Acute #pulmonary #embolism and #COVID19 #pneumonia: a random association? (Eur Heart J., summary)

[Source: European Heart Journal, full page: (LINK). Summary, edited.]

Acute pulmonary embolism and COVID-19 pneumonia: a random association?

Gian Battista Danzi 1*, Marco Loffi 1, Gianluca Galeazzi 1, and Elisa Gherbesi 2

1 Division of Cardiology, Ospedale di Cremona, Cremona, Italy; and 2 Universita degli Studi di Milano, Milano, Italy

* Corresponding author. Division of Cardiology, Ospedale di Cremona, Viale Concordia 1, 26100 Cremona, Italy. Tel: 139 0372405333, Email: gbdanzi@tin.it

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In a 75-year-old Covid-19-positive woman hospitalized for severe bilateral pneumonia, CT scan documented bilateral pulmonary embolism associated with extensive groundglass opacifications involving both the lung parenchymas

(…)

Keywords: SARS-CoV-2; COVID-19; Cardiology.

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Retrospective Analysis of 61 Cases of #Children Died of #Viral #Pneumonia (Fa Yi Xue Za Zhi, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Fa Yi Xue Za Zhi, 36 (2) 2020 Mar 25 [Online ahead of print]

Retrospective Analysis of 61 Cases of Children Died of Viral Pneumonia

[Article in English, Chinese]

X B Chen 1, S H Du 1, J C Lu 1, X H Tan 1, D R Li 1, X Yue 1, Q Wang 1, H J Wang 1, D F Qiao 1

Affiliation: 1 Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, Guangzhou 510515, China.

PMID: 32212512 DOI: 10.12116/j.issn.1004-5619.2020.02.002

 

Abstract in English , Chinese

Objective

To retrospectively analyze the forensic and pathological postmortem examination and clinical data of children who died of viral pneumonia in identification of cause of death cases and to discuss the clinical characteristics and pathological features of viral pneumonia in children, in order to provide reference to pathological diagnosis of viral pneumonia in children caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection.

Methods

In this study, postmortem examination data from the institute of 61 cases of children whose cause of death were identified as viral pneumonia in recent years were collected. The gender, age, clinical symptoms and pathological features were comparatively analyzed.

Results

Among the 61 cases of children who died of viral pneumonia, most were within 2 years old (83.61%), and a large proportion died within 2 weeks after the onset of the disease (91.80%). General changes in postmortem examination included respiratory mucosal hyperemia, pleural effusion, pulmonary swelling, variegated pulmonary pleura and serosa, focal hemorrhage and edema of the cut surface of the lung. A large proportion of children had enlarged mesenteric lymph nodes (83.61%), and 21.31% of children had thymic dysplasia. Histopathological changes included pulmonary alveoli and interstitial edema, pulmonary hemorrhage, alveolar epithelial shedding, serous and (or) fibrous exudation in the alveoli, formation of viral inclusions, formation of transparent membranes, infiltration of inflammatory cells that mainly consisted of macrophages and lymphocytes in interstitial substance and alveoli. Viral infections often affected the heart and gastrointestinal tract.

Conclusion

The clinical symptoms of children with viral pneumonia are difficult to notice, and because their immune system is not fully developed and they have poor autoimmunity, they can easily get into a critical condition and even die. Through analysis of the characteristics of forensic autopsy and histopathological changes, this study could provide reference for pathological diagnosis of viral pneumonia.

Keywords: forensic pathology; viral pneumonia; autopsy; children; cases analysis.

Copyright© by the Editorial Department of Journal of Forensic Medicine.

Conflict of interest statement – The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose.

Keywords: Pneumonia; Pediatrics; China.

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#Findings of #lung #ultrasonography of novel #coronavirus #pneumonia during the 2019–2020 #epidemic (Int Care Med., abstract)

[Source: Intensive Care Medicine, full page: (LINK). Abstract, edited.]

Letter / Published: 12 March 2020

Findings of lung ultrasonography of novel corona virus pneumonia during the 2019–2020 epidemic

Qian-Yi Peng, Xiao-Ting Wang, Li-Na Zhang & Chinese Critical Care Ultrasound Study Group (CCUSG)

Intensive Care Medicine (2020)

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Dear Editor, Up to 24 February 2020, there have been 77,269 officially reported confirmed cases of 2019 novel corona virus (SARS-CoV-2) infection in China. As lung abnormalities may develop before clinical manifestations and nucleic acid detection, experts have recommended early chest computerized tomography (CT) for screening suspected patients [1]. The high contagiousness of SARS-CoV-2 and the risk of transporting unstable patients with hypoxemia and hemodynamic failure make chest CT a limited option for the patient with suspected or established COVID-19. Lung ultrasonography gives the results that are similar to chest CT and superior to standard chest radiography for evaluation of pneumonia and/or adult respiratory distress syndrome (ARDS) with the added advantage of ease of use at point of care, repeatability, absence of radiation exposure, and low cost [2]. In this report, we summarize our early experience with lung ultrasonography for evaluation of SARS-CoV-2 infection in China with the intent of alerting frontline intensivists to the utility of lung ultrasonography for management of COVID-19.

