Follow-up chest radiographic findings in patients with MERS-CoV after recovery
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Auteurs : Karuna M. Das ; Edward Y. Lee [États-Unis] ; Rajvir Singh [Qatar] ; Mushira A. Enani ; Khalid Al Dossari ; Klaus Van Gorkom ; Sven G. Larsson ; Ruth D. LangerSource :
- The Indian Journal of Radiology & Imaging [ 0971-3026 ] ; 2017.
Abstract
To evaluate the follow-up chest radiographic findings in patients with Middle East respiratory syndrome coronavirus (MERS-CoV) who were discharged from the hospital following improved clinical symptoms.
Thirty-six consecutive patients (9 men, 27 women; age range 21–73 years, mean ± SD 42.5 ± 14.5 years) with confirmed MERS-CoV underwent follow-up chest radiographs after recovery from MERS-CoV. The 36 chest radiographs were obtained at 32 to 230 days with a median follow-up of 43 days. The reviewers systemically evaluated the follow-up chest radiographs from 36 patients for lung parenchymal, airway, pleural, hilar and mediastinal abnormalities. Lung parenchyma and airways were assessed for consolidation, ground-glass opacity (GGO), nodular opacity and reticular opacity (i.e., fibrosis). Follow-up chest radiographs were also evaluated for pleural thickening, pleural effusion, pneumothorax and lymphadenopathy. Patients were categorized into two groups: group 1 (no evidence of lung fibrosis) and group 2 (chest radiographic evidence of lung fibrosis) for comparative analysis. Patient demographics, length of ventilations days, number of intensive care unit (ICU) admission days, chest radiographic score, chest radiographic deterioration pattern (Types 1-4) and peak lactate dehydrogenase level were compared between the two groups using the student
Follow-up chest radiographs were normal in 23 out of 36 (64%) patients. Among the patients with abnormal chest radiographs (13/36, 36%), the following were found: lung fibrosis in 12 (33%) patients GGO in 2 (5.5%) patients, and pleural thickening in 2 (5.5%) patients. Patients with lung fibrosis had significantly greater number of ICU admission days (19 ± 8.7 days;
Lung fibrosis may develop in a substantial number of patients who have recovered from Middle East respiratory syndrome coronavirus (MERS-CoV). Significantly greater number of ICU admission days, older age, higher chest radiographic scores, chest radiographic deterioration patterns and peak lactate dehydrogenase levels were noted in the patients with lung fibrosis on follow-up chest radiographs after recovery from MERS-CoV.
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DOI: 10.4103/ijri.IJRI_469_16
PubMed: 29089687
PubMed Central: 5644332
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Karuna M. Das<affiliation><nlm:aff id="aff1">Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, UAE</nlm:aff><wicri:noCountry code="subfield">UAE</wicri:noCountry></affiliation><affiliation><nlm:aff id="aff2">Department of Medical Imaging, King Fahad Medical City, Riyadh, KSA</nlm:aff><wicri:noCountry code="subfield">KSA</wicri:noCountry></affiliation><affiliation><nlm:aff id="aff2">Department of Medical Imaging, King Fahad Medical City, Riyadh, KSA</nlm:aff><wicri:noCountry code="subfield">KSA</wicri:noCountry></affiliation><affiliation><nlm:aff id="aff5">Department of Medicine (Infectious Disease), King Fahad Medical City, Riyadh, KSA</nlm:aff><wicri:noCountry code="subfield">KSA</wicri:noCountry></affiliation><affiliation><nlm:aff id="aff2">Department of Medical Imaging, King Fahad Medical City, Riyadh, KSA</nlm:aff><wicri:noCountry code="subfield">KSA</wicri:noCountry></affiliation><affiliation><nlm:aff id="aff1">Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, UAE</nlm:aff><wicri:noCountry code="subfield">UAE</wicri:noCountry></affiliation><affiliation><nlm:aff id="aff2">Department of Medical Imaging, King Fahad Medical City, Riyadh, KSA</nlm:aff><wicri:noCountry code="subfield">KSA</wicri:noCountry></affiliation><affiliation><nlm:aff id="aff1">Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, UAE</nlm:aff><wicri:noCountry