2019-novel Coronavirus severe adult respiratory distress syndrome in two cases in Italy: An uncommon radiological presentation
2019-novel Coronavirus severe adult respiratory distress syndrome in two cases in Italy: An uncommon radiological presentation
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DOI：
10.1016/j.ijid.2020.02.043
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发表时间：
2020-04-01
影响因子：
8.4
通讯作者：
Ippolito, Giuseppe
中科院分区：
文献类型：
--
作者：
Albarello, Fabrizio;Pianura, Elisa;Ippolito, Giuseppe
简介：最近的一些病例报告描述了2019年新型冠状病毒（SARS-COV 2）引起的肺部病理的常见早期胸部影像学表现，这些表现似乎与先前在SARS-CoV和MERS-CoV感染患者中观察到的表现相似。目的：我们介绍了意大利从中国武汉旅行的COVID-19感染的前两名患者的一些显着影像学表现。结果：肺浸润呈中度至重度进展，高密度浸润的比例逐渐增加，并伴有双侧和多节段肺阴影的扩展。在随访期间，除了胸腔积液，还观察到肺血管管状和扩大的外观，并突然缩小口径，主要见于二分束，在那里观察到一个新的反叛性肺病变的中心。这可能是一个早期预警放射学体征，以预测初始肺恶化。另一个不常见的元素是存在纵隔淋巴结病与短轴椭圆nodes.Conclusions：虽然只有两个病人进行了研究，这些研究结果是一致的放射学模式中描述的文献。最后，在随访CT扫描中出现新的肺浸润的区域中的肺血管增大可以描述肺损伤的早期预测放射学征象。(C)2020年，任作家。由爱思唯尔有限公司代表国际传染病学会出版。
Introduction: Several recent case reports have described common early chest imaging findings of lung pathology caused by 2019 novel Coronavirus (SARS-COV2) which appear to be similar to those seen previously in SARS-CoV and MERS-CoV infected patients.Objective: We present some remarkable imaging findings of the first two patients identified in Italy with COVID-19 infection travelling from Wuhan, China. The follow-up with chest X-Rays and CT scans was also included, showing a progressive adult respiratory distress syndrome (ARDS).Results: Moderate to severe progression of the lung infiltrates, with increasing percentage of high-density infiltrates sustained by a bilateral and multi-segmental extension of lung opacities, were seen. During the follow-up, apart from pleural effusions, a tubular and enlarged appearance of pulmonary vessels with a sudden caliber reduction was seen, mainly found in the dichotomic tracts, where the center of a new insurgent pulmonary lesion was seen. It could be an early alert radiological sign to predict initial lung deterioration. Another uncommon element was the presence of mediastinal lymphadenopathy with short-axis oval nodes.Conclusions: Although only two patients have been studied, these findings are consistent with the radiological pattern described in literature. Finally, the pulmonary vessels enlargement in areas where new lung infiltrates develop in the follow-up CT scan, could describe an early predictor radiological sign of lung impairment. (C) 2020 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.