(…)

Keywords: SARS-CoV-2; COVID-19; Radiology; Pneumonia; ARDS; Ultrasonography.

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A #Comparative Study on the #Clinical Features of #COVID19 #Pneumonia to Other Pneumonias (Clin Infect Dis., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Clin Infect Dis 2020 Mar 12 [Online ahead of print]

A Comparative Study on the Clinical Features of COVID-19 Pneumonia to Other Pneumonias

Dahai Zhao 1, Feifei Yao 2, Lijie Wang 3, Ling Zheng 1, Yongjun Gao 4, Jun Ye 5, Feng Guo 2, Hui Zhao 1, Rongbao Gao 4

Affiliations: 1 Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui Province, China. 2 Department of Respiratory Medicine, Suzhou Municipal Hospital, Suzhou, Anhui, China. 3 State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China. 4 National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China. 5 Infectious disease department, the Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui Province, China.

PMID: 32161968 DOI: 10.1093/cid/ciaa247

 

Abstract

Background:

A novel coronavirus (2019-nCoV) has raised world concern since it emerged in Wuhan Hubei China in December, 2019. The infection may result into severe pneumonia with clusters illness onsets. Its impacts on public health make it paramount to clarify the clinical features with other pneumonias.

Methods:

Nineteen 2019-nCoV pneumonia (NCOVID-19) and fifteen other pneumonia patients (NON-NCOVID-19) in out of Hubei places were involved in this study. Both NCOVID-19 and NON-NCOVID-19 patients were confirmed to be infected in throat swabs or/and sputa with or without 2019-nCoV by real-time RT-PCR. We analyzed the demographic, epidemiological, clinical, and radiological features from those patients, and compared the difference between NCOVID-19 and NON-NCOVID-19.

Results:

All patients had a history of exposure to confirmed case of 2019-nCoV or travel to Hubei before illness. The median duration, respectively, was 8 (IQR:6~11) and 5 (IQR:4~11) days from exposure to onset in NCOVID-19 and NON-NCOVID-19. The clinical symptoms were similar between NCOVID-19 and NON-NCOVID-19. The most common symptoms were fever and cough. Fifteen (78.95%) NCOVID-19 but 4 (26.67%) NON-NCOVID-19 patients had bilateral involvement while 17 (89.47%) NCOVID-19 but 1 (6.67%) NON-NCOVID-19 patients had multiple mottling and ground-glass opacity of chest CT images. Compared to NON-NCOVID-19, NCOVID-19 present remarkably more abnormal laboratory tests including AST, ALT, γ-GT, LDH and α-HBDH.

Conclusion:

The 2019-nCoV infection caused similar onsets to other pneumonias. CT scan may be a reliable test for screening NCOVID-19 cases. Liver function damage is more frequent in NCOVID-19 than NON-NCOVID-19 patients. LDH and α-HBDH may be considerable markers for evaluation of NCOVID-19.

Keywords: Clinical features; Infectious diseases; Novel coronavirus pneumonia; Respiratory infection.

© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Keywords: COVID-19; SARS-CoV-2; Pneumonia.

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#Clinical and #Imaging #Evidence of Wuhan-Viral #Pneumonia: A Large-Scale Prospective Cohort Study (SSRN, abstract)

[Source: SSRN, full page: (LINK). Abstract, edited.]

Clinical and Imaging Evidence of Wuhan-Viral Pneumonia: A Large-Scale Prospective Cohort Study

22 Pages Posted: 21 Feb 2020

Liang Wang, Huazhong University of Science and Technology (Formerly Tongi Medical University) – Tongji Hospital; Qiubai Li, Independent

 

Abstract

Background:

On December 31st, 2019, the World Health Organization (WHO) reported a large patient population with symptoms resembling those associated with viral pneumonia of unknown cause in Wuhan, China. Using a large – scale prospective cohort study, we have obtained and assessed the clinical and imaging results relating to the Wuhan-viral pneumonia.