code="subfield">UAE</wicri:noCountry></affiliation>Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Follow-up chest radiographic findings in patients with MERS-CoV after recovery</title><author><name sortKey="Das, Karuna M" sort="Das, Karuna M" uniqKey="Das K" first="Karuna M" last="Das">Karuna M. Das</name><affiliation><nlm:aff id="aff1">Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, UAE</nlm:aff><wicri:noCountry code="subfield">UAE</wicri:noCountry></affiliation><affiliation><nlm:aff id="aff2">Department of Medical Imaging, King Fahad Medical City, Riyadh, KSA</nlm:aff><wicri:noCountry code="subfield">KSA</wicri:noCountry></affiliation></author><author><name sortKey="Lee, Edward Y" sort="Lee, Edward Y" uniqKey="Lee E" first="Edward Y" last="Lee">Edward Y. Lee</name><affiliation wicri:level="1"><nlm:aff id="aff3">Department of Radiology and Medicine, Pulmonary Division, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiology and Medicine, Pulmonary Division, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts</wicri:regionArea></affiliation></author><author><name sortKey="Singh, Rajvir" sort="Singh, Rajvir" uniqKey="Singh R" first="Rajvir" last="Singh">Rajvir Singh</name><affiliation wicri:level="1"><nlm:aff id="aff4">Department of Cardiology and Biostatistics, Hamad Medical Corporation, Doha, Qatar</nlm:aff><country xml:lang="fr">Qatar</country><wicri:regionArea>Department of Cardiology and Biostatistics, Hamad Medical Corporation, Doha</wicri:regionArea></affiliation></author><author><name sortKey="Enani, Mushira A" sort="Enani, Mushira A" uniqKey="Enani M" first="Mushira A" last="Enani">Mushira A. Enani</name><affiliation><nlm:aff id="aff5">Department of Medicine (Infectious Disease), King Fahad Medical City, Riyadh, KSA</nlm:aff><wicri:noCountry code="subfield">KSA</wicri:noCountry></affiliation></author><author><name sortKey="Al Dossari, Khalid" sort="Al Dossari, Khalid" uniqKey="Al Dossari K" first="Khalid" last="Al Dossari">Khalid Al Dossari</name><affiliation><nlm:aff id="aff2">Department of Medical Imaging, King Fahad Medical City, Riyadh, KSA</nlm:aff><wicri:noCountry code="subfield">KSA</wicri:noCountry></affiliation></author><author><name sortKey="Van Gorkom, Klaus" sort="Van Gorkom, Klaus" uniqKey="Van Gorkom K" first="Klaus" last="Van Gorkom">Klaus Van Gorkom</name><affiliation><nlm:aff id="aff1">Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, UAE</nlm:aff><wicri:noCountry code="subfield">UAE</wicri:noCountry></affiliation></author><author><name sortKey="Larsson, Sven G" sort="Larsson, Sven G" uniqKey="Larsson S" first="Sven G" last="Larsson">Sven G. Larsson</name><affiliation><nlm:aff id="aff2">Department of Medical Imaging, King Fahad Medical City, Riyadh, KSA</nlm:aff><wicri:noCountry code="subfield">KSA</wicri:noCountry></affiliation></author><author><name sortKey="Langer, Ruth D" sort="Langer, Ruth D" uniqKey="Langer R" first="Ruth D" last="Langer">Ruth D. Langer</name><affiliation><nlm:aff id="aff1">Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, UAE</nlm:aff><wicri:noCountry code="subfield">UAE</wicri:noCountry></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">29089687</idno><idno type="pmc">5644332</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5644332</idno><idno type="RBID">PMC:5644332</idno><idno type="doi">10.4103/ijri.IJRI_469_16</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">000626</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000626</idno><idno type="wicri:Area/Pmc/Curation">000626</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000626</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Follow-up chest radiographic findings in patients with MERS-CoV after recovery</title><author><name sortKey="Das, Karuna M" sort="Das, Karuna M" uniqKey="Das K" first="Karuna M" last="Das">Karuna M. Das</name><affiliation><nlm:aff id="aff1">Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, UAE</nlm:aff><wicri:noCountry code="subfield">UAE</wicri:noCountry></affiliation><affiliation><nlm:aff id="aff2">Department of Medical Imaging, King Fahad Medical City, Riyadh, KSA</nlm:aff><wicri:noCountry