Coronavirus disease 2019(COVID-19)was discovered after unusual cases of severe pneumonia emerged in December 2019 in Wuhan Province(China).Coronavirus is a family of single-stranded RNA viruses.Severe acute respirator...Coronavirus disease 2019(COVID-19)was discovered after unusual cases of severe pneumonia emerged in December 2019 in Wuhan Province(China).Coronavirus is a family of single-stranded RNA viruses.Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is transmitted from person to person.Although asymptomatic individuals can transmit the virus,symptomatic patients are more contagious.The incubation period ranges from 3-7 d and symptoms are mainly respiratory,including pneumonia or pulmonary embolism in severe cases.Elevated serum levels of interleukins(IL)-2,IL-6,IL-7 indicate the presence of cytokine release syndrome,which is associated with disease severity.The disease has three main phases:Viral infection,pulmonary involvement,and hyperinflammation.To date,no treatment has proved to be safe or effective.Chest X-ray and computed tomography(CT)are the primary imaging tests for diagnosis of SARS-CoV-2 pneumonia,follow-up,and detection of complications.The main radiological findings are ground-glass opacification and areas of consolidation.The long-term clinical course is unknown,although some patients may develop pulmonary fibrosis.Positron emission tomography-computed tomography(PETCT)is useful to assess pulmonary involvement,to define the affected areas,and to assess treatment response.The pathophysiology and clinical course of COVID-19 infection remain poorly understood.However,patterns detected on CT and PETCT may help to diagnose and guide treatment.In this mini review,we analyze the clinical manifestations and radiological findings of COVID-19 infection.展开更多
In December 2019,cases of unknown origin pneumonia appeared in Wuhan,China;the causal agent of this pneumonia was a new virus of the coronaviridae family called severe acute respiratory syndrome coronavirus-2(SARS-CoV...In December 2019,cases of unknown origin pneumonia appeared in Wuhan,China;the causal agent of this pneumonia was a new virus of the coronaviridae family called severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).According to the clinical severity,symptoms and response to the different treatments,the evolution of the disease is divided in three phases.We analysed the most used treatments for coronavirus disease 2019 and the phase in which they are supposed to be effective.In the viral phase,remdesivir has demonstrated reduction in recovery time but no mortality reduction.Other drugs proposed for viral phase such as convalescent plasma and lopinavir/ritonavir did not demonstrate to be effective.In the inflammatory phase,corticosteroids demonstrated reduction of 28-d mortality in patients who needed oxygen,establishing that a corticosteroid regimen should be part of the standard treatment of critically ill patients.There are other immunosuppressive and immunomodulatory treatments such as anakinra,sarilumab,tocilizumab,colchicine or baricitinib that are being studied.Other treatments that were proposed at the beginning,like hydroxichloroquine or azithromycin,demonstrated no efficacy and increased mortality when combined.展开更多
Coronavirus disease 2019(COVID-19)was first discovered after unusual cases of severe pneumonia emerged by the end of 2019 in Wuhan(China)and was declared a global public health emergency by the World Health Organizati...Coronavirus disease 2019(COVID-19)was first discovered after unusual cases of severe pneumonia emerged by the end of 2019 in Wuhan(China)and was declared a global public health emergency by the World Health Organization in January 2020.The new pathogen responsible for the infection,genetically similar to the beta-coronavirus family,is known as severe acute respiratory syndrome coronavirus-2(SARS-CoV-2),and the current gold standard diagnostic tool for its detection in respiratory samples is the reverse transcription-polymerase chain reaction test.Imaging findings on COVID-19 have been widely described in studies published throughout last year,2020.In general,ground-glass opacities and consolidations,with a bilateral and peripheral distribution,are the most typical patterns found in COVID-19 pneumonia.Even though much of the literature focuses on chest computed tomography(CT)and X-ray imaging and their findings,other imaging modalities have also been useful in the assessment of COVID-19 patients.Lung ultrasonography is an emerging technique with a high sensitivity,and thus useful in the initial evaluation of SARS-CoV-2 infection.In addition,combined positron emission tomography-CT enables the identification of affected areas and follow-up treatment responses.This review intends to clarify the role of the imaging modalities available and identify the most common radiological manifestations of COVID-19.展开更多
