Chest CT Findings Research Articles

Usefulness of laboratory parameters and chest CT in the early diagnosis of COVID-19.

ABSTRACTIn the present study, the importance of laboratory parameters and CT findings in the early diagnosis of COVID-19 was investigated. To this end, 245 patients admitted between April 1st, and May 30th, 2020 with suspected COVID-19 were enrolled. The patients were divided into three groups according to chest CT findings and RT-PCR results. The non-COVID-19 group consisted of 71 patients with negative RT-PCR results and no chest CT findings. Ninety-five patients with positive RT-PCR results and negativechest CT findings were included in the COVID-19 group; 79 patients with positive RT-PCR results and chest CT findings consistent with COVID-19 manifestations were included in COVID-19 pneumonia group. Chest CT findings were positive in 45% of all COVID-19 patients. Patients with positive chest CT findings had mild (n=30), moderate (n=21) andor severe (n=28) lung involvement. In the COVID-19 group, CRP levels and the percentage of monocytes increased significantly. As disease progressed from mild to severe, CRP, LDH and ferritin levels gradually increased. In the ROC analysis, the area under the curve corresponding to the percentage value of monocytes (AUC=0.887) had a very good accuracy in predicting COVID-19 cases. The multinomial logistic regression analysis showed that CRP, LYM and % MONO were independent factors for COVID-19. Furthermore, the chest CT evaluation is a relevant tool in patients with clinical suspicion of COVID-19 pneumonia and negative RT-PCR results. In addition to decreased lymphocyte count, the increased percentage of monocytes may also guide the diagnosis.

Significance of Chest Computed Tomography Scan Findings at Time of Diagnosis in Patients with COVID-19 Pneumonia

Background and objectives: Many published reports demonstrated the cardinal hallmark of COVID-19 infection, such as bilateral ground glass opacities (GGO) with or without consolidation in posterior and peripheral lungs fields. Various CT algorithms including CT scoring system were used to assess quantitively and qualitatively the severity of COVID-19 pneumonia. The aim of this study was to summarize the significance of certain radiological features in evaluating Covid-19 pneumonia severity in Iraqi patients. Materials and methods: This was a cross sectional study conducted in Erbil tertiary hospitals in Iraq from June 2020, until August 2020. Review of chest CT scan for 132 patients was done and the main chest CT manifestations of patients with COVID-19 infection was reported. Then, CT scoring system was implicated in a quantitative comparison with radiological findings observed in chest CT examinations of patients having different disease severity at time of diagnosis. Results: The mean age of study sample was 51.08 ±14.2 years. The typical CT findings were consistent with mainly GGOs (78.8%) followed by consolidation. Atypical CT patterns according to previous reports were also observed including tree in bud, crazy paving, bronchiectasis, round organizing pneumonia, pulmonary nodules, mediastinal lymphadenopathy, cavitation and pleural thickening. Lung involvement was significantly more in the lower lobes than upper lobes. CT severity score was significantly higher in the lower lobes as well. Chest CT severity score (CT-SS) was significantly higher in cases with most common pathological lung changes (p < 0.001) except for tree in bud, crazy paving and cavitation. Conclusion: CT-SS is an essential examination tool in the diagnosis, disease severity evaluation and lobar extension of COVID-19 infection. High CT-SS are significantly associated with certain chest CT findings like GGOs, consolidation, bronchiectasis and interlobular septa thickening which reflects the seriousness of such CT findings in COVID-19 at time of diagnosis.

The correlation between combined nasal and throat swab and chest CT findings in the diagnosis of COVID 19

The correlation between combined nasal and throat swab and chest CT findings in the diagnosis of COVID 19

Influencing demographic characteristics, comorbidities disease, and radiologic finding on mortality due to Covid-19 in Iran.

Recognition of death risk factors is urgently needed, not only to identify the defining clinical and epidemiological characteristics with greater precision but also to facilitate the appropriate supportive care and prompt access to the intensive care unit (ICU) if necessary. This study aimed to investigate the influencing demographic characteristics, comorbidities disease, and radiologic finding on COVID-19 death. Descriptive cross-sectional study included adult patients with COVID-19 from Imam Hossein. Demographic characteristics, comorbidities disease, chest CT scan findings, and outcome (death/survive) data were extracted from information health system (HIS), by using a data collection check list. To explore the influencing factors on mortality, logistic regression method was used. Result demonstrated that most patients who died because of Covid-19 were men (63.4%), more than 60 years (86.4%), married (95.8%), and self-employed (37.1%) with a mean age of 72.1 ± 15.46 years ranging from 22 to 93 years. Having comorbidities disease such as cancer, cardiac disease, diabetes, age, and pathologic chest CT findings was associated with death. In contrast, gender, marital, job, cerebral vascular disease, and HTN were not correlated. Identification of demographic characteristics, comorbidities disease, and radiographic finding correlated with death of COVID-19 can help clinicians in order to with rapid diagnose and triages of high-risk patients to have a better plan for the care of these patients.

