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      Aspectos imagenológicos útiles en el diagnóstico y seguimiento de pacientes con COVID-19 Translated title: Useful imaging aspects in the diagnosis and monitoring of patients with COVID-19

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          Abstract

          RESUMEN Las neumonías por virus son la causa principal de infecciones de las vías respiratorias en la comunidad y suelen remitir espontáneamente. Los coronavirus son una familia de virus que causan infección tanto a humanos como a muchos animales. El actual brote se debe a una nueva cepa del coronavirus denominada SARS-CoV-2, hasta ahora nunca antes descrita en humanos. La prueba diagnóstica de elección es la reacción en cadena de la polimerasa en tiempo real. Los estudios imagenológicos están jugando un papel clave en el manejo de los pacientes con infección por COVID-19. Este artículo tiene como objetivo señalar aspectos imagenológicos de interés para el diagnóstico por radiografía y tomografía computarizada en estos pacientes, apuntar sobre la semántica que imagenológicamente se está utilizando y mencionar algunas consideraciones importantes de sociedades científicas.

          Translated abstract

          ABSTRACT Viral pneumonia is the main cause of respiratory system infections in the community and they usually regress spontaneously. Coronavirus is part of a family of viruses that cause infections in humans and certain animals. The current outbreak that originated in Wuhan city in Hubei Province, China, is due to a new strain called SARS Covid 2, never described in humans before .The diagnostic test is real-time PCR. Imaging studies are being a key role in the management of patients with covid infection 19.This article aims to point out the aspects of interest for x rays and tomography diagnosis in these patients, point out the semantics used and to mention some important considerations from scientific societies.

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          Most cited references22

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          Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China

          In December 2019, novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited.
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            Correlation of Chest CT and RT-PCR Testing in Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases

            Background Chest CT is used for diagnosis of 2019 novel coronavirus disease (COVID-19), as an important complement to the reverse-transcription polymerase chain reaction (RT-PCR) tests. Purpose To investigate the diagnostic value and consistency of chest CT as compared with comparison to RT-PCR assay in COVID-19. Methods From January 6 to February 6, 2020, 1014 patients in Wuhan, China who underwent both chest CT and RT-PCR tests were included. With RT-PCR as reference standard, the performance of chest CT in diagnosing COVID-19 was assessed. Besides, for patients with multiple RT-PCR assays, the dynamic conversion of RT-PCR results (negative to positive, positive to negative, respectively) was analyzed as compared with serial chest CT scans for those with time-interval of 4 days or more. Results Of 1014 patients, 59% (601/1014) had positive RT-PCR results, and 88% (888/1014) had positive chest CT scans. The sensitivity of chest CT in suggesting COVID-19 was 97% (95%CI, 95-98%, 580/601 patients) based on positive RT-PCR results. In patients with negative RT-PCR results, 75% (308/413) had positive chest CT findings; of 308, 48% were considered as highly likely cases, with 33% as probable cases. By analysis of serial RT-PCR assays and CT scans, the mean interval time between the initial negative to positive RT-PCR results was 5.1 ± 1.5 days; the initial positive to subsequent negative RT-PCR result was 6.9 ± 2.3 days). 60% to 93% of cases had initial positive CT consistent with COVID-19 prior (or parallel) to the initial positive RT-PCR results. 42% (24/57) cases showed improvement in follow-up chest CT scans before the RT-PCR results turning negative. Conclusion Chest CT has a high sensitivity for diagnosis of COVID-19. Chest CT may be considered as a primary tool for the current COVID-19 detection in epidemic areas. A translation of this abstract in Farsi is available in the supplement. - ترجمه چکیده این مقاله به فارسی، در ضمیمه موجود است.
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              Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study

              Summary Background A cluster of patients with coronavirus disease 2019 (COVID-19) pneumonia caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were successively reported in Wuhan, China. We aimed to describe the CT findings across different timepoints throughout the disease course. Methods Patients with COVID-19 pneumonia (confirmed by next-generation sequencing or RT-PCR) who were admitted to one of two hospitals in Wuhan and who underwent serial chest CT scans were retrospectively enrolled. Patients were grouped on the basis of the interval between symptom onset and the first CT scan: group 1 (subclinical patients; scans done before symptom onset), group 2 (scans done ≤1 week after symptom onset), group 3 (>1 week to 2 weeks), and group 4 (>2 weeks to 3 weeks). Imaging features and their distribution were analysed and compared across the four groups. Findings 81 patients admitted to hospital between Dec 20, 2019, and Jan 23, 2020, were retrospectively enrolled. The cohort included 42 (52%) men and 39 (48%) women, and the mean age was 49·5 years (SD 11·0). The mean number of involved lung segments was 10·5 (SD 6·4) overall, 2·8 (3·3) in group 1, 11·1 (5·4) in group 2, 13·0 (5·7) in group 3, and 12·1 (5·9) in group 4. The predominant pattern of abnormality observed was bilateral (64 [79%] patients), peripheral (44 [54%]), ill-defined (66 [81%]), and ground-glass opacification (53 [65%]), mainly involving the right lower lobes (225 [27%] of 849 affected segments). In group 1 (n=15), the predominant pattern was unilateral (nine [60%]) and multifocal (eight [53%]) ground-glass opacities (14 [93%]). Lesions quickly evolved to bilateral (19 [90%]), diffuse (11 [52%]) ground-glass opacity predominance (17 [81%]) in group 2 (n=21). Thereafter, the prevalence of ground-glass opacities continued to decrease (17 [57%] of 30 patients in group 3, and five [33%] of 15 in group 4), and consolidation and mixed patterns became more frequent (12 [40%] in group 3, eight [53%] in group 4). Interpretation COVID-19 pneumonia manifests with chest CT imaging abnormalities, even in asymptomatic patients, with rapid evolution from focal unilateral to diffuse bilateral ground-glass opacities that progressed to or co-existed with consolidations within 1–3 weeks. Combining assessment of imaging features with clinical and laboratory findings could facilitate early diagnosis of COVID-19 pneumonia. Funding None.
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                Author and article information

                Journal
                ms
                MediSur
                Medisur
                Facultad de Ciencias Médicas de Cienfuegos, Centro Provincial de Ciencias Médicas Provincia de Cienfuegos. (Cienfuegos, , Cuba )
                1727-897X
                October 2020
                : 18
                : 5
                : 886-898
                Affiliations
                [1] Cienfuegos Cienfuegos orgnameHospital General Universitario Dr. Gustavo Aldereguia Lima Cuba
                Article
                S1727-897X2020000500886 S1727-897X(20)01800500886
                5971d526-88e4-42f3-b201-9921b52e1f1b

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 11 September 2020
                : 20 May 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 22, Pages: 13
                Product

                SciELO Cuba


                radiography,diagnostic imaging,tomography,infecciones por coronavirus,diagnóstico por imagen,coronavirus infections,tomografía,radiografía

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