Laboratory markers and radiological signs of mild versus severe COVID-19 patients

Background Coronavirus disease 2019 (COVID-19), a global pandemic that has spread worldwide in a dramatic manner since its first emergence in December 2019 from Wuhan, China. To date, there is still lack of an appropriate protocol that predicts cases who are impending to develop severe COVID-19. Hence, this work was an attempt to determine the potential association of the clinical, laboratory, and radiological parameters with the severity of COVID-19 and the ability of these parameters to predict the severe cases. Patients and methods This is a retrospective study that was based on recruiting the data from the files of patients who attended the chest outpatient clinic, or admitted to the chest department or the ICU of our institution. The study included adult patients who were diagnosed with COVID-19. Patients were categorized into two groups: severe/critical cases and mild/moderate disease cases. Data concerning the patient history, clinical picture, and radiological data were obtained and analyzed. Results Eighty adult patients with COVID-19 were included in this study. They were classified into severe/critical (40 patients) or mild/moderate disease (40 patients). Patients with severe/critical COVID-19 disease were significantly older in age and had higher comorbidities, prevalence, higher incidence of cough, dyspnea, gastrointestinal tract symptoms and fatigue, elevated total leukocyte count, lower relative lymphocytes, lower absolute lymphocytes and higher neutrophils, higher blood glucose levels, higher alanine transaminase, higher aspartate aminotransferase and lower serum albumin, reduced Ca levels, elevated lactate dehydrogenase, serum ferritin, D-dimer, and C-reactive protein levels. They had significantly higher computed tomographic (CT) scores and CT chest with greater than 50% lesions or progressive lesions. The mortality rate was 10%, all of which were from the severe disease group. Conclusion The current study is confirming an overall substantial association between severe COVID-19 and older age, chronic diseases, CT imaging pattern, and severity score, leukocyte count, lymphopenia, blood glucose, serum albumin, alanine transaminase, aspartate aminotransferase, calcium levels, C-reactive protein, D-dimer, lactate dehydrogenase, and ferritin. These results highlighted the importance of using clinical, laboratory, and radiological features for monitoring of COVID-19 patients

Role of Chest Ultrasound in Management of Exudative Pleural Effusion

Background: During the planning and execution of diagnostic and therapeutic procedures, thoracic ultrasonography is an appropriate imaging tool for the interventional pulmonologist (IP). Aim of the work: to determine whether or not thoracic ultrasonography should be used in the management of exudative pleural effusion. Patients and Methods: One hundred patients with exudative pleural effusion were included in a prospective interventional analytical study. During this study, the patients underwent ultrasonographic examination and evaluation to guide various diagnostic manoeuvres. These manoeuvres included diagnostic thoracentesis, tru cut needle biopsy from pleural or underlying lung or mediastinal lesions, and thoracoscopic assistance. In addition to assisting in therapeutic operations (such as therapeutic thoracentesis, installation of pleural drains, and pleurodesis), ultrasound was also used for prognostic reasons (post-pleural drainage assessment, pleural drain follow up, non-expandable lung prediction, and pleurodesis success detection). Results: 70 patients underwent ultrasound-guided diagnostic procedures, including diagnostic thoracentesis in 19 patients, biopsy from pleural, lung, or mediastinal lesions in 30 patients, and thoracoscopic assistance in 21 patients in order to select the appropriate type of intervention, either medical thoracoscopy (MT) or video-assisted thoracoscopic surgery (VATS)