Lung Ultrasound Findings Compared to Chest CT Scan in Patients with COVID-19 Associated Pneumonia: A Pilot Study

Introduction: Lung US has been reported to be as useful as a chest CT scan and much better than a chest x-ray for the evaluation of pneumonia. Objective: This study aimed to compare the findings of lung ultrasound (US) and chest CT scan of patients with COVID-19-associated pneumonia in the Emergency Department (ED). Methods: This retrospective observational pilot study was carried out on confirmed COVID-19 patients in the isolation corona ward of the Imam Hussein Hospital ED from March 15 to March 22, 2020. After obtaining demographic data, the patients underwent a pulmonary bedside US examination, with the patients in the sitting position, turning their back to the examiner. A 10-point lung US was performed. Each lung was divided into two areas: posterior (three zones) and lateral (two zones). The patients’ lung ultrasound and chest CT scan as the standard imaging were blindly reviewed and recorded. The clinical value of ultrasound was evaluated with different severity of lung involvement according to CT severity score. Results: Nineteen patients (38 zones), including 13 males, were evaluated with a mean age of 62.5±16.8 years. B2 lines and consolidation observed in the US examinations were significantly correlated with ground-glass opacity and consolidation observed in CT scan examinations, respectively (p <0.0001). US sensitivity and specificity of finding B2 lines were 90% and 100%, respectively. Also, the sensitivity and specificity of US in identifying consolidation were 82% and 100%, respectively. In the lungs with moderate and severe lobar involvement, US findings were significantly correlated (p <0.05) with CT scan findings. Conclusions: Ultrasound evaluation is a safe, fast, and rapid technique for the evaluation of patients with moderate to severe COVID-19-associated pneumonia. It is a reproducible procedure and can be implemented by the operator after a short course of training

Findings of Serial Computed Tomography Imaging in Patients with Coronavirus Disease-19

AIM: We investigated the serial changes of chest computed tomography (CT) in patients with coronavirus disease-2019 (COVID-19) presenting with viral-induced lung damage on follow-up CT. METHODS: We evaluated 66 patients with confirmed COVID-19, who had undergone at least two chest CTs from February 24 to April 21, 2020. Nine patients also had a third CT. All patients demonstrated viral-induced lung damage (organizing pneumonia-like pattern) on second CT. The involvement pattern of each lobe and the extent of infiltration (based on CT score) were assessed on serial CTs to determine changes throughout the disease course. Patients’ demographic and clinical data and final outcome were also recorded. RESULTS: Mean age (standard deviation [SD]) of patients was 56.04 (15.2) years old; 51.5% were male. About 93.9% of patients had survived. Mean (SD) interval between the first and second CT and second and third CT was 7.6 (5.9) and 16.8 (8.3) days, respectively. The extent of total lung involvement was significantly higher in the second CT compared with the first CT (p < 0.001) and also increased non-significantly in the third CT (p = 0.29). The right lower lobe persistently had the highest CT score through the disease course. CONCLUSION: Evaluation of serial CT imaging can reveal information regarding the stage of COVID-19, thus providing help for appropriate treatment planning

Investigating Carotid Intima Media Thickness in Children with Type 1 Diabetes and Its Relationship with HbA1c, Cholesterol, Duration of Disease and BMI: A Cross-Sectional Study

Background: internal carotid intima thickness has been identified as a predictor of atherosclerosis. Patients with type 1 diabetes are at risk for macrovascular complications. Atherosclerosis is 2 to 4 times more common in patients with diabetes, which exposes them to mortality and morbidity. The aim of this study was to determine the thickness of internal carotid intima thickness in children and adolescents with type 1 diabetes and its relationship with cardiovascular risk factors in Iranian children and adolescents with type 1 diabetes. Method: The present study is a cross-sectional study that was performed in Mofid and Imam Hossein hospitals in Tehran from 2020 to 2021. A total of 91 patients with type 1 diabetes in the age range of 6-18 years, who have been diagnosed with diabetes for at least three years, were included in the study as a diabetic group. Result: In total, 91 children and adolescents with type 1 diabetes were included in this study, of which 44 (48.4%) were boys and 47 (51.6%) were girls. The mean age of patients was 12.24 ± 3.17 and ranged from 6 to 18 years. The mean age of the patients at the time of diagnosis was 5.86 ± 2.98. In this study, blood pressure of 6 patients (6.6%) was abnormal and the rest had normal blood pressure. In addition, the mean duration of disease in this study was 6.3 ± 2.57 years. The insulin of most patients (93.2%) was Analogue and only 8.8% of patients used Neutral Protamine Hagedorn (NPH) and Regular. The thickness of the intima of the right internal carotid artery is 0.54 ± 0.05 and the thickness of the intima of the left internal carotid artery is 0.48 ± 0.07. Conclusion: According to the results of this study, none of the factors of disease duration, age of onset, blood pressure, cholesterol, triglycerides, LDL (Low-Density Lipoprotein), HDL (High-Density Lipoprotein), HbA1C (Hemoglobin A1c), history of CHD (Coronary Heart Disease) and hyperlipidemia were significantly associated with the thickness of the intima of internal carotid artery. However, body mass index showed a significant relationship with the thickness of the left internal carotid intima