code="subfield">KSA</wicri:noCountry></affiliation></author><author><name sortKey="Lee, Edward Y" sort="Lee, Edward Y" uniqKey="Lee E" first="Edward Y" last="Lee">Edward Y. Lee</name><affiliation wicri:level="1"><nlm:aff id="aff3">Department of Radiology and Medicine, Pulmonary Division, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiology and Medicine, Pulmonary Division, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts</wicri:regionArea></affiliation></author><author><name sortKey="Singh, Rajvir" sort="Singh, Rajvir" uniqKey="Singh R" first="Rajvir" last="Singh">Rajvir Singh</name><affiliation wicri:level="1"><nlm:aff id="aff4">Department of Cardiology and Biostatistics, Hamad Medical Corporation, Doha, Qatar</nlm:aff><country xml:lang="fr">Qatar</country><wicri:regionArea>Department of Cardiology and Biostatistics, Hamad Medical Corporation, Doha</wicri:regionArea></affiliation></author><author><name sortKey="Enani, Mushira A" sort="Enani, Mushira A" uniqKey="Enani M" first="Mushira A" last="Enani">Mushira A. Enani</name><affiliation><nlm:aff id="aff5">Department of Medicine (Infectious Disease), King Fahad Medical City, Riyadh, KSA</nlm:aff><wicri:noCountry code="subfield">KSA</wicri:noCountry></affiliation></author><author><name sortKey="Al Dossari, Khalid" sort="Al Dossari, Khalid" uniqKey="Al Dossari K" first="Khalid" last="Al Dossari">Khalid Al Dossari</name><affiliation><nlm:aff id="aff2">Department of Medical Imaging, King Fahad Medical City, Riyadh, KSA</nlm:aff><wicri:noCountry code="subfield">KSA</wicri:noCountry></affiliation></author><author><name sortKey="Van Gorkom, Klaus" sort="Van Gorkom, Klaus" uniqKey="Van Gorkom K" first="Klaus" last="Van Gorkom">Klaus Van Gorkom</name><affiliation><nlm:aff id="aff1">Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, UAE</nlm:aff><wicri:noCountry code="subfield">UAE</wicri:noCountry></affiliation></author><author><name sortKey="Larsson, Sven G" sort="Larsson, Sven G" uniqKey="Larsson S" first="Sven G" last="Larsson">Sven G. Larsson</name><affiliation><nlm:aff id="aff2">Department of Medical Imaging, King Fahad Medical City, Riyadh, KSA</nlm:aff><wicri:noCountry code="subfield">KSA</wicri:noCountry></affiliation></author><author><name sortKey="Langer, Ruth D" sort="Langer, Ruth D" uniqKey="Langer R" first="Ruth D" last="Langer">Ruth D. Langer</name><affiliation><nlm:aff id="aff1">Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, UAE</nlm:aff><wicri:noCountry code="subfield">UAE</wicri:noCountry></affiliation></author></analytic><series><title level="j">The Indian Journal of Radiology & Imaging</title><idno type="ISSN">0971-3026</idno><idno type="eISSN">1998-3808</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="st1"><title>Purpose:</title><p>To evaluate the follow-up chest radiographic findings in patients with Middle East respiratory syndrome coronavirus (MERS-CoV) who were discharged from the hospital following improved clinical symptoms.</p></sec><sec id="st2"><title>Materials and Methods:</title><p>Thirty-six consecutive patients (9 men, 27 women; age range 21–73 years, mean ± SD 42.5 ± 14.5 years) with confirmed MERS-CoV underwent follow-up chest radiographs after recovery from MERS-CoV. The 36 chest radiographs were obtained at 32 to 230 days with a median follow-up of 43 days. The reviewers systemically evaluated the follow-up chest radiographs from 36 patients for lung parenchymal, airway, pleural, hilar and mediastinal abnormalities. Lung parenchyma and airways were assessed for consolidation, ground-glass opacity (GGO), nodular opacity and reticular opacity (i.e., fibrosis). Follow-up chest radiographs were also evaluated for pleural thickening, pleural effusion, pneumothorax and lymphadenopathy. Patients were categorized into two groups: group 1 (no evidence of lung fibrosis) and group 2 (chest radiographic evidence of lung fibrosis) for comparative analysis. Patient demographics, length of ventilations days, number of intensive care unit (ICU) admission days, chest radiographic score, chest radiographic deterioration pattern (Types 1-4) and peak lactate dehydrogenase level were compared between the two groups using the student <italic>t</italic>-test, Mann-Whitney <italic>U</italic> test and Fisher's exact test.