiary Care Facility in Dubai: Can a Severe Radiological Appearance Predict Clinical Outcome?

Aim: We aimed to describe the most prominent features of COVID-19 on the chest X-ray (CXR) and to classify them using the radiographic assessment of lung edema (RALE) score. Furthermore, we aimed to correlate the RALE scores with clinically significant outcomes namely intensive care unit (ICU) admission and intubation from the emergency versus during hospital stay. In-hospital, death was studied as a secondary endpoint for severe RALE score. Materials and Methods: A retrospective cohort study was conducted on patients presenting to the emergency department (ED) of a tertiary hospital between the periods of March 2020 to August 2020. Included patients were symptomatic, COVID-19 positive by nasopharyngeal real-time polymerase chain reaction (RT-PCR), who also performed an initial CXR in the ED. Two experienced radiologists interpreted the CXRs and categorized them using RALE score into normal mild, moderate, and severe for further correlation with clinical endpoints. Results: From the 404 CXRs, most were categorized as mild and characteristically CXRs had bilateral lower and mid-zone ground-glass opacities. The frequency of intubation and ICU admission increased as the RALE score worsened with a statistically significant p value of <0.001. Severe CXR required earlier intervention and was found to have the highest proportion of mortality. Discussion: The RALE score has shown to be a highly reliable indicator for worse outcome in patients with acute respiratory distress syndrome. While RT-PCR has variable sensitivities, CXR has demonstrated to have characteristic findings and higher RALE scores having a significant correlation for intubation and ICU admission in this research. Conclusion: The prognostic utility of CXR in COVID-19 has been found to be of statistical significance for intubation and ICU admission. CXR is a simple, portable, and easy-to-disinfect method of evaluation that can be invaluable in determining timely intervention and disposition of patients expecting deterioration.

Computed Tomography Chest Findings in COVID-19 Patients.

COVID-19 which has caused significant morbidity and mortality around the world has been declared by the World Health Organization to be a global health emergency. Our objective was to find out the lung parenchymal patterns commonly evident in high resolution Computed Tomography in patients with COVID-19 pneumonia. A retrospective cross-sectional study was conducted at a tertiary multi-specialty hospital in Kathmandu, Nepal. With ethical clearance from the institutional review board, a total of 235 patients with positive reverse transcriptase polymerase chain reaction for COVID-19 and having respiratory symptoms were included in the study. High Resolution Computed Tomography images of chest were retrieved from picture archiving and communication systems retrospectively and studied for the findings commonly attributed to COVID-19 pneumonia. The data was then analyzed using Stata version 14 (Stata Corp, College Station, TX, USA). Descriptive statistics were presented as mean and median while chi-square test was used to assess the association between socio-demographic characteristics and CT severity indices. Out of 235 patients, 174 (74.0%) were males and 61(26%) were females with a mean age of 54.8±14.5 years. The most commonly encountered pattern of pulmonary changes was bilateral involvement in 222 (94.5%) patients followed by ground-glass opacities in 218 (92.8%) patients and peripheral predominance of ground-glass opacities in 211 (89.8%) patients. Chest Computed Tomography abnormalities are common in COVID-19 positive patients with respiratory symptoms. These findings can guide in the assessment of the severity of the disease as well as patient management.

The impact of COVID-19 on open access publishing in radiology and nuclear medicine: an in-depth analysis.

In response to the COVID-19 pandemic, numerous initiatives have been implemented to ensure open access availability of COVID-19-related articles to make published articles accessible for anyone. This study aimed to assess the impact of the COVID-19 pandemic on open-access publishing in radiology and nuclear medicine. We conducted a comprehensive analysis of articles and reviews published in these fields during the COVID-19 publishing era using the Web of Science database. We analyzed several indicators between COVID-19 and non-COVID-19 related articles, including the number and percentage of open-access articles, the top ten cited articles, and the number of reviews. In total, 67,100 articles were published in radiology and nuclear medicine between January 2020 and June 2022. Among those, more than half (51.1%) were open-access articles. Among these publications, 2,336 were COVID-19-related, and 64,764 were non-COVID-19-related. However, articles related to COVID-19 had an open access rate of 91.5%, compared to only 49.6% of the non-COVID-19-related articles. Moreover, COVID-19-related articles had a higher percentage of highly cited and hot papers compared to articles not related to COVID-19. Moreover, most highly cited studies were related to chest computerized tomography (CT) scan findings in COVID-19 patients. The findings emphasize the significant proportion of open access COVID-19-related publications in radiology and nuclear medicine, facilitating widespread and timely access to everyone.