Typical and Atypical Clinical Presentation of COVID-19 Infection in Children in The Top of Pandemic in EL-Minia Governorate (Two Center Experience).

BackgroundA novel coronavirus that is identified as the cause of pandemic situation inFebruary2020 and affects adults and children with variable presentation and outcome.ObjectiveWe studied the typical and atypical clinical and laboratory presentation of COVID-19 during the peak of the first wave in two main referral hospitals, upper Egypt EL-Minia governorate.MethodsAmong 88 children with suspected cases tested for COVID-19, only 22 proved to be positive. Studied patients were classified into three groups based on age. The first group was 2–5years, the second was 5–10years, and the third included those aged more than 10 years. All patients met diagnostic guidelines established by the Egyptian Ministry of Health.Resultsout of the positive 22 (25%) patients, 13(59.1%) of them were male, while 9 (40.9%) were females. All enrolled patients have a history of near contact exposure (100%). Thrombocytopenia was the highest presenting symptom in all enrolled patients18 (81.8%), while other hematological findings were anemia in 11 (50%), thrombotic symptoms in 2 (9.1%), pancytopenia in 2(9.1%) while bleeding was found in 1 patient (4.5%). Fever, present in 16 (72.7%), the most common constitutional symptom in COVID-19, was not reported in all enrolled patients, while sore throat was reported in only 2 patients (9.1%). The respiratory presentation was only dominant in positive chest C.T. finding, 17(72.3%), rather than clinical symptoms; GUT symptoms were the dominant presenting features as vomiting was found in 15 (68.2%), diarrhea in 10 (45.5%), abdominal pain in 11 (50%), jaundice in 9 (40.9%) and dehydration in 6 (27.3%). Neurological symptoms were convulsions in 4 (18.2%), while encephalopathy was 2 (9.1%). Nephritis was the only renal presentation in the enrolled patients, 3 (13.6%). Cardiac presentations were only cyanosis 8 (36.4%) and arrhythmias 6 (27.3%).ConclusionCOVID-19 has many clinical classic presentations in children; however other non-typical presentations like hematological, CNS, and renal presentations have been reported.

Chest CT findings and experience in 100 COVID19 patients in Mosul city, Iraq

Introduction: Due to lack of PCR kits in our area, as well as the extensive dissemination and peaking of COVID-19 since March 2020, our knowledge as radiologists has become increasingly relevant for recognizing CT patterns in order to diagnose and isolate COVID-19-infected patients. In 100 instances, the investigation began with the most prevalent CT chest abnormalities and the CT severity score index in relation to sex. The goal of this study is to better diagnose COVID-19-related lung injuries, enhance the diagnostic accuracy of chest CT scans, and track disease development in Mosul City. Materials and Methods: From June 2020 to January 2021, one hundred patients were enrolled in this cross-sectional study in Mosul, with 71 males (71%) and 29 females (29%) ranging in age from 15 to 85 years, mean SD (53.2317.80). Non contrast chest CT were done as part of investigation tool on patients were suspected COVID-19 infection. Results: A radiologist gathered data between 4 and 10 days after the onset of symptoms and evaluated it for lesion pattern, location, and severity. The commonest CT changes (ground glass opacity 55.23%, consolidation 17.44%, broncho vascular thickening 9.88%, crazy paving 5.81% and tree in bud 5.23%) were seen, along with less common pattern (bronchiectasis 1.74%, nodules 2.33%, reversed halo sign and pleural effusion 1.17%), and no lymphadenopathy were seen. Multilobe involvement was detected in 52/100 instances (68.92%), while peripheral affection was seen in 52/100 cases (65%). The higher CT severity score 4 and 5 with male gender were found to have a significant link (P value 0.002). Conclusion: CT pulmonary are useful as a physician's helper for management and as an excellent predictor of disease severity and patient outcome. In patients with COVID-19 positive infection, the CT scan severity score is highly linked to laboratory findings, hospital stay, and oxygen demands.