Methods:

From the 1st until the 22nd of January 2020, we prospectively collected and analyzed clinical and imaging data of patients with viral pneumonia, determined by the use of both clinical and CT imaging scan at Wuhan’s largest hospital. Bilateral lung involvement was compared between patients with symptoms and those without them. Five cases describe the whole clinical and imaging spectrum of the Wuhan-viral Pneumonia.

Findings:

From the 1st until the 22nd of January 2020, 887 patients were identified as having Wuhan-viral pneumonia, constituting 855 (96.40%) outpatients, 32 (3.60%) inpatients, and 5 (0.56%) patients admitted to the intensive care unit (ICU). Median age was 49 years of age (IQR 14 – 90). 20 (2.25%)] infected patients had underlying diseases, including diabetes (2 [0.23%]), mitral valve prolapse (1 [0.11%]), pulmonary nodule/mass (2 [0.23%]), lung cancer (2 [0.23%]), Sjogren’s syndrome (1 [0.11%]), hypernatremia (1 [0.11%]), proteinuria (1 [0.11%]), acute pancreatitis (1 [0.11%]), colon cancer (1 [0.11%]), malignant tumor of tongue (1 [0.11%]), after nephrectomy (1 [0.11%]), kidney transplant (1 [0.11%]), demyelinating encephalopathy (1 [0.11%]), lumbar fracture (1 [0.11%]), myasthenia gravis (1 [0.11%]), aortic dissection (1 [0.11%]), autoimmune pancreatitis (1 [0.11%]). Common symptoms at onset of illness were fever (679 [76.55%]), cough (241 [27.17%]), discomfort (32 [3.61%]), less common symptoms were dizziness (3 [0.34%]), fatigue (6 [0.68%]), haemoptysis (5 [0.56%]), chest distress or chest pain (6 [0.68%]), abdominal pain (3 [0.34%]), dyspnoea (3 [0.34%]), back pain (3 [0.34%]), headache (2 [0.23%]), palpitation (1 patient, [0.1%]). 16 [1.80%] infected patients were initially asymptomatic. 4 [0.45%] infected patients had complications included respiratory failure (1 patient [0.11%]), heart failure (1 [0.11%]), shock (1 [0.11%]), and enteritis (1 patient [0.11%]). None of the infected patients died. Abnormalities in chest CT images were detected in all patients. The typical imaging findings were ill-defined ground-glass opacities and subsegmental consolidation. Later findings noted an increase or decrease in the extent of involvement with reticular opacities. 13 [81.25%] asymptomatic patients had bilaterial lung involvement while 740 [84.96%] symptomatic patients had bilaterial lung involvement. No statistically significant difference was found (X2 = 0.16, p = .68 > .05).

Interpretation:

Although the virus has demonstrated that it is highly contagious and causes infection in both lungs spontaneously, clinical evidence shows that Wuhan-viral pneumonia has a low fatality rate. CT Imaging plays a pivotal role in the screening, diagnosis, isolation plan, treatment, management or prognosis of patients with Wuhan-viral pneumonia.

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Funding: The work was partially funded by the National Natural Science Foundation of China (NSFC) (# 81171307, 81671656).

Declaration of Interest: All authors declare no competing interests.

Ethical Approval: This study was approved by the Ethical Committee of Wuhan Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, and written informed consent was provided by all patients before examination.

Keywords: coronavirus; Wuhan; Pneumonia outbreak; large-scale, prospective, cohort study

Suggested Citation: Wang, Liang and Li, Qiubai, Clinical and Imaging Evidence of Wuhan-Viral Pneumonia: A Large-Scale Prospective Cohort Study (2/9/2020). Available at SSRN: https://ssrn.com/abstract=3537088

Keywords: COVID-19; SARS-CoV-2; China.

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#Clinical and HR #CT #Features of the Severe Acute Respiratory Syndrome #Coronavirus 2 (#SARS-CoV-2) #Pneumonia: Comparison of the Initial and Follow-Up Changes (SSRN, abstract)

[Source: SSRN, full page: (LINK). Abstract, edited.]

Clinical and High-Resolution CT Features of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Pneumonia: Comparison of the Initial and Follow-Up Changes

48 Pages Posted: 19 Feb 2020

Ying Xiong, Huazhong University of Science and Technology (Formerly Tongi Medical University) – Department of Radiology; Dong Sun, Huazhong University of Science and Technology (Formerly Tongi Medical University) – Department of Radiology; Yao Liu, Huazhong University of Science and Technology (Formerly Tongi Medical University) – Department of Radiology; Yanqing Fan, Jin Yin-tan Hospital – Department of Radiology; Lingyun Zhao, Huazhong University of Science and Technology (Formerly Tongi Medical University) – Department of Radiology; Xiaoming Li, Huazhong University of Science and Technology (Formerly Tongi Medical University) – Department of Radiology; Wenzhen Zhu, Huazhong University of Science and Technology (Formerly Tongi Medical University) – Department of Radiology

 

Abstract

Background :

To quantify severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia on High-Resolution CT and to determine its relationship with clinical parameters.