Tissue Inhibitor of Matrix Metalloproteinases-1 (TIMP-1) and Pulmonary Involvement in COVID-19 Pneumonia.

Background: The aim of the study was to longitudinally evaluate the association between MMP-2, MMP-9, TIMP-1 and chest radiological findings in COVID-19 patients. Methods: COVID-19 patients were evaluated based on their hospital admission (baseline) and three months after hospital discharge (T post) and were stratified into ARDS and non-ARDS groups. As a control group, healthy donors (HD) were enrolled. Results: At the baseline, compared to HD (n = 53), COVID-19 patients (n = 129) showed higher plasma levels of MMP-9 (p < 0.0001) and TIMP-1 (p < 0.0001) and the higher plasma activity of MMP-2 (p < 0.0001) and MMP-9 (p < 0.0001). In the ARDS group, higher plasma levels of MMP-9 (p = 0.0339) and TIMP-1 (p = 0.0044) and the plasma activity of MMP-2 (p = 0.0258) and MMP-9 (p = 0.0021) compared to non-ARDS was observed. A positive correlation between the plasma levels of TIMP-1 and chest computed tomography (CT) score (ρ = 0.2302, p = 0.0160) was observed. At the T post, a reduction in plasma levels of TIMP-1 (p < 0.0001), whereas an increase in the plasma levels of MMP-9 was observed (p = 0.0088). Conclusions: The positive correlation between TIMP-1 with chest CT scores highlights its potential use as a marker of fibrotic burden. At T post, the increase in plasma levels of MMP-9 and the reduction in plasma levels of TIMP-1 suggested that inflammation and fibrosis resolution were still ongoing.

Comparison of Chest CT Findings between COVID-19 Pneumonia and Influenza Pneumonia

Introduction: With increasing global concerns about the prevalence of COVID-19, chest imaging findings are essential for effective diseases diagnosis and treatment. There is a need to distinguish between imaging features of COVID-19 pmeumonia and other viral pneumonia like Influenza.For this purpose, a study was performed on a comparison of chest CT findings between COVID-19 pneumonia and Influenza pneumonia. Methods: Fifty patients with respiratory symptoms and positive real-time PCR (RT-PCR) of nasopharyngeal swab for Influenza and fifty patients with respiratory symptoms and positive real-time PCR (RT-PCR) of nasopharyngeal swabfor COVID-19 from March to May 2020 were enrolled in the study. In the patient’s checklist, information such as demographic characteristics (age, sex), laboratory findings including (CRP, ESR, WBC), and clinical signs (fever, cough, fatigue, dyspnea) were also recorded. Results: Gastrointestinal symptoms, anorexia, high CRP, ground-glass opacityare more common in patients with COVID-19 pneumonia than in patients with influenza pneumonia and this difference was statistically significant (P &lt;0.05). But, fever is more common in influenza patients than in Covid-19 patients and this difference is statistically significant (P=0.029). The location of CT scan findings in COVID-19 patients was dominant in peripheral (54 %), while the location of CT scan findings in patients with Influenza was dominant in central (32 %), which is statistically significant (P &lt;0.05). Conclusion: According to the results of the study, lung CTscan findings along with some clinical and laboratory findings can help differentiate COVID-19 pneumonia from influenza pneumonia, which is very important in faster diagnosis and timely treatment of both diseases.

Clinical Laboratory and Radiological Findings in COVID-19 Patients with Variable Severity: King Fahad Medical City Experience

Clinical Laboratory and Radiological Findings in COVID-19 Patients with Variable Severity: King Fahad Medical City Experience

Association of Clinical and Laboratory Findings in COVID-19 Patients with Thromboembolic Complications