The relationship between Intima-Media Thickness and Carotid Plaque Characteristics with Incidence and Severity of Premature Coronary Artery Disease

Background: Carotid intima media thickness (CIMT) and carotid plaque can predict premature coronary heart disease (PCAD) in patients hospitalized due to coronary artery disease or undergoing therapeutic interventions. This study aimed to determine the relationship between intima media thickness and carotid plaque characteristics with the incidence and severity of premature coronary artery disease. Materials and Methods: The current study was an analytical cross-sectional study conducted on patients referred to Imam Hossein Hospital in 2021-2022 who underwent coronary angiography. Patients were classified into two groups with coronary artery involvement and the group without evidence of significant coronary involvement. Then the data of patients, such as sex, age, risk factors of cardiovascular diseases, and clinical history of individuals, were collected through interviews and aspects related to carotid intima media thickness and plaque formation through a specialized review of reports. Results: A total of 59 women (%59) and 41 men (%41) participated in this study. The mean age was 51.50±9.54. The results of this study showed that there was a direct (positive) and significant correlation between carotid intima media thickness factors, including right and left carotid intima-media thickness, right and left carotid intima media thickness scores, and the number of carotid plaques with increasing severity of coronary artery involvement (P-values<0.05). There was a statistically significant correlation between carotid plaque number and severity of coronary artery disease (P-value<0.05). Conclusion: CIMT has a significant correlation with PCAD, and in patients at risk of PCAD, measurement of CIMT was a suitable method

Lung Ultrasound Findings Compared to Chest CT Scan in Patients with COVID-19 Associated Pneumonia: A Pilot Study

Introduction: Lung US has been reported to be as useful as a chest CT scan and much better than a chest x-ray for the evaluation of pneumonia.&nbsp;Objective: This study aimed to compare the findings of lung ultrasound (US) and chest CT scan of patients with COVID-19-associated pneumonia in the Emergency Department (ED).&nbsp;Methods: This retrospective observational pilot study was carried out on confirmed COVID-19 patients in the isolation corona ward of the Imam Hussein Hospital ED from March 15 to March 22, 2020. After obtaining demographic data, the patients underwent a pulmonary bedside US examination, with the patients in the sitting position, turning their back to the examiner. A&nbsp;10-point lung US was performed. Each lung was divided into two areas: posterior (three zones) and lateral (two zones). The patients’ lung ultrasound and chest CT scan as the standard imaging were blindly reviewed and recorded. The clinical value of ultrasound was evaluated with different severity of lung involvement according to CT severity score.&nbsp;Results: Nineteen patients (38 zones), including 13 males, were evaluated with a mean age of 62.5±16.8 years. B2 lines and consolidation observed in the US examinations were significantly correlated with ground-glass opacity and consolidation observed in CT scan examinations, respectively (p &lt;0.0001). US sensitivity and specificity of finding B2 lines were 90% and 100%, respectively. Also, the sensitivity and specificity of US in identifying consolidation were 82% and 100%, respectively. In the lungs with moderate and severe lobar involvement, US findings were significantly correlated (p &lt;0.05) with CT scan findings.&nbsp;Conclusions: Ultrasound evaluation is a safe, fast, and rapid technique for the evaluation of patients with moderate to severe COVID-19-associated pneumonia. It is a reproducible procedure and can be implemented by the operator after a short course of training