Post CO VID-19 Encephalopathy Treatment

Aim. To evaluate the severity of encephalopathy and the efficacy of the second stage of rehabilitation in patients with post-infectious encephalopathy. Material and methods. The study included 92 patients with post-infectious encephalopathy, who underwent the second stage of rehabilitation after СOVID-19 infection. All patients were divided into 2 groups: those, who were referred to rehabilitation after the end of the treatment (n=54) and those, who refused to undergo rehabilitation (n=38). In all cases the severity of coronavirus infection, percentage of pulmonary involvement (based on chest CT-findings) and the presence of comorbid pathology were assessed. The severity of the prevailing syndromes was assessed using the International Classification of Functioning, Disability and Health (ICF). Patient status dynamics was assessed using Rehabilitation routing scale (RRS), Rivermead, Holden and Hauser scales. Results and discussion. Post-infectious encephalopathy was mainly accompanied by vestibular ataxia syndrome in 51 (55.4%) patients (in 51.9% and 60.5% patients in groups 1 and 2, respectively) and cerebro-asthenic syndrome in 73 (79.3%) patients (in 72.2% and 89.5% patients in groups 1 and 2, respectively). Comprehensive rehabilitation process is characterized by staging aimed at compensating for all components of pathogenesis that affected during the period of severe course of COVID-19 infection. Rehabilitation was an effective measure for the compensation of neurologic complications of COVID-19 infection. After 2 weeks, cerebro-asthenic syndrome was observed in 24.1% patients in group 1 and 71.0% in group 2 (p <0.05), vestibular ataxia syndrome – in 18.5% and 28.9% (p<0.05) of patients in groups 1 and 2, respectively. The current pandemic is highly likely to be accompanied by a significant increase in the prevalence of encephalopathy affecting the ability to return to daily functioning. Conclusion. The main manifestations of post-covid encephalopathy are cerebro-asthenic (79.3%) and vestibular ataxia (55.4%) syndromes. Therapeutic and rehabilitation measures carried out at the 2nd stage of rehabilitation is an effective measure to compensate for the severity of post-covid encephalopathy.

Influenza viruses and SARS-CoV-2 in adult: 'Similarities and differences'.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), causing a global pandemic starting from December 2019, showed a course that resulted in serious mortality in the world. In order to understand SARSCoV-2 better, here we aimed to compare the similar and different characteristics of Influenza viruses occurring in the same season with SARS-CoV-2. A total of 144 patients (31 patients with COVID-19, 62 patients with H1N1 influenza, and 51 patients with influenza B) were included in the study. Demographic findings, chronic diseases, laboratory values, chest x-ray, and chest CT findings of the patients were evaluated retrospectively. Median age of the COVID-19 patients and rate of male patients were higher than other patient groups (55 years; p< 0.001) (61% male; p< 0.001). The most common chronic medical conditions were hypertension and diabetes. Platelet numbers and alanine aminotransferase values were significantly higher in COVID-19 patients. Radiologically, bilateral (74.2%) and nonspecific distribution (58.1%), ground-glass opacities with consolidation (51.6%), patchy image (25.8%), ground-glass opacities with interstitial changes (22.6%) and halo sign (22.6%) were quite evident than other groups in COVID-19 patients (p< 0.05). We suggest that due to the higher PLT values observed in COVID-19 patients, initiation of anticoagulant therapy should be considered in the early stage and routine follow-up with d-dimer and fibrinogen should be applied for suspected patients. Moreover, attention should be paid in terms of possible liver toxicity of the drugs to be used in treatment due the higher ALT values observed in COVID-19 patients. Since we did not detect SARS-CoV-2 and influenza viruses concurrently in the same patient, it may be helpful to focus on only one virus in a patient with symptoms, and radiographic differences can be used to differentiate COVID-19 from influenza.