Background: COVID-19 is associated with dangerous thromboembolic complications, such as stroke, heart attack, pulmonary embolism, and arterial and venous thromboembolism (VTE). Early diagnosis and even prediction of thromboembolic complications using biomarkers could facilitate the treatment and decrease the mortality rate. Objectives: This study evaluated and compared the clinical and laboratory findings of COVID-19 patients with thrombotic events with other COVID-19 patients. Methods: A total of 114 confirmed COVID-19 patients referred to Taleghani Hospital, Tehran, Iran, between February and September 2020 were included in this cross-sectional study. Those with a history of thromboembolic disease were excluded. The laboratory data, including the levels of lactate dehydrogenase (LDH), D-dimer, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and counts of lymphocyte and neutrophil, along with clinical findings (such as oxygen saturation and lung involvement percentage), were retrospectively collected from the patients’ clinical files. The incidence of thrombotic events was evaluated in patients. Results: The prevalence of thrombosis in the right and left main pulmonary arteries, right and left sub-segmental pulmonary arteries, and right and left deep veins was 2.7%, 3.5%, 7%, 7.9%, 4.4%, and 1.8% of all patients, respectively. The results showed that thromboembolic complications were significantly associated with mortality (P &lt; 0.001). Besides, it was found that LDH (P &lt; 0.001) and neutrophil (P = 0.002) levels in thromboembolic COVID-19 patients were respectively higher and lower than those without thromboembolic manifestations. Conclusions: High LDH and neutropenia might serve as biomarkers for thromboembolism in COVID-19 patients.

RADIOLOGICAL FEATURES OF TYPICAL AND ATYPICAL COVID-19 INFECTION

Background:This study describes thecommon radiological findings in COVID-19 patients and defines the typical and atypical findings seen on chest radiography and computed tomography (CT) in these patients. Methods:A cross-sectional study of 385 patients diagnosed with COVID-19, aged 18 years or over who presented to King Abdullah University Hospital. Patients with incomplete data were excluded. Data were collected from electronic patient records and analyzed using IBM SPSS Statistics. Statistical significance was set at P &lt;0.05. Results:The age group with most patients was 31 to 50 years old. The most common COVID-19 symptoms were fever and cough. The most frequent distribution of findings on chest X-rays was peripheral predominant, and the most frequently involved is the left lower zone. The study showed a high prevalence of the typical appearance of COVID-19 on CT scans. Conclusion:Chest X-rays and CT are vital tools for early diagnosis and management of COVID-19, as patients frequently show typical imaging findings on CT and chest X-rays.

Serum D-Dimer Level and Chest CT Scoring in SARS-Cov-2 Virus Patients - It’s Relevance in Prognostication and Severity of the Disease

Background: COVID -19 has wide range of presentation, from asymptomatic infection to severe viral pneumonia and death. D-dimer &gt;1μg/ml is one of the risk factors for mortality. CT chest plays an important role in early detection and monitoring of disease. Objectives: 1. To compare D-dimer value and CT chest findings in Covid-19 patients. 2. To study platelet count, PT, aPTT and CRP in Covid-19 patients. Methodology: RT-PCR confirmed Covid- 19 patients admitted in hospital investigated with D-dimer and CT chest were included in the study. Case details retrieved from medical records. Venous blood collected and plasma processed in coagulation analyser for PT, aPTT, INR and D-dimer. Platelet count was performed using auto analyser. CT findings were retrieved from radiology software (PACS). Statistical tests used were mean, percentage and Fisher’s exact test (SPSS Version 20). Results: During study period of January-June 2021, 38 patients were included. Mean age was 51.1±15.6 years and M:F ratio 2.8:1. 65.8% patients had comorbidities (25/38). D-dimer elevated in 60.5% (23/38) patients. CT showed 10.53%, 28.94%, 60.53% of patients had affected lungs of &lt;15%, 15%-49% and ≥50% of the total area and showed significant association with D- dimer (P=0.018). 17.4% (4/23) patients with elevated D-dimer did not survive. 15.8% (6/38) patients had low platelet, 23.7% (9/38) had abnormal PT, 70.3% had abnormal aPTT and 89.5% (34/38) had elevated CRP. There was no significant correlation between platelet, PT, aPTT, CRP and D-dimer. Conclusion: D-Dimer is elevated in COVID -19 patients and shows significant association with lung involvement and can be used as prognostic marker.

