Chest CT findings in patients with coronavirus disease 2019 (COVID-19): a comprehensive review

Which sequence should be used in the thorax magnetic resonance imaging of COVID-19: a comparative study

Background and aim

To evaluate and compare magnetic resonance imaging (MRI) sequences that could potentially be used in the diagnosis of coronavirus disease 2019 (COVID-19).

Materials and methods

Included in the study were 42 patient who underwent thorax computed tomography (CT) for COVID-19 pneumonia and thorax MRI for any reason within 24 h after CT. The T2-weighted fast spin echo periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) (T2W-FSE-P), fast imaging employing steady-state acquisition, T2 fat-saturated FSE, axial T1 liver acquisition with volume acceleration (LAVA) and single-shot FSE images were compared in terms of their ability to show COVID-19 findings.

Results

The mean age of the patients was 47.2 ± 24 years. Of the patients, 22 were male (52.4%) and 20 (47.6%) were female. The interobserver intraclass coefficient (ICC) for the image quality score was the highest in the T2W-FSE-P sequence and lowest in the T1 LAVA sequence. All of the lesion-based evaluations of the interobserver agreement were statistically significant, with the kappa value varying between 0.798 and 0.998.

Conclusion

All 5 sequences evaluated in the study were successful in showing the parenchymal findings of COVID-19. Since the T2W-FSE-P sequence had the best scores in both interobserver agreement and ICC for the image quality score, it was considered that it can be included in thorax MRI examinations to assist the diagnosis of COVID-19.

Automated diagnosis of COVID-19 using radiological modalities and Artificial Intelligence functionalities: A retrospective study based on chest HRCT database

Background and Objective

The spread of coronavirus has been challenging for the healthcare system's proper management and diagnosis during the rapid spread and control of the infection. Real-time reverse transcription-polymerase chain reaction (RT-PCR), though considered the standard testing measure, has low sensitivity and is time-consuming, which restricts the fast screening of individuals. Therefore, computer tomography (CT) is used to complement the traditional approaches and provide fast and effective screening over other diagnostic methods. This work aims to appraise the importance of chest CT findings of COVID-19 and post-COVID in the diagnosis and prognosis of infected patients and to explore the ways and means to integrate CT findings for the development of advanced Artificial Intelligence (AI) tool-based predictive diagnostic techniques.

Methods

The retrospective study includes a 188 patient database with COVID-19 infection confirmed by RT-PCR testing, including post-COVID patients. Patients underwent chest high-resolution computer tomography (HRCT), where the images were evaluated for common COVID-19 findings and involvement of the lung and its lobes based on the coverage region. The radiological modalities analyzed in this study may help the researchers in generating a predictive model based on AI tools for further classification with a high degree of reliability.

Results

Mild to moderate ground glass opacities (GGO) with or without consolidation, crazy paving patterns, and halo signs were common COVID-19 related findings. A CT score is assigned to every patient based on the severity of lung lobe involvement.

Conclusion

Typical multifocal, bilateral, and peripheral distributions of GGO are the main characteristics related to COVID-19 pneumonia. Chest HRCT can be considered a standard method for timely and efficient assessment of disease progression and management severity. With its fusion with AI tools, chest HRCT can be used as a one-stop platform for radiological investigation and automated diagnosis system.

Bronchiectasis and COVID-19 infection: a two-way street

ABSTRACT

Bronchiectasis (BE) has been linked to past viral infections such as influenza, measles, or adenovirus. Two years ago, a new pandemic viral infection severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) broke out and it still persists today, and a significant proportion of surviving patients have radiological and clinical sequelae, including BE. Our aim was to thoroughly review the information available in the literature on the bidirectional relationship between SARS-CoV-2 infection and the development of BE, as well as the impact of this infection on patients already suffering from BE. Available information indicates that only a small percentage of patients in the acute phase of coronavirus disease 2019 (COVID-19) pneumonia develop BE, although the latter is recognized as one of the radiological sequelae of COVID-19 pneumonia, especially when it is caused by traction. The severity of the initial pneumonia is the main risk factor for the development of future BE, but during the COVID-19 pandemic, exacerbations in BE patients were reduced by approximately 50%. Finally, the impact of BE on the prognosis of patients with COVID-19 pneumonia is not yet known.

Do COVID-19 CT features vary between patients from within and outside mainland China? Findings from a meta-analysis

Background

Chest computerized tomography (CT) plays an important role in detecting patients with suspected coronavirus disease 2019 (COVID-19), however, there are no systematic summaries on whether the chest CT findings of patients within mainland China are applicable to those found in patients outside.