Methods:

From Jan 11, 2020, to Feb 5, 2020, the clinical, laboratory and HRCT features of 42 patients (26-75 years, 25 males) with SARS-CoV-2 pneumonia were analyzed. The initial and follow-up CT obtained a mean of 4.45 days and 11.64 days from the illness onset were retrospectively assessed for the severity and progression of pneumonia. Correlations among clinical parameters, initial CT features and progression of opacifications were evaluated with Spearman correlation and linear regression analysis.

Findings:

Thirty-five (83%) patients exhibited a progressive process according to CT features during the early stage from onset. Follow-up CT findings showed increasement in the severity of opacifications, consolidation, interstitial thickening, fibrous strips and air bronchogram, compared to initial CT (all p<0.05). Before regular treatments, there was a moderate correlation between the days from onset and sum score of opacifications (R=0.68, p<0.01). The C-reactive protein, erythrocyte sedimentation rate and lactate dehydrogenase showed significantly positive correlation with the severity of pneumonia assessed on initial CT (R range 0.36-0.75, p<0.05). The highest temperature and the severity of opacifications assessed on initial CT were significantly related to the progression of opacifications on follow-up CT (p=0.001-0.04).

Interpretation:

Patients with the SARS-CoV-2 pneumonia usually presented with typical ground-grass opacities and other CT features, which showed significant correlations with some clinical and laboratory measurements. Follow-up CT images often demonstrated progressions during the early stage from illness onset.

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Funding Statement: This work was supported, in part, by the National Natural Science Foundation of China (grant numbers: 81730049, 81930045, 31630025 and 81601480)

Declaration of Interests: All authors declare no competing interests.

Ethics Approval Statement: Our institutional review board approved this retrospective study. Informed consent was not required as the study involved no potential risk to patients.

Keywords: SARS-CoV-2 pneumonia; High-Resolution CT Features; Clinical Features; Follow-up

Suggested Citation: Xiong, Ying and Sun, Dong and Liu, Yao and Fan, Yanqing and Zhao, Lingyun and Li, Xiaoming and Zhu, Wenzhen, Clinical and High-Resolution CT Features of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Pneumonia: Comparison of the Initial and Follow-Up Changes (2/15/2020). Available at SSRN: https://ssrn.com/abstract=3539695

Keywords: SARS-CoV-2; COVID-19; Pneumonia; Radiology.

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Novel #Coronavirus #Pneumonia #Outbreak in 2019: #CT #Findings in Two Cases (Korean J Radiol., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Korean J Radiol  2020 Feb 11 [Online ahead of print]

Novel Coronavirus Pneumonia Outbreak in 2019: Computed Tomographic Findings in Two Cases

Xiaoqi Lin # 1, Zhenyu Gong # 2, Zuke Xiao 3, Jingliang Xiong 4, Bing Fan 5, Jiaqi Liu 1

Affiliations: 1 Department of Radiology, Jiangxi Provincial People’s Hospital, Jiangxi, China. 2 Department of Prevention and Health Care, Jiangxi Provincial People’s Hospital, Jiangxi, China. 3 Department of Respiratory, Jiangxi Provincial People’s Hospital, Jiangxi, China. 4 Department of Radiology, Jiangxi Chest Hospital, Jiangxi, China. 5 Department of Radiology, Jiangxi Provincial People’s Hospital, Jiangxi, China. 26171381@qq.com.

#Contributed equally.

PMID: 32056397 DOI: 10.3348/kjr.2020.0078

 

Abstract

Since the 2019 novel coronavirus (2019-nCoV or officially named by the World Health Organization as COVID-19) outbreak in Wuhan, Hubei Province, China in 2019, there have been a few reports of its imaging findings. Here, we report two confirmed cases of 2019-nCoV pneumonia with chest computed tomography findings of multiple regions of patchy consolidation and ground-glass opacities in both lungs. These findings were characteristically located along the bronchial bundle or subpleural lungs.

Keywords: 2019 novel coronavirus; Computed tomography; Severe acute respiratory infection.

Copyright © 2020 The Korean Society of Radiology.

Conflict of interest statement The authors have no potential conflicts of interest to disclose.

Keywords: SARS-CoV-2; COVID-19; Pneumonia; Radiology.

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