The Spectrum of Pulmonary Histomorphology Changes in COVID-19 Cases

Abstract Introduction/Objective Pulmonary specimens following COVID-19 virus infection demonstrate a spectrum of pulmonary histomorphology. Six patients with a history of COVID-19 infection are summarized in this review. The purpose of our study is to elucidate any possible correlations between clinical, laboratory, radiographic, and pathologic findings in COVID-19 patients. Further, we aim to characterize both non-specific and specific histomorphology and cytomorphology in COVID-19 patients. Methods/Case Report Six patients with known COVID-19 infection and lung biopsies/resections are identified. A chart review is performed to collect clinical histories, the results of COVID-19 PCR testing, radiographic impressions, pathologic interpretations of histology, and clinical outcomes. Information is summarized and tabulated. Results (if a Case Study enter NA) The most common, non-specific histological findings are focal/diffuse acute lung injury, organizing lung injury, or a combination of both patterns. Unique features of COVID-19 infection are identified in three cases, which illustrate viral cytopathic changes within hyperplastic pneumocytes. These include basophilic, vacuolated, granular cytoplasm and variably sized cytoplasmic/nuclear inclusions. Virus-loaded pneumocytes are typically identified in the organizing phase, and rarely in the acute lung injury phase. Immunohistochemical staining of anti-nuclear capsule antibody with appropriate controls shows focal positive staining in one case. SARS-CoV-2 PCR is positive in formalin-fixed paraffin-embedded (FFPE) tissue, while a serum PCR assay is negative. Conclusion The severity of clinical symptoms and clinical outcome are unrelated to the degree of lung involvement. Viral cytopathic changes are identified in three cases, with these specific findings associated with the organizing phase of lung injury, and either concurrent PCR positivity or positive immunohistochemical staining.

NOX2 and NOX5 are increased in cardiac microvascular endothelium of deceased COVID-19 patients

BackgroundCardiac injury and inflammation are common findings in COVID-19 patients. Autopsy studies have revealed cardiac microvascular endothelial damage and thrombosis in COVID-19 patients, indicative of microvascular dysfunction in which reactive oxygen species (ROS) may play a role. We explored whether the ROS producing proteins NOX2, NOX4 and NOX5 are involved in COVID-19-induced cardio-microvascular endothelial dysfunction. MethodsHeart tissue were taken from the left (LV) and right (RV) ventricle of COVID-19 patients (n = 15) and the LV of controls (n = 14) at autopsy. The NOX2-, NOX4-, NOX5- and Nitrotyrosine (NT)-positive intramyocardial blood vessels fractions were quantitatively analyzed using immunohistochemistry. ResultsThe LV NOX2+, NOX5+ and NT+ blood vessels fractions in COVID-19 patients were significantly higher than in controls. The fraction of NOX4+ blood vessels in COVID-19 patients was comparable with controls. In COVID-19 patients, the fractions of NOX2+, NOX5+ and NT+ vessels did not differ significantly between the LV and RV, and correlated positively between LV and RV in case of NOX5 (r = 0.710; p = 0.006). A negative correlation between NOX5 and NOX2 (r = −0.591; p = 0.029) and between NOX5 and disease time (r = −0.576; p = 0.034) was noted in the LV of COVID-19 patients. ConclusionWe show the induction of NOX2 and NOX5 in the cardiac microvascular endothelium in COVID-19 patients, which may contribute to the previously observed cardio-microvascular dysfunction in COVID-19 patients. The exact roles of these NOXes in pathogenesis of COVID-19 however remain to be elucidated.

Spectrum of computed tomography (Ct)-brain findings in Covid-19 patients with CNS manifestations

Background: Infection with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-COV-2) results in Corona Virus Disease 2019 (COVID -19) predominantly it affects respiratory system; however it has become apparent that many other organ systems including central nervous system can also be involved. Imaging plays an essential role in diagnosis of all manifestations of the disease and its complications. Objective: To study the spectrum of neuro-imaging findings on CT in COVID-19 patients with CNS symptoms. Material and Methods: Non-contrast CT scan of brain was done in 80 patients of either gender having COVID-19, confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) with CNS manifestations. Images were assessed for presence of abnormal findings like Infarcts, hemorrhage, venous/arterial thrombosis, leukoencephalopathy, white matter disease, hypoxic ischemic injury, encephalitis and posterior reverse encephalopathy syndrome. Results: A total of 80 patients with COVID-19 were reviewed, out of which CT was abnormal in 35 patients (43.7%). findings included various types of infarcts, intra and extra axial haemorrhages, Diffuse axonal injury and PRES (Posterior Reversible Encephalopathy Syndrome). Our study demonstrated that the neurological imaging of patients with COVID-19 were variable without a specific pattern but is dominated by ischemic infarcts and intracranial haemorrhages. Conclusion: C0VID-19 is a serious public health crisis and can have neurological manifestations, therefore these patients should be evaluated early for neurological symptoms as timely analysis and management of neurological complications are key to improving the prognosis.

