CT imaging features of COVID-19 pneumonia: initial experience from Turkey.

新型冠状病毒肺炎例肺炎的CT影像特征: 土耳其的初步经验。

  • 影响因子:1.75
  • DOI:10.5152/dir.2020.20307
  • 作者列表:"Çinkooğlu A","Hepdurgun C","Bayraktaroğlu S","Ceylan N","Savaş R
  • 发表时间:2020-07-01

PURPOSE:We aimed to demonstrate the computed tomography (CT) findings observed at the initial presentation of coronavirus disease 2019 (COVID-19) pneumonia and reveal the most frequent infiltration and distribution patterns of the disease. METHODS:One hundred and eighty-five patients (87 men, 98 women; mean age, 48.7 years), who underwent RT-PCR sampling and high-resolution CT examination in our hospital between March 15, 2020, and April 15, 2020, and got a definitive diagnosis of COVID-19 disease via initial or follow-up RT-PCR test, were included in the study. We comprehensively analyzed the most common and relatively rare CT imaging features (e.g., distribution pattern, density of the lesions, additional CT signs) in patients diagnosed with COVID-19 pneumonia. RESULTS:Thirty-eight patients (20.6%) had no evidence of pneumonia on their initial high-resolution CT images. Among 147 patients (79.4%) who had parenchymal infiltration consistent with pneumonia, 10 (6.8%) had a negative baseline RT-PCR test, and positivity was detected as a result of repeated tests. Most of the patients had multifocal (89.1%) and bilateral (86.4%) lesions. The most common location, right lower lobe, was affected in 87.8% of the patients. Lesions were distributed predominantly at peripheral (87.1%) and posterior (46.3%) areas of lung parenchyma. Most of the patients had pure ground glass opacity (GGO) (82.3%) followed by GGO with consolidation (32.7%) and crazy paving pattern (21.8%). Pure consolidation, solid nodules, halo sign, reverse halo sign, vascular enlargement, subpleural line, air-bronchogram, and bronchiectasis were the other findings observed in at least 15% of the cases. Halo sign, acinar nodules, air-bubble sign, pleural thickening and effusion, mediastinal and/or hilar lymphadenopathy were seen rarely (2%-12.9%). Pericardial effusion, pneumothorax, cavitation, and tree-in-bud pattern were not detected in our study group. CONCLUSION:Multifocal and bilateral GGO infiltration predominantly distributed in peripheral, posterior, and lower lung areas was the most common infiltration pattern.


目的: 我们旨在展示在冠状病毒疾病2019 (新型冠状病毒肺炎) 肺炎的最初表现时观察到的计算机断层扫描 (CT) 结果,并揭示该疾病最常见的浸润和分布模式。 方法: 选择2020年3月15日至20 20年4月15日在我院行rt-pcr采样和高分辨ct检查的患者48.7例,其中男性87例,女性98例; 平均年龄岁,并通过初始或随访rt-pcr检测明确诊断为新型冠状病毒肺炎,被纳入研究。我们综合分析了诊断为新型冠状病毒肺炎肺炎的患者中最常见和相对罕见的CT成像特征 (例如,分布模式、病灶密度、额外的CT征象)。 结果: 38例患者 (20.6%) 在最初的高分辨率CT图像上没有肺炎的证据。在符合肺炎的147例患者 (79.4%) 中,10例 (6.8%) 基线rt-pcr检测阴性,重复检测结果为阳性。大多数患者有多灶性 (89.1%) 和双侧 (86.4%) 病变。最常见的位置,右下叶,在87.8% 的患者中受影响。病灶主要分布在肺实质的周边 (87.1%) 和后部 (46.3%)。大多数患者有纯磨玻璃混浊 (GGO) (82.3%),其次是GGO合并实变 (32.7%) 和疯狂铺路 (21.8%)。在至少15% 的病例中观察到纯实变、实性结节、晕征、反向晕征、血管增大、胸膜下线、空气支气管图和支气管扩张是其他发现。晕征、腺泡结节、气泡征、胸膜增厚和积液、纵隔和/或肺门淋巴结肿大少见 (2%-12.9%)。在我们的研究组中没有检测到心包积液、气胸、空洞和树芽模式。 结论: 多灶性和双侧GGO浸润主要分布于周围、后、下肺区,是最常见的浸润方式。