710. Comparison of Initial CXR to CT in Patients (pts) with Hematologic Malignancy (HEM) and Documented Symptomatic Pulmonary Mucormycosis (PM)

BackgroundThere is a spectrum of pulmonary disease burden in pts with HEM and PM. There have not been any data comparing the sensitivity and findings of initial Chest X-Ray (CXR) and chest CT in these pts.MethodsWe compared the findings of the initial CXR and CT in all pts with proven or probable PM via EORTC/MSG criteria. We included only pts who had pulmonary symptoms and who had both CXR and CT within 5 days of each other and within seven days of symptom onset or date of culture at MD Anderson Cancer Center from April 2000 and April 2020. We collected data regarding demographics, status of HEM, clinical presentation, frequency and findings of BAL and imaging findings, mold-active prophylaxis and treatment regimens, and mortality. CXR findings were classified as normal or abnormal, and if abnormal sub-classified as mass-like/consolidative, nodular, cavitary or heterogenous/non-specific. CT findings were classified in a similar manner. ResultsWe Identified such 39 pts with PM who had both CXR and CT within 5 d. All pts had positive CT. Five pts (13%) had a negative CXR. The majority of pts 28 (72%) were neutropenic (neutrophil count < 500). The most common CXR findings were consolidation or mass-like lesions (56%), followed by patchy, heterogenous or non-specific findings (33%) and nodules (13%). Only 3% had cavitary lesions. Similarly, consolidation or mass-like lesions were the most common finding on CT (69%), followed by nodular lesions with or without ground glass halos (56%). Cavitary lesions and/or reverse halo sign (RHS) were common (31%) on CT. Patients with normal CXR vs those with abnormal CXR were comparable in all clinical parameters we collected. The median survival from time of symptoms onset for all pts was 45 days. There was a trend for lower 42 day mortality in pts with normal CXR (20% vs 47%, P=.253). ConclusionA negative CXR does not preclude PM, especially in neutropenic pts. A CT is recommended for better sensitivity and although there was concordance in CXR with CT findings in some chest abnormalities (mass, consolidation), CT more commonly revealed nodules and signs highly suggestive of PM such as RHS. Although small numbers precluded a robust comparison, it is possible that HEM pts with PM and negative initial CXR have better prognosis, perhaps reflecting a lower burden of pulmonary involvement Disclosures Dimitrios P. Kontoyiannis, MD, Astellas (Consultant)Cidara Therapeutics (Advisor or Review Panel member)Gilead Sciences (Consultant, Grant/Research Support, Other Financial or Material Support, Honoraria)

Examination of clinical conditions and chest CT images of Covid-19 cases in Turkey; single center study.

In this study, we aim to study the clinical features and chest CT findings of the patients, COVID-19 diagnosis of which are verified. This retrospective study was conducted on RT-PCR (+) COVID-19 patients who were examined in our hospital's emergency department between March 11, 2020 and June 30, 2020. 326 patients were included in this retrospective study in total. Of the patients, 53.1% and 46.9% are males and females, respectively. The patients applied to the service with the symptoms of shortness of breath at the rate of 21.8% and cough at the rate of 20.6%. The study found that the most frequent abnormal CT finding is ground glass opacity at the rate of 26.7% and it is followed by atelectasis at the rate of 12.3%. Patients in the> 65 age group and patients with COPD comorbidities have significantly higher rates of admission to the intensive care unit. The most frequent findings in examination of pathological chest CT findings are ground glass opacity. The rate of length of intensive care unit stay and mortality is significantly higher in the patients above 65 years old compared to those below 65 years old.

Chest Radiograph and CT Findings in Patients Hospitalized with Breakthrough COVID-19.

PurposeTo characterize chest radiograph and CT imaging appearance in patients with breakthrough COVID-19 (defined as an illness occurring in patients that previously received a COVID-19 vaccination) in a hospital setting.Materials and MethodsIn this retrospective study, all patients admitted to the hospital between August 26 and September 8, 2021 with a positive SARS-CoV-2 reverse transcription polymerase chain reaction-confirmed infection who were fully vaccinated against COVID-19 were evaluated. Clinical, laboratory data, and outcomes were collected and assessed. All patients had chest imaging performed (either radiography, CT, or a combination of both). Chest radiographs and CTs were assessed and scored on admission and on follow up to determine the extent and type of pulmonary involvement. Descriptive statistics were used.ResultsCharts of 60 hospitalized patients that tested positive for SARS-CoV-2 were reviewed for a prior history of COVID-19 vaccination. Eight (13.3%) such patients were identified and included for analysis (mean age, 54 years; range 34–81 years; four women). Patients received either two doses of Pfizer-BioNTech (n = 6), two doses of Moderna (n = 1), or one dose of Johnson and Johnson (n = 1). Five (63%) patients were immunosuppressed at the time of presentation, and six (75%) reported respiratory symptoms. Most of the patients had normal radiographs (4 of 7; 57%). The most common chest CT findings were ground glass opacities (three of five), with mild to moderate severity scores (average, 51; range 8–88). Two patients required intensive care unit admission. However, no patients died and all were either discharged or were on room air without residual respiratory symptoms by the end of the study period.ConclusionIn hospitalized patients with COVID-19 breakthrough illness, normal to mild or moderately positive imaging findings were observed.©RSNA, 2021

The Evolving Landscape of Lung Cancer Surgical Resection: An Update for Radiologists With Focus on Key Chest CT Findings.