161 Multicenter Interobserver Agreement of Lung Ultrasound Findings in COVID-19 Patients

161 Multicenter Interobserver Agreement of Lung Ultrasound Findings in COVID-19 Patients

The Prevalence of Anemia and Hematological Findings in COVID-19 Patients in Saudi Arabia

The Prevalence of Anemia and Hematological Findings in COVID-19 Patients in Saudi Arabia

Common and uncommon audio-vestibular findings in COVID-19 patients

BackgroundCOVID-19 is the new version of the old coronavirus known since 1960, which caused the Middle East respiratory syndrome (MERS-CoV) in 2012 and the severe acute respiratory syndrome (SARS) in 2003.Symptoms included fever and cough, diarrhea and vomiting, and neurological symptoms like anosmia.MethodsOne hundred twenty-eight patients diagnosed as COVID-19 with audio-vestibular complaints were subjected to audio-vestibular assessment and were included in the study.ResultsIn our study on COVID-19 patients who reported audio-vestibular complaints, hearing loss was found in 43.8% of patients in comparison to vertigo that represented 40.6% of cases. The most common type was sensorineural hearing loss representing 29.7% of patients and which was unilateral and sudden in 35.7% of them. Less commonly conductive hearing loss (CHL) was found in 14.1% of cases the most common form was bilateral mild to moderate CHL (83.3%) due to bilateral middle ear effusion.Among cases with vertigo, the most common etiology was benign paroxysmal positional vertigo (BPPV) (42.5%) then uncompensated vestibular neuritis (VN) (31.5%), and lastly, combined BPPV with VN (25%) of cases. Less frequently we found tinnitus in (13.3%) which was bilateral in (64.7%), labyrinthitis (5.5%), and acute VN 5.5%).The significant increase in the number of audiovestibular complaining cases that were observed in the course of the recurrent waves’ peaks pushed us to study the relationship between the pandemic and the audiovestibular system. The effect of COVID on AV systems is well noticed and management would be mandatory.

WE-160. Electrodiagnostic findings in COVID-19 patients: A single-center experience

WE-160. Electrodiagnostic findings in COVID-19 patients: A single-center experience

Elevated D-dimer and Adverse In-hospital Outcomes in COVID-19 Patients and Synergism with Hyperglycemia.

AimOne of the most common laboratory findings in COVID-19 patients has been observed to be hypercoagulability with elevated D-dimer levels. An activation of thrombosis may be generated by hyperglycemia. We aimed to explore the association between D-dimer and in-hospital outcomes, and evaluate the synergistic effect between elevated D-dimer and hyperglycemia on COVID-19 prognosis.MethodsA retrospective cohort study was undertaken with 2467 COVID-19 inpatients. D-dimer and fasting blood glucose (FBG) on admission and adverse in-hospital outcomes (events of death and aggravated severity) were collected. Cox proportional risk model was performed to assess the association of D-dimer and adverse in-hospital outcomes, and the combined effects of D-dimer and FBG.ResultsAmong these COVID-19 patients, 1100 (44.6%) patients had high D-dimer (≥0.50 mg/L). Patients with high D-dimer were older, with higher FBG (≥7.00 mmol/L), and had significantly higher adjusted risk of adverse in-hospital outcomes when comparing with those who with D-dimer<0.50 mg/L (hazard ratio, 2.73; 95% confidence interval, 1.46–5.11). Moreover, patients with high FBG and D-dimer levels had an increasing risk (hazard ratio, 5.72; 95% confidence interval: 2.65–12.34) than those with normal FBG and D-dimer.ConclusionRisk of adverse in-hospital outcomes is higher among patients with high D-dimer levels. Additionally, this study found for the first time that elevated D-dimer and hyperglycemia had a synergistic effect on COVID-19 prognosis, and this risk was independent of diabetes history.

Correlation of CT severity grade with laboratory findings in COVID-19 patients

Correlation of CT severity grade with laboratory findings in COVID-19 patients