Role of Chest Computed Tomography in Patients with COVID-19 for Triaging

  • Hajir Hassan Hussein Department of Dentistry, Hilla University College, Babylon, Iraq.
  • Abdulridha Taha Sarhan Department of Dentistry, Hilla University College, Babylon, Iraq.
  • Hawraa K Judi Department of Medical Physics, Hilla University College, Babylon, Iraq.
Keywords: Computed Tomographic, Chest ST Scan, SGOT, SGPT, COVID-19

Abstract

Background: Coronavirus is detected utilising radiological images obtained by a simple scanning technique, such as computed tomography (CT). The current study looked at how chest CT changed during hospitalisation to better understand and diagnose COVID-19.

Aim: To see if a chest CT scan could help in COVID-19 patients with limited PCR diagnostic capabilities, early isolation, contact tracing, and therapy. Also to find the association of COVID-19 mortality with High aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels.

Method: The current study included 40 COVID-19 patients from Morgan Hospital Hilla. Two certified radiologists independently obtained and evaluated CT scans for 40 COVID-19 patients, and their findings were presented in Hillah city only referral hospital approved by the government to admit COVID-19 patients. Blood tests of COVID-19 people were examined for ALT (SGOT) and AST (SGPT) to evaluate how much damage they had to their livers.

Results: The percentages tree in bud, LAP, pleural elusion, crazy paving and honeycombing were present in lower percentage (4, 10%; 4, 10%; 6, 15%; 6, 15%; 2, 5% respectively), while, bilateral involvement and multiple lesions were found with higher percentage (32, 80%; 36, 90% respectively). Consolidations and GGO appeared with median percentage (12, 30%; 20, 50%) respectively. 12 patients were shown high level in SGOT (30%). 6 (15%) patients with SGPT were showed median percentage, and only 4 (10%) patients have increased alkaline phosphate.

Conclusion: We conclude that chest CT scan may aid in the identification and triage of suspected or confirmed COVID-19 patients in cities with limited PCR diagnostic capabilities.

How to cite this article:
Hussein HH, Sarhan AT, Judi HK. Role of Chest Computed Tomography in Patients with COVID-19 for Triaging. Special Issue - COVID-19 & Other Communicable Disease. 2022;165-170.

DOI: https://doi.org/10.24321/0019.5138.202226

References

Li J, Gong X, Wang Z, Chen R, Li T, Zeng D, Li M. Clinical features of familial clustering in patients infected with 2019 novel coronavirus in Wuhan, China. Virus Res. 2020 Sep;286:198043. [PubMed] [Google Scholar]

World Health Organization. Covid-19 situation report. WHO. 2020;31(2):61-6.

de Waal MJ. A comparative overview. Chapter - Exploring the Law of Succession: Studies National, Historical and Comparative. 2012;2002:1-26. [Google Scholar]

Uhteg K, Jarrett J, Richards M, Howard C, Morehead E, Geahr M, Gluck L, Hanlon A, Ellis B, Kaur H, Simner P, Carroll KC, Mostafa HH. Comparing the analytical performance of three SARS-CoV-2 molecular diagnostic assays. J Clinic Virol. 2020 Jun;127(20):104384. [PubMed] [Google Scholar]

Lippi G, Simundic AM, Plebani M. Potential preanalytical and analytical vulnerabilities in the laboratory diagnosis of coronavirus disease 2019 (COVID-19). Clinic Chem Lab Med. 2020 Jun;58(7):1070-6. [PubMed] [Google Scholar]

Lieveld AWE, Kok B, Schuit FH, Azijli K, Heijmans J, van Laarhoven A, Assman NL, Kootte RS, Olgers TJ, Nanayakkara PWB, Bosch FH. Diagnosing COVID-19 pneumonia in a pandemic setting: Lung Ultrasound versus CT (LUVCT) – a multicentre, prospective, observational study. ERJ Open Res. 2020 Dec;6(4):00539-2020. [PubMed] [Google Scholar]

Turkoglu M. COVID-19 detection system using chest CT images and multiple kernels-extreme learning machine based on deep neural network. Ing Rech Biomed. 2021 Aug;42(4):207-14. [PubMed] [Google Scholar]

World Health Organization [Internet]. Clinical management of severe acute respiratory infection when novel coronavirus (‎nCoV)‎ infection is suspected: interim guidance, 25 January 2020. Available from: https://apps.who.int/iris/handle/10665/330854 [Google Scholar]

Wong HY, Lam HY, Fong AH, Leung ST, Chin TW, Lo CS, Lui MM, Lee JC, Chiu KW, Chung TW, Lee EY, Wan EY, Hung IF, Lam TP, Kuo MD, Ng MY. Frequency and distribution of chest radiographic findings in patients positive for COVID-19. Radiology. 2020 Aug;296(2): E72-8. [PubMed] [Google Scholar]

Wang Y, Dong C, Hu Y, Li C, Ren Q, Zhang X, Shi H, Zhou M. Temporal changes of CT findings in 90 patients with COVID-19 pneumonia: a longitudinal study. Radiology. 2020 Aug;296(2):E55-64. [PubMed] [Google Scholar]

Pan F, Ye T, Sun P, Gui S, Liang B, Li L, Zheng D, Wang J, Hesketh RL, Yang L, Zheng C. Time course of lung changes on chest CT during recovery from 2019 Novel Coronavirus (COVID-19) pneumonia. Radiology. 2020 Jun;295(3):715-21. [PubMed] [Google Scholar]

Chung M, Bernheim A, Mei X, Zhang N, Huang M, Zeng X, Cui J, Xu W, Yang Y, Fayad ZA, Jacobi A, Li K, Li S, Shan H. CT imaging features of 2019 novel coronavirus (2019-NCoV). Radiology. 2020 Apr;295(1):202-7. [PubMed] [Google Scholar]

World Heal Organization. WHO Director-General’s opening remarks at the media briefing on COVID-19. 11 March 2020. World Heal Organization; 2020.