Evolution of the multimodality management of early lung cancer, including progress in surgical techniques, has introduced the possibility of resection for lung cancer cases that historically were considered unresectable (e.g., select cases of T4 disease and oligometastatic disease). However, the TNM classification does not uniformly correlate with lung cancer operability and resectability. Radiologic evaluation is therefore critical in identifying patients' suitability to undergo lung cancer resection and in guiding the selection of a surgical approach from among a range of such approaches, including wedge resection, segmentectomy, lobectomy, bilobectomy, and pneumonectomy. The radiologist must understand the available surgical options, along with their advantages and disadvantages, and provide a report that includes critical information on tumor size, location, and extension and anatomic relations that may influence the surgical technique. Preoperative CT findings may also help predict expected postoperative lung function and the associated impact on the postoperative course of the patient. This article reviews the role of chest CT in the preoperative evaluation of lung cancer, focusing on the key CT findings that help direct surgical decision making in the context of an expanding range of patients who may be considered candidates for resection.

Chest CT findings in COVID-19

RT-PCR is the gold standard in the diagnosis of COVID-19 infections, due to its high specificity. However, there are clinical situations in which chest CT may prove vital, for example in patients with high clinical and epidemiologic suspicion towards COVID-19 before positive RT-PCR conversion or in detecting complications. Researchers have developed scales that, based on the findings in chest CT, help predict the severity of the disease.&#x0D; There are three main pathologic patterns of lung injury that correlate with the duration of COVID-19 symptoms. Epithelial pattern with diffuse alveolar damage and desquamation/reactive hyperplasia of pneumocytes; vascular pattern with capillary congestion and (micro)thrombi and fibrotic pattern with interstitial fibrous changes. The epithelial pattern and vascular pattern appear early, even before the symptoms of the disease, whereas the fibrous pattern appears approximately three weeks after the onset of the disease.&#x0D; Typical findings on chest CT in COVID-19 infection are: GGO, consolidation, GGO mixed with consolidation, interlobular septal thickening, air bronchogram sign, crazy paving, bronchial wall thickening and vascular enlargement.&#x0D; Findings that may suggest a different etiology include multiple nodules, tree-in-bud opacities, bronchiectasis, pleural and pericardial effusion, extensive consolidations.

Potential diagnosis of COVID-19 from chest X-ray and CT findings using semi-supervised learning.

COVID-19 is an infectious disease, which has adversely affected public health and the economy across the world. On account of the highly infectious nature of the disease, rapid automated diagnosis of COVID-19 is urgently needed. A few recent findings suggest that chest X-rays and CT scans can be used by machine learning for the diagnosis of COVID-19. Herein, we employed semi-supervised learning (SSL) approaches to detect COVID-19 cases accurately by analyzing digital chest X-rays and CT scans. On a relatively small COVID-19 radiography dataset, which contains only 219 COVID-19 positive images, 1341 normal and 1345 viral pneumonia images, our algorithm, COVIDCon, which takes advantage of data augmentation, consistency regularization, and multicontrastive learning, attains 97.07% average class prediction accuracy, with 1000 labeled images, which is 7.65% better than the next best SSL method, virtual adversarial training. COVIDCon performs even better on a larger COVID-19 CT Scan dataset that contains 82,767 images. It achieved an excellent accuracy of 99.13%, at 20,000 labels, which is 6.45% better than the next best pseudo-labeling approach. COVIDCon outperforms other state-of-the-art algorithms at every label that we have investigated. These results demonstrate COVIDCon as the benchmark SSL algorithm for potential diagnosis of COVID-19 from chest X-rays and CT-Scans. Furthermore, COVIDCon performs exceptionally well in identifying COVID-19 positive cases from a completely unseen repository with a confirmed COVID-19 case history. COVIDCon, may provide a fast, accurate, and reliable method for screening COVID-19 patients.