Methods

Relevant studies were retrieved comprehensively by searching PubMed, Embase, and Cochrane Library databases before 15 April 2022. Quality assessment of diagnostic accuracy studies (QUADAS) was used to evaluate the quality of the included studies, which were divided into two groups according to whether they were in mainland China or outside. Data on diagnostic performance, unilateral or bilateral lung involvement, and typical chest CT imaging appearances were extracted, and then, meta-analyses were performed with R software to compare the CT features of COVID-19 pneumonia between patients from within and outside mainland China.

Results

Of the 8,258 studies screened, 19 studies with 3,400 patients in mainland China and 14 studies with 554 outside mainland China were included. Overall, the risk of quality assessment and publication bias was low. The diagnostic value of chest CT is similar between patients from within and outside mainland China (93, 91%). The pooled incidence of unilateral lung involvement (15, 7%), the crazy-paving sign (31, 21%), mixed ground-glass opacities (GGO) and consolidations (51, 35%), air bronchogram (44, 25%), vascular engorgement (59, 33%), bronchial wall thickening (19, 12%), and septal thickening (39, 26%) in patients from mainland China were significantly higher than those from outside; however, the incidence rates of bilateral lung involvement (75, 84%), GGO (78, 87%), consolidations (45, 58%), nodules (12, 17%), and pleural effusion (9, 15%) were significantly lower.

Conclusion

Considering that the chest CT features of patients in mainland China may not reflect those of the patients abroad, radiologists and clinicians should be familiar with various CT presentations suggestive of COVID-19 in different regions.

Correlation of Lung Damage on CT Scan with Laboratory Inflammatory Markers in COVID-19 Patients: A Single-Center Study from Romania

(1) Background: This study aims to evaluate the association of CRP, NLR, IL-6, and Procalcitonin with lung damage observed on CT scans; (2) Methods: A cross-sectional study was performed among 106 COVID-19 patients hospitalized in Timisoara Municipal Emergency Hospital. Chest CT and laboratory analysis were performed in all patients. The rank Spearmen correlation was used to assess the association between inflammatory markers and lung involvement. In addition, ROC curve analysis was used to determine the accuracy of inflammatory markers in the diagnosis of severe lung damage; (3) Results: CRP, NLR, and IL-6 were significantly positively correlated with lung damage. All inflammatory markers had good accuracy for diagnosis of severe lung involvement. Moreover, IL-6 has the highest AUC- ROC curve; (4) Conclusions: The inflammatory markers are associated with lung damage and can be used to evaluate COVID-19 severity.

Frequency and predictors of no-reflow phenomenon in patients with COVID-19 presenting with ST-segment elevation myocardial infarction

OBJECTIVES

Thrombotic process is triggered in the course of Coronavirus disease-2019 (COVID-19), which is a global pandemic, and both arterial and venous systems are affected. ST-elevation myocardial infarction (STEMI) that may develop in these patients may cause more complicated results with the effect of thrombosis burden. Our aim in this study is to determine the frequency of no-reflow phenomenon in COVID-19 patients with STEMI and to determine the factors that predict this complication.

METHODS

In this study, which is a single-centre, retrospective and observational, a total of 126 patients who underwent primary percutaneous coronary intervention (pPCI) in our centre due to STEMI between 11 March 2020 and 10 January 2021 were evaluated. Patients were divided into two groups according to the presence of COVID-19 infection.

RESULTS

While 62 patients were in the COVID-19 (+) group, 64 patients were evaluated in the COVID-19 (-) group. When the two groups are compared, C-reactive protein, D-dimer, ferritin and neutrophil-lymphocyte ratio (NLR) were significantly higher, and the lymphocyte count was significantly lower in the COVID-19 (+) group. No-reflow was numerically higher in patients with COVID-19. In multivariable analysis, D-dimer and NLR were found to be independent predictors of no-reflow phenomenon in COVID-19 patients.

CONCLUSIONS

Although the no-reflow phenomenon was numerically higher in COVID-19 patients who underwent pPCI due to STEMI compared to the non-COVID group, no statistical difference was found in our study. However, NLR and D-dimer have been identified as independent predictors of no-reflow development risk in COVID-19 patients.

The Worldwide Effort to Develop Vaccines for COVID-19

There have been recent encouraging reports about the development of vaccines for COVID-19. Given the scale and effects of this pandemic on public health and economies worldwide, there has been an unprecedented approach across the globe, leading to the emergence of vaccine candidates many times faster than the normal process would allow. This review gives up-to-date information as of November 28, 2020, on the latest developments in this area and covers the plans to roll out the most promising vaccines across the entire world to halt the spread of this devastating virus.