Wang H, Wei R, Rao G, Zhu J, Song B. Characteristic CT findings distinguishing 2019 novel coronavirus disease (COVID-19) from influenza pneumonia. Eur Radiol. 2020 Sep;30(9):4910-7. [PubMed] [Google Scholar]

Di Gennaro F, Pizzol D, Marotta C, Antunes M, Racalbuto V, Veronese N, Smith L. Coronavirus diseases (COVID-19) current status and future perspectives: a narrative review. Int J Environ Res Public Health. 2020 Apr;17(8):2690. [PubMed] [Google Scholar]

Zhou Z, Guo D, Li C, Fang Z, Chen L, Yang R, Li X, Zeng W. Coronavirus disease 2019: initial chest CT findings. Eur Radiol. 2020 Aug;30(8):4398-406. [PubMed] [Google Scholar]

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb;395(10223):497-506. [PubMed] [Google Scholar]

Corman VM, Landt O, Kaiser M, Molenkamp R, Meijer A, Chu DK, Bleicker T, Brünink S, Schneider J, Schmidt ML, Mulders DG, Haagmans BL, van der Veer B, van den Brink S, Wijsman L, Goderski G, Romette JL, Ellis J, Zambon M, Peiris M, Goossens H, Reusken C, Koopmans MP, Drosten C. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Euro Surveill. 2020 Jan;25(3):2000045. [PubMed] [Google Scholar]

Fang Y, Pang P. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR. Radiology. 2020 Aug;296:15-7. [PubMed] [Google Scholar]

Sarkodie BD, Mensah YB, Ayetey H, Dzefi-Tettey K, Brakohiapa E, Kaminta A, Idun E. Chest Computed Tomography findings in patients with corona virus disease 2019 (COVID-19): An initial experience in three centres in Ghana, West Africa. J Med Imaging Radiat Sci. 2020 Dec;51(4):604-9. [PubMed] [Google Scholar]

Xue H, Jin Z. The appropriate position of radiology in COVID-19 diagnosis and treatment -current status and opinion from China. Chinese J Acad Radiol. 2020;3(1):1-3. [PubMed] [Google Scholar]

Wu J, Wu X, Zeng W, Guo D, Fang Z, Chen L, Huang H, Li C. Chest CT findings in patients with coronavirus disease 2019 and its relationship with clinical features. Invest Radiol. 2020 May;55(5):257-61. [PubMed] [Google Scholar]

Zhao W, Zhong Z, Xie X, Yu Q, Liu J. Relation between chest CT findings and clinical conditions of coronavirus disease (covid-19) pneumonia: A multicenter study. Am J Roentgenol. 2020 May;214(5):1072-7. [PubMed] [Google Scholar]

Bernheim A, Mei X, Huang M, Yang Y, Fayad ZA, Zhang N, Diao K, Lin B, Zhu X, Li K, Li S, Shan H, Jacobi A, Chung M. Chest CT findings in coronavirus disease-19 (COVID-19): relationship to duration of infection. Radiology. 2020 Jun;295(3):200463. [PubMed] [Google Scholar]

Betron M, Gottert A, Pulerwitz J, Shattuck D, Stevanovic-Fenn N. Men and COVID-19: adding a gender lens. Glob Public Health. 2020 Jul;15(7):1090-2. [PubMed] [Google Scholar]

Hannah MF, Bajic VB, Klein SL. Sex differences in the recognition of and innate antiviral responses to Seoul virus in Norway rats. Brain Behav Immun. 2008 May;22(4):503-16. [PubMed] [Google Scholar]

Berghöfer B, Frommer T, Haley G, Fink L, Bein G, Hackstein H. TLR7 Ligands Induce Higher IFN-α Production in Females. J Immunol. 2006 Aug;177(4):2088-96. [PubMed] [Google Scholar]

Pisitkun P, Deane JA, Difilippantonio MJ, Tarasenko T, Satterthwaite AB, Bolland S. Autoreactive B cell responses to RNA-related antigens due to TLR7 gene duplication. Science. 2006 Jun;312(5780):1669-72. [PubMed] [Google Scholar]

Klein SL, Flanagan KL. Sex differences in immune responses. Nat Rev Immunol. 2016 Oct;16(10):626-38. [PubMed] [Google Scholar]

Wang Y, Shi L, Wang Y, Yang H. An updated meta-analysis of AST and ALT levels and the mortality of COVID-19 patients. Am J Emerg Med. 2021 Feb;40:208-9. [PubMed] [Google Scholar]

Published
2022-03-16