Comparison of chest CT findings in outpatient and hospitalized COVID-19 RT-PCR positive patients of Shiraz

IntroductionChest CT provides valuable information regarding coronavirus disease 2019 (COVID-19) during the treatment process. The present study aimed to assess the distribution of chest CT findings in outpatient (OPD) and hospitalized corona patients. Material and methodThis was a retrospective study. Archived corona patient's data on the picture archiving and communication system (PACS) was assessed in terms of demographic data and patients' lungs' radiologic features. The OPD and hospitalized patients referred to University hospitals from February 20 to the study's date were evaluated. Data were analyzed using independent chi-square and t-test. ResultsFive hundred and fifty nine patients, including 187 OPD and 372 hospitalized patients, were analyzed. The frequency of normal chest CT, typical, and possible corona features was 37.4%, 40.8%, and 14.3%. The normal chest CT rate was significantly higher in outpatient versus hospitalized patients (P<0.001). Consolidation and/or ground-glass opacity were seen in 61% of patients, considerably higher in hospitalized patients (P<0.001). 2% and 15% OPD and hospitalized patients had more than 25% lung involvement, respectively. The frequency of other signs such as Crazy Paving, atoll sign, subpleural band/distortion also was significantly higher in hospitalized patients (P<0.001). ConclusionMost OPD patients had less than 5% lung involvement or normal chest CT. The typical features of lung involvement in COVID-19 were significantly higher in hospitalized patients.

Comparison of chest computed tomography findings of RT-PCR negative and RT-PCR positive cases in COVID-19 patients

ObjectiveThe purpose was to compare the results of the RT-PCR test, with the findings of Chest CT and to determine the features of CT for the diagnosis of COVID-19 and how to approach RT-PCR negative patients. Material methodChest CT findings of 569 COVID-19 diagnosed patients, followed up at the pandemic wards between March and June 2020 were retrospectively examined. Patients were grouped according to RT-PCR results, gender, and age. Results284 (49%) were RT-PCR(+), 285 (50.8%) were RT-PCR(−) of total 569 patients. 11 (1.9%) of RT-PCR(+) had no involvement in Chest CT while all the RT-PCR(−) patients were CT(+). The distribution of lesions in CT were; 544 (95.6%) bilateral, 553 (97.2%) multilobar, 557(98%) peripherally 151 (26.5%) posteriorly localized. The most common findings were; 539 (94.7%) ground-glass opacity (GGO), 365 (64.1%) consolidation, 160 (28.1%) crazy paving interlobular septal thickening. CO-RADS mean value was 5.4 ± 0.7. GGO and reticulation in RT-PCR(−) patients were 280 (98.2%) and 24 (8.4%); while they were 259 (91.2%) and 12 (4.2%) in RT-PCR(+) patients, were significantly higher (p < 0.05). No significant difference was observed, in CT findings for gender. Only the findings of crazy paving interlobular septal thickening and reticulation in 18–64 age group were significantly higher than that in 65–94 age group, 105 (24.8%)–55 (37.9%), 19 (4.5%)–17 (11.7%) respectively (p < 0.05). ConclusionThe typical findings of COVID-19 pneumonia in Chest CT are: GGO, consolidation and crazy paving in bilateral, peripheral, posterior localization. CT plays an essential role for diagnosis, isolation and treatment in cases of COVID-19 and RT-PCR negative test should be verified by CT.

Computed tomography findings in 3,557 COVID-19 infected children: a systematic review.

Although it was assumed in the early stages of the coronavirus disease 2019 (COVID-19) outbreak that the novel coronavirus infection was uncommon among children, the number of infected children has since been increasing significantly. Real-time polymerase chain reaction (RT-PCR) is the gold standard modality for the diagnosis of COVID-19 infection. In adults, chest CT is performed as an adjunct for identifying suspected COVID-19 cases along with patients' management and follow-up. However, CT findings in COVID-19 children studies have shown a diverse incidence of abnormal CT and finding patterns that made CT scan necessity to have remained controversial. The aim of the present review was to comprehensively determine the imaging findings of chest CT scans of confirmed COVID-19-infected pediatric patients through a systematic review of the available published studies. A systematic literature search was performed in the PubMed, Embase, Scopus, and Web of Science core collection databases (four databases including SSCI, SCIE, AHCI, and ESCI) to find original articles containing chest CT findings in children with COVID-19 through May 7, 2021. This review included 81 articles published in English that in total included 3,557 pediatric patients. This review included 81 articles published in English that in total included 3,557 pediatric patients. Among the total confirmed coronavirus-infected cases (via RT-PCR test), two-thirds had abnormal chest CT findings; among these patients, 549 (37.8%) had bilateral lung involvement, and 475 (32.7%) had unilateral disease. Regarding the types of lung lesions, ground glass opacities were observed in 794 (54.7%) of patients, and consolidation was observed in 10.2%; moreover, halo sign, discrete pulmonary nodules, interstitial abnormalities or reticulations, and vascular thickening shadows were reported in 7.4%, 2.6%, 9.7% and 1.7% of the patients, respectively. This review revealed that chest CT scan manifestations in majority of COVID-19 positive children are mild, so regarding the risk of radiation exposure, it is reasonable to confine CT scan to individual cases that its benefits outweigh the risks.