文摘Coronavirus disease 2019(COVID-19)was discovered after unusual cases of severe pneumonia emerged in December 2019 in Wuhan Province(China).Coronavirus is a family of single-stranded RNA viruses.Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is transmitted from person to person.Although asymptomatic individuals can transmit the virus,symptomatic patients are more contagious.The incubation period ranges from 3-7 d and symptoms are mainly respiratory,including pneumonia or pulmonary embolism in severe cases.Elevated serum levels of interleukins(IL)-2,IL-6,IL-7 indicate the presence of cytokine release syndrome,which is associated with disease severity.The disease has three main phases:Viral infection,pulmonary involvement,and hyperinflammation.To date,no treatment has proved to be safe or effective.Chest X-ray and computed tomography(CT)are the primary imaging tests for diagnosis of SARS-CoV-2 pneumonia,follow-up,and detection of complications.The main radiological findings are ground-glass opacification and areas of consolidation.The long-term clinical course is unknown,although some patients may develop pulmonary fibrosis.Positron emission tomography-computed tomography(PETCT)is useful to assess pulmonary involvement,to define the affected areas,and to assess treatment response.The pathophysiology and clinical course of COVID-19 infection remain poorly understood.However,patterns detected on CT and PETCT may help to diagnose and guide treatment.In this mini review,we analyze the clinical manifestations and radiological findings of COVID-19 infection.
文摘In December 2019,cases of unknown origin pneumonia appeared in Wuhan,China;the causal agent of this pneumonia was a new virus of the coronaviridae family called severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).According to the clinical severity,symptoms and response to the different treatments,the evolution of the disease is divided in three phases.We analysed the most used treatments for coronavirus disease 2019 and the phase in which they are supposed to be effective.In the viral phase,remdesivir has demonstrated reduction in recovery time but no mortality reduction.Other drugs proposed for viral phase such as convalescent plasma and lopinavir/ritonavir did not demonstrate to be effective.In the inflammatory phase,corticosteroids demonstrated reduction of 28-d mortality in patients who needed oxygen,establishing that a corticosteroid regimen should be part of the standard treatment of critically ill patients.There are other immunosuppressive and immunomodulatory treatments such as anakinra,sarilumab,tocilizumab,colchicine or baricitinib that are being studied.Other treatments that were proposed at the beginning,like hydroxichloroquine or azithromycin,demonstrated no efficacy and increased mortality when combined.
文摘Coronavirus disease 2019(COVID-19)was first discovered after unusual cases of severe pneumonia emerged by the end of 2019 in Wuhan(China)and was declared a global public health emergency by the World Health Organization in January 2020.The new pathogen responsible for the infection,genetically similar to the beta-coronavirus family,is known as severe acute respiratory syndrome coronavirus-2(SARS-CoV-2),and the current gold standard diagnostic tool for its detection in respiratory samples is the reverse transcription-polymerase chain reaction test.Imaging findings on COVID-19 have been widely described in studies published throughout last year,2020.In general,ground-glass opacities and consolidations,with a bilateral and peripheral distribution,are the most typical patterns found in COVID-19 pneumonia.Even though much of the literature focuses on chest computed tomography(CT)and X-ray imaging and their findings,other imaging modalities have also been useful in the assessment of COVID-19 patients.Lung ultrasonography is an emerging technique with a high sensitivity,and thus useful in the initial evaluation of SARS-CoV-2 infection.In addition,combined positron emission tomography-CT enables the identification of affected areas and follow-up treatment responses.This review intends to clarify the role of the imaging modalities available and identify the most common radiological manifestations of COVID-19.