</p></sec><sec id="st3"><title>Results:</title><p>Follow-up chest radiographs were normal in 23 out of 36 (64%) patients. Among the patients with abnormal chest radiographs (13/36, 36%), the following were found: lung fibrosis in 12 (33%) patients GGO in 2 (5.5%) patients, and pleural thickening in 2 (5.5%) patients. Patients with lung fibrosis had significantly greater number of ICU admission days (19 ± 8.7 days; <italic>P</italic> value = 0.001), older age (50.6 ± 12.6 years; <italic>P</italic> value = 0.02), higher chest radiographic scores [10 (0-15.3); <italic>P</italic> value = 0.04] and higher peak lactate dehydrogenase levels (315-370 U/L; <italic>P</italic> value = 0.001) when compared to patients without lung fibrosis.</p></sec><sec id="st4"><title>Conclusion:</title><p>Lung fibrosis may develop in a substantial number of patients who have recovered from Middle East respiratory syndrome coronavirus (MERS-CoV). Significantly greater number of ICU admission days, older age, higher chest radiographic scores, chest radiographic deterioration patterns and peak lactate dehydrogenase levels were noted in the patients with lung fibrosis on follow-up chest radiographs after recovery from MERS-CoV.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Zaki, Am" uniqKey="Zaki A">AM Zaki</name></author><author><name sortKey="Van Boheemen, S" uniqKey="Van Boheemen S">S Van Boheemen</name></author><author><name sortKey="Bestebroer, Tm" uniqKey="Bestebroer T">TM Bestebroer</name></author><author><name sortKey="Osterhaus, Ad" uniqKey="Osterhaus A">AD Osterhaus</name></author><author><name sortKey="Fouchier, Ra" uniqKey="Fouchier R">RA Fouchier</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Das, Km" uniqKey="Das K">KM 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Indian J Radiol Imaging</journal-id><journal-id journal-id-type="iso-abbrev">Indian J Radiol Imaging</journal-id><journal-id journal-id-type="publisher-id">IJRI</journal-id><journal-title-group><journal-title>The Indian Journal of Radiology & Imaging</journal-title></journal-title-group><issn pub-type="ppub">0971-3026</issn><issn pub-type="epub">1998-3808</issn><publisher><publisher-name>Medknow Publications & Media Pvt Ltd</publisher-name><publisher-loc>India</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">29089687</article-id><article-id pub-id-type="pmc">5644332</article-id><article-id pub-id-type="publisher-id">IJRI-27-342</article-id><article-id pub-id-type="doi">10.4103/ijri.IJRI_469_16</article-id><article-categories><subj-group subj-group-type="heading"><subject>Thoracic Imaging</subject></subj-group></article-categories><title-group><article-title>Follow-up chest radiographic findings in patients with MERS-CoV after recovery</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Das</surname><given-names>Karuna M</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="corresp" rid="cor1"></xref></contrib><contrib contrib-type="author"><name><surname>Lee</surname><given-names>Edward Y</given-names></name><xref ref-type="aff" rid="aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Singh</surname><given-names>Rajvir</given-names></name><xref ref-type="aff" rid="aff4">4</xref></contrib><contrib contrib-type="author"><name><surname>Enani</surname><given-names>Mushira A</given-names></name><xref ref-type="aff" rid="aff5">5</xref></contrib><contrib contrib-type="author"><name><surname>Al Dossari</surname><given-names>Khalid</given-names></name><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Van Gorkom</surname><given-names>Klaus</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Larsson</surname><given-names>Sven G</given-names></name><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Langer</surname><given-names>Ruth D</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib></contrib-group><aff id="aff1"><label>1</label>Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, UAE</aff><aff id="aff2"><label>2</label>Department