P1‐24: Correlation of chest CT findings and severity of coronavirus disease (COVID‐19) infections in patients admitted at Chinese General Hospital and Medical Center

P1‐24: Correlation of chest CT findings and severity of coronavirus disease (COVID‐19) infections in patients admitted at Chinese General Hospital and Medical Center

Chest computed tomography findings of 1271 patients with COVID-19 pneumonia and classifications with different age groups: a descriptive study from Istanbul, Turkey.

The objectives of this study were to describe lung computed tomography findings of patients with COVID-19 diagnosed by real-time reverse transcription polymerase chain reaction test, investigate whether the findings differ regarding age and gender, and evaluate the diagnostic performance of chest computed tomography based on the duration of symptoms at the time of presentation to the hospital. From March 11 to May 11, 2020, 1271 consecutive patients (733 males and 538 females) were included in this retrospective, cross-sectional study. Based on age, patients were divided into five separate subgroups. Then based on the duration of symptoms, patients were divided into five separate phases. The presence of lung lesion(s) and their characteristics, distribution patterns, and the presence of concomitant pleural thickening/effusion and other findings (malignancy, metastasis, chronic obstructive pulmonary disease, interstitial lung disease, bronchiectasis, bronchiectasis, cardiomegaly, pericardial effusion) were evaluated by five radiologists independently. The "normal lung computed tomography finding" was the most common chest CT finding (37%), followed by ground-glass opacity (31%). Regardless of the shape of the lesion, the distribution features were significant (peripheral, subpleural, and lower lobe distribution) (p<0.05). The presence of pleural thickening posteriorly and adjacent to the lesion was statistically different in groups 1-3 (p<0.05). Other concomitant pathologies, except pulmonary congestion, did not suppress the typical findings of COVID-19. Chest computed tomography findings were mostly normal in the early phase (P1). Therefore, it may be appropriate to perform the first computed tomography screening of COVID-19 after 6 days to decrease the radiation exposure.

EP.WE.334Value of including CT chest in the management of acute abdominal emergencies: Experience during first wave of COVID-19 pandemic at a District General Hospital

AimsThe aim of this retrospective study was to assess the incidence of positive findings on CT chest in patients presenting with acute abdomen, who underwent CT thorax as part of the Intercollegiate General Surgical Guidance on COVID-19 during the first wave. To correlate CT chest findings with confirmed cases on RT-PCR; and to determine its influence on surgical management of abdominal emergencies.MethodsA retrospective observational study of adult emergency surgical referrals (excluding trauma) for acute abdomen over a ten week period was performed. COVID changes on CT Chest were categorized as per the BSTI CT reporting criteria. Patient demographics, COVID RT-PCR, management and outcome were recorded. Statistical analysis was performed using Microsoft Excel with p value significant at ≤ 0.05.ResultsOf the 160 patients included, only 111(69.38%) had COVID RT-PCR. Of 24 (15%) patients with CT chest features of COVID, 45.83% demonstrated classic/probable CT features of COVID of which 36.36% had positive RT PCR. 54.17% had indeterminate pattern and none tested positive for COVID. There was a significant association between positive CT abdomen with normal CT chest findings (p = 0.03). Of 25 (15.63%) patients with normal CT abdomen, 7(28%) had CT features of COVID. Only 43(34.4%) patients needed surgical intervention of which 18.6% had COVID changes on CT, confirmed by positive RT PCR in 12.5%.ConclusionsCT chest as an additional investigation modality in acute abdomen had clinically helped in triaging of patients to appropriate specialties but did not influence emergency surgical management.