Pattern and prevalence of different findings in high resolution computed tomography images in patients with coronavirus disease and kidney injury; a pilot study

IF 0.2 Q4 UROLOGY & NEPHROLOGY

Journal of Renal Injury Prevention Pub Date : 2022-03-04 DOI:10.34172/jrip.2022.31946

A. Dalili, E. Ramezanzadeh, Fahime Soleimani Farsani, Elahe Saffari, Azin Vakilpour, Eshagh Mohammadyari, S. Samiee, Masumeh Namdar

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引用次数: 0

Abstract

Introduction: Since December 2019, an outbreak of pneumonia caused by a new coronavirus has emerged. The standard diagnostic method for COVID-19 infection is the real-time reverse transcriptase-polymerase chain reaction (RT-PCR). High-resolution computed tomography (HRCT) has been proven as a sensitive, feasible and accessible test in Iran. In addition to respiratory system, other organs could also be involved in this disease. The exact mechanism of renal involvement is unknown; however, acute kidney injury (AKI) occurs in almost 5-15% of cases. Different HRCT patterns might be associated with AKI presence and severity of the disease. Objectives: To investigate patterns and prevalence of different HRCT findings in COVID-19 patients with concurrent AKI. Patients and Methods: In this retrospective study, we reviewed all hospitalized patients with COVID-19 infection, from February to April 2020 in Razi hospital, Rasht. Twenty-two cases who had AKI were enrolled. The HRCT findings of the patients were reviewed independently by two radiologists. Percentage and prevalence of HRCT findings were analyzed in SPSS 21 software. Results: All 22 cases had multifocal distribution on HRCT. Around 95.5% had peripheral involvement, 86.4% had central zones opacity while 72.2% of cases had peribronchovascular pattern. Bilateral lung involvement was found in 90.9%, but only 9.1% had unilateral involvement. There was 59.1% of lower lobe predominance for COVID-19 involvement since sub-pleural regions were spared in 18.2% of individuals. All the patients’ HRCTs showed ground glass opacity. Reticular pattern (81.8%), consolidation (77.3%), vascular enlargement in involved zones (68.2%) and airway changes (68.2%) were the next more prevalent findings. Half of the subjects showed crazy paving, 45.5% had pleural effusion and 13.6% had also lymphadenopathy. We found 40.9% of the patients had arcade-like sign. Less frequent findings were nodular opacities (13.6%), halo sign (9.1%) and reverse-halo sign (9.1%), respectively. Conclusion: This study demonstrated that atypical patterns are likely to be more common in COVID-19 patients with kidney injury.

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冠状病毒病合并肾损伤患者高分辨率计算机断层扫描不同表现的模式及流行程度一项初步研究

导语:2019年12月以来，出现了新型冠状病毒引起的肺炎疫情。新冠病毒感染的标准诊断方法是实时逆转录聚合酶链反应(RT-PCR)。在伊朗，高分辨率计算机断层扫描(HRCT)已被证明是一种敏感、可行和容易获得的检测方法。除呼吸系统外，其他器官也可能参与这种疾病。肾脏受累的确切机制尚不清楚;然而，急性肾损伤(AKI)发生在近5-15%的病例中。不同的HRCT模式可能与AKI的存在和疾病的严重程度有关。目的:探讨COVID-19合并AKI患者不同HRCT表现的模式和流行程度。患者和方法:在这项回顾性研究中，我们回顾了2020年2月至4月在拉希特市拉兹医院住院的所有COVID-19感染患者。纳入了22例AKI患者。患者的HRCT结果由两名放射科医生独立审查。采用SPSS 21软件分析HRCT表现的百分比和患病率。结果:22例HRCT均有多灶分布。约95.5%为外周受累，86.4%为中心带不透明，72.2%为支气管血管周围型。双侧肺部受累90.9%，单侧受累仅9.1%。由于18.2%的个体保留了胸膜下区域，因此下肺叶优势为59.1%。所有患者hrct均显示磨玻璃影。网状型(81.8%)、实变(77.3%)、受累区血管扩张(68.2%)和气道改变(68.2%)是其次常见的表现。半数患者有疯狂铺路，45.5%有胸腔积液，13.6%有淋巴结病变。我们发现40.9%的患者有拱廊状征象。较少见的是结节性混浊(13.6%)、晕征(9.1%)和反晕征(9.1%)。结论:本研究表明，非典型模式可能在COVID-19肾损伤患者中更为常见。

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来源期刊

Journal of Renal Injury Prevention UROLOGY & NEPHROLOGY-

CiteScore

1.60

自引率

0.00%

发文量

期刊介绍： The Journal of Renal Injury Prevention (JRIP) is a quarterly peer-reviewed international journal devoted to the promotion of early diagnosis and prevention of renal diseases. It publishes in March, June, September and December of each year. It has pursued this aim through publishing editorials, original research articles, reviews, mini-reviews, commentaries, letters to the editor, hypothesis, case reports, epidemiology and prevention, news and views and renal biopsy teaching point. In this journal, particular emphasis is given to research, both experimental and clinical, aimed at protection/prevention of renal failure and modalities in the treatment of diabetic nephropathy. A further aim of this journal is to emphasize and strengthen the link between renal pathologists/nephropathologists and nephrologists. In addition, JRIP welcomes basic biomedical as well as pharmaceutical scientific research applied to clinical nephrology. Futuristic conceptual hypothesis that integrate various fields of acute kidney injury and renal tubular cell protection are encouraged to be submitted.