Organizing Pneumonia-like Pattern in COVID-19

Introduction: Organizing pneumonia (OP) is a radio-histologic pattern that forms in response to lung damage in patients with focal or diffuse lung injury. OP is frequently observed subsequent to viral-induced lung damage and is associated with a diverse range of clinical outcomes. Material and methods: We included 210 patients (mean age: 55.8 ± 16.5 years old; 61% male) with mild Coronavirus disease 2019 (COVID-19) who underwent chest computed tomography (CT) from 25 February to 22 April, 2020. The patients were divided into two groups based on the presence (n = 103) or absence of typical OP-like pattern (n =107) on initial chest CT. The extent of lung involvement and final outcome was compared across the two groups. Serial changes in imaging were also evaluated in 36 patients in the OP-group with a second CT scan. Results: Duration from symptom onset to presentation was significantly higher in the OP group (7.07 ± 3.71 versus 6.13 ± 4.96 days, p = 0.008). A higher COVID-19-related mortality rate was observed among patients with OP-like pattern (17.5% vs. 3.7%, p = 0.001).There was no significant difference in the overall involvement of the lungs (p = 0.358), but lower lobes were significantly more affected in the OP group (p &lt; 0.001). Of the 36 patients with follow-up imaging (mean duration of follow-up = 8.3 ± 2.1 days), progression of infiltration was seen in more than 61% of patients while lesions had resolved in only 22.2% of cases. Conclusions: Our observation indicates that physicians should carefully monitor for the presence of OP-like pattern on initial CT as it is associated with a poor outcome. Furthermore, we recommend interval CT to evaluate the progression of infiltrations in these patients

The relationship between Intima-Media Thickness and Carotid Plaque Characteristics with Incidence and Severity of Premature Coronary Artery Disease: Intima-Media Thickness and PCAD

Background: Carotid intima media thickness (CIMT) and carotid plaque can predict premature coronary heart disease (PCAD) in patients hospitalized due to coronary artery disease or undergoing therapeutic interventions. This study aimed to determine the relationship between intima media thickness and carotid plaque characteristics with the incidence and severity of premature coronary artery disease. Materials and Methods: The current study was an analytical cross-sectional study conducted on patients referred to Imam Hossein Hospital in 2021-2022 who underwent coronary angiography. Patients were classified into two groups with coronary artery involvement and the group without evidence of significant coronary involvement. Then the data of patients, such as sex, age, risk factors of cardiovascular diseases, and clinical history of individuals, were collected through interviews and aspects related to carotid intima media thickness and plaque formation through a specialized review of reports. Results: A total of 59 women (%59) and 41 men (%41) participated in this study. The mean age was 51.50±9.54. The results of this study showed that there was a direct (positive) and significant correlation between carotid intima media thickness factors, including right and left carotid intima-media thickness, right and left carotid intima media thickness scores, and the number of carotid plaques with increasing severity of coronary artery involvement (P-values&lt;0.05). There was a statistically significant correlation between carotid plaque number and severity of coronary artery disease (P-value&lt;0.05). Conclusion: CIMT has a significant correlation with PCAD, and in patients at risk of PCAD, measurement of CIMT was a suitable method

Organizing pneumonia-like pattern in COVID-19

Introduction: Organizing pneumonia (OP) is a radio-histologic pattern that forms in response to lung damage in patients with focal or diffuse lung injury. OP is frequently observed subsequent to viral-induced lung damage and is associated with a diverse range of clinical outcomes.Material and methods: We included 210 patients (mean age: 55.8 ± 16.5 years old; 61% male) with mild Coronavirus disease 2019 (COVID-19) who underwent chest computed tomography (CT) from 25 February to 22 April, 2020. The patients were divided into two groups based on the presence (n = 103) or absence of typical OP-like pattern (n =107) on initial chest CT. The extent of lung involvement and final outcome was compared across the two groups. Serial changes in imaging were also evaluated in 36 patients in the OP-group with a second CT scan.Results: Duration from symptom onset to presentation was significantly higher in the OP group (7.07 ± 3.71 versus 6.13 ± 4.96 days, p = 0.008). A higher COVID-19-related mortality rate was observed among patients with OP-like pattern (17.5% vs 3.7%, p = 0.001).There was no significant difference in the overall involvement of the lungs (p = 0.358), but lower lobes were significantly more affected in the OP group (p &lt; 0.001). Of the 36 patients with follow-up imaging (mean duration of follow-up = 8.3 ± 2.1 days), progression of infiltration was seen in more than 61% of patients while lesions had resolved in only 22.2% of cases.Conclusions: Our observation indicates that physicians should carefully monitor for the presence of OP-like pattern on initial CT as it is associated with a poor outcome. Furthermore, we recommend interval CT to evaluate the progression of infiltrations in these patients

Dysgerminoma in a 15 years old phenotypically female Swyer syndrome with 46, XY pure gonadal dysgenesis: A case report

Abstract Swyer syndrome is a 46, XY karyotype, with pure gonadal dysgenesis and primary amenorrhea. These females have primordial Mullerian structures and seek medical attention as they experience primary amenorrhea. Here, we report a 15‐year‐old girl, diagnosed as Swyer syndrome associated with left ovarian dysgerminoma