作者列表:["van der Schans J","Cao Q","Bos EH","Rours GIJG","Hoekstra PJ","Hak E","de Vries TW"]

METHODS::In a recent meta-analysis, we found that atopic diseases, like asthma and allergic rhinitis, occur more frequently prior to the onset of attention-deficit/hyperactivity disorder (ADHD). Our aim was to determine the temporal order of the association between daily fluctuations in atopic disease symptoms and in ADHD symptoms in individual participants. In this observational study among 21 participants, age 7-16 years, we performed a replicated time-series analysis of symptom fluctuations in asthma and/or allergic rhinitis and ADHD. Data were collected through parents who filled in a daily online questionnaire during up to 50 days. In each individual, we investigated the temporal order of fluctuations in atopic disease symptoms and ADHD symptoms using a vector autoregressive (VAR) model while using sleep problems and medication use as covariates. For 16 out of 21 participants, we constructed a VAR model. For a majority of the participants, significant associations were detected between atopic disease symptoms and ADHD symptoms. The results were heterogeneous; the direction, sign, and timing of the relationship between ADHD, atopy, sleep problems, and medication use varied between individuals. This study provides additional evidence that the symptom expression of atopy and ADHD are related. However, the connection between both diseases in children is found to be heterogeneous within our study population.

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作者列表:["Whitworth KW","Berumen-Flucker B","Delclos GL","Fragoso S","Mata C","Gimeno Ruiz de Porras D"]

METHODS::The occupational hazards and respiratory symptoms of domestic cleaners in USA are largely unknown. We conducted a cross-sectional study among 56 Hispanic female domestic cleaner on their health status and frequency of cleaning products used and tasks performed. While women used multi-use products (60.0%) and toilet bowl cleaners (51.8%) most days of the week, many (39.3%) reported not using personal protective equipment while cleaning. Itchy/watery eyes (61.8%) and itchy nose (56.4%) were the most frequently reported symptoms. A history of physician-diagnosed asthma was reported by 14.3% while 33.9% had symptoms of bronchial hyperresponsiveness (BHR). In conclusion, this vulnerable population has high prevalence of physician-diagnosis asthma and BHR symptoms and is potentially exposed to myriad occupational hazards. Further research exploring associations between products use, cleaning tasks and respiratory symptoms is warranted.

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作者列表:["Sunadome H","Matsumoto H","Izuhara Y","Nagasaki T","Kanemitsu Y","Ishiyama Y","Morimoto C","Oguma T","Ito I","Murase K","Muro S","Kawaguchi T","Tabara Y","Chin K","Matsuda F","Hirai T"]

METHODS:BACKGROUND:Obesity affects the pathogenesis of various chronic diseases, including asthma. Research on correlations between obesity/BMI and eosinophilic inflammation in asthma has yielded contradictory results, which could be partly ascribed to the absence of epidemiological data on the correlations. We aimed to elucidate the correlations between blood eosinophil count, its genetic backgrounds, and BMI in the general population. METHODS:This community-based Nagahama study in Japan enrolled 9789 inhabitants. We conducted self-reporting questionnaires, lung function tests, and blood tests in the baseline and 5-year follow-up studies. A genome-wide association study (GWAS) was performed in 4650 subjects at the baseline and in 4206 of these at the follow-up to determine single-nucleotide polymorphisms for elevated blood eosinophil counts. We assessed the correlations between BMI and eosinophil counts using a multifaceted approach, including the cluster analysis. RESULTS:Eosinophil counts positively correlated with BMI, observed upon the interchange of an explanatory variable, except for subjects with the highest quartile of eosinophils (≥200/μL), in whom BMI negatively correlated with eosinophil counts. GWAS and human leukocyte antigen (HLA) imputation identified rs4713354 variant (MDC1 on chromosome 6p21) for elevated eosinophil counts, independent of BMI and IgE. Rs4713354 was accumulated in a cluster characterized by elevated eosinophil counts (mean, 498 ± 178/μL) but normal BMI. CONCLUSIONS:Epidemiologically, there may be a positive association between blood eosinophil counts and BMI in general, but there was a negative correlation in the population with high eosinophil counts. Factors other than BMI, particularly genetic backgrounds, may contribute to elevated eosinophil counts in such populations.

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