of Medical Imaging, King Fahad Medical City, Riyadh, KSA</aff><aff id="aff3"><label>3</label>Department of Radiology and Medicine, Pulmonary Division, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA</aff><aff id="aff4"><label>4</label>Department of Cardiology and Biostatistics, Hamad Medical Corporation, Doha, Qatar</aff><aff id="aff5"><label>5</label>Department of Medicine (Infectious Disease), King Fahad Medical City, Riyadh, KSA</aff><author-notes><corresp id="cor1"><bold>Correspondence:</bold> Dr. Karuna M Das, Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain-17666, UAE. E-mail: <email xlink:href="daskmoy@gmail.com">daskmoy@gmail.com</email></corresp></author-notes><pub-date pub-type="ppub"><season>Jul-Sep</season><year>2017</year></pub-date><volume>27</volume><issue>3</issue><fpage>342</fpage><lpage>349</lpage><permissions><copyright-statement>Copyright: © 2017 Indian Journal of Radiology and Imaging</copyright-statement><copyright-year>2017</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc-sa/3.0"><license-p>This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.</license-p></license></permissions><abstract><sec id="st1"><title>Purpose:</title><p>To evaluate the follow-up chest radiographic findings in patients with Middle East respiratory syndrome coronavirus (MERS-CoV) who were discharged from the hospital following improved clinical symptoms.</p></sec><sec id="st2"><title>Materials and Methods:</title><p>Thirty-six consecutive patients (9 men, 27 women; age range 21–73 years, mean ± SD 42.5 ± 14.5 years) with confirmed MERS-CoV underwent follow-up chest radiographs after recovery from MERS-CoV. The 36 chest radiographs were obtained at 32 to 230 days with a median follow-up of 43 days. The reviewers systemically evaluated the follow-up chest radiographs from 36 patients for lung parenchymal, airway, pleural, hilar and mediastinal abnormalities. Lung parenchyma and airways were assessed for consolidation, ground-glass opacity (GGO), nodular opacity and reticular opacity (i.e., fibrosis). Follow-up chest radiographs were also evaluated for pleural thickening, pleural effusion, pneumothorax and lymphadenopathy. Patients were categorized into two groups: group 1 (no evidence of lung fibrosis) and group 2 (chest radiographic evidence of lung fibrosis) for comparative analysis. Patient demographics, length of ventilations days, number of intensive care unit (ICU) admission days, chest radiographic score, chest radiographic deterioration pattern (Types 1-4) and peak lactate dehydrogenase level were compared between the two groups using the student <italic>t</italic>-test, Mann-Whitney <italic>U</italic> test and Fisher's exact test.</p></sec><sec id="st3"><title>Results:</title><p>Follow-up chest radiographs were normal in 23 out of 36 (64%) patients. Among the patients with abnormal chest radiographs (13/36, 36%), the following were found: lung fibrosis in 12 (33%) patients GGO in 2 (5.5%) patients, and pleural thickening in 2 (5.5%) patients. Patients with lung fibrosis had significantly greater number of ICU admission days (19 ± 8.7 days; <italic>P</italic> value = 0.001), older age (50.6 ± 12.6 years; <italic>P</italic> value = 0.02), higher chest radiographic scores [10 (0-15.3); <italic>P</italic> value = 0.04] and higher peak lactate dehydrogenase levels (315-370 U/L; <italic>P</italic> value = 0.001) when compared to patients without lung fibrosis.</p></sec><sec id="st4"><title>Conclusion:</title><p>Lung fibrosis may develop in a substantial number of patients who have recovered from Middle East respiratory syndrome coronavirus (MERS-CoV). Significantly greater number of ICU admission days, older age, higher chest radiographic scores, chest radiographic deterioration patterns and peak lactate dehydrogenase levels were noted in the patients with lung fibrosis on follow-up chest radiographs after recovery from MERS-CoV.</p></sec></abstract><kwd-group><kwd>Lung fibrosis</kwd><kwd>MERS-CoV</kwd><kwd>Chest radiograph</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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