tetano
Editor, Senior Moderator
Cureus
. 2022 May 9;14(5):e24860.
doi: 10.7759/cureus.24860. eCollection 2022 May.
Revisiting Middle East Respiratory Coronavirus (MERS-CoV) Outbreak Chest Radiographic Initial Findings, Temporal Progression, and Correlation to Outcomes: A Multicenter Study
Amr M Ajlan[SUP] 1 [/SUP], Nesreen H Abourokbah[SUP] 2 [/SUP], Samirah Alturkistani[SUP] 3 [/SUP], Rayan A Ahyad[SUP] 1 [/SUP], Ahmed Alharthy[SUP] 1 [/SUP], Majed Ashour[SUP] 3 [/SUP], Ghassan Wali[SUP] 4 [/SUP], Tariq A Madani[SUP] 5 [/SUP]
Affiliations
Abstract
Objectives Accounts of initial and follow-up chest X-rays (CXRs) of the Middle East respiratory coronavirus (MERS-CoV) patients, and correlation with outcomes, are sparse. We retrospectively evaluated MERS-CoV CXRs initial findings, temporal progression, and outcomes correlation. Materials and methods Fifty-three real-time reverse-transcriptase-polymerase chain reaction (rRT-PCR)-confirmed MERS-CoV patients with CXRs were retrospectively identified from November 2013 to October 2014. Initial and follow-up CXR imaging findings and distribution were evaluated over 75 days. Findings were correlated with outcomes. Results Twenty-two of 53 (42%) initial CXRs were normal. In 31 (68%) abnormal initial CXRs, 15 (48%) showed bilateral non-diffuse involvement, 16 (52%) had ground-glass opacities (GGO), and 13 (42%) had peripheral distribution. On follow-up CXRs, mixed airspace opacities prevailed, seen in 16 (73%) of 22 patients 21-30 days after the initial CXRs. Bilateral non-diffuse involvement was the commonest finding throughout follow-up, affecting 16 (59%) of 27 patients 11-20 days after the initial CXRs. Bilateral diffuse involvement was seen in five (63%) of eight patients 31-40 days after the initial CXRs. A bilateral diffuse CXR pattern had an odds ratio for mortality of 13 (95% CI=2-78) on worst and 18 (95% CI=3-119) on final CXRs (P-value <0.05). Conclusion Initially, normal CXRs are common in MERS-CoV patients. Peripherally located ground-glass and mixed opacities are common on initial and follow-up imaging. The risk of mortality is higher when bilateral diffuse radiographic abnormalities are detected.
Keywords: chest x-ray; consolidation; ground-glass opacities; mers-cov; middle east respiratory coronavirus.
. 2022 May 9;14(5):e24860.
doi: 10.7759/cureus.24860. eCollection 2022 May.
Revisiting Middle East Respiratory Coronavirus (MERS-CoV) Outbreak Chest Radiographic Initial Findings, Temporal Progression, and Correlation to Outcomes: A Multicenter Study
Amr M Ajlan[SUP] 1 [/SUP], Nesreen H Abourokbah[SUP] 2 [/SUP], Samirah Alturkistani[SUP] 3 [/SUP], Rayan A Ahyad[SUP] 1 [/SUP], Ahmed Alharthy[SUP] 1 [/SUP], Majed Ashour[SUP] 3 [/SUP], Ghassan Wali[SUP] 4 [/SUP], Tariq A Madani[SUP] 5 [/SUP]
Affiliations
- PMID: 35698685
- PMCID: PMC9186472
- DOI: 10.7759/cureus.24860
Abstract
Objectives Accounts of initial and follow-up chest X-rays (CXRs) of the Middle East respiratory coronavirus (MERS-CoV) patients, and correlation with outcomes, are sparse. We retrospectively evaluated MERS-CoV CXRs initial findings, temporal progression, and outcomes correlation. Materials and methods Fifty-three real-time reverse-transcriptase-polymerase chain reaction (rRT-PCR)-confirmed MERS-CoV patients with CXRs were retrospectively identified from November 2013 to October 2014. Initial and follow-up CXR imaging findings and distribution were evaluated over 75 days. Findings were correlated with outcomes. Results Twenty-two of 53 (42%) initial CXRs were normal. In 31 (68%) abnormal initial CXRs, 15 (48%) showed bilateral non-diffuse involvement, 16 (52%) had ground-glass opacities (GGO), and 13 (42%) had peripheral distribution. On follow-up CXRs, mixed airspace opacities prevailed, seen in 16 (73%) of 22 patients 21-30 days after the initial CXRs. Bilateral non-diffuse involvement was the commonest finding throughout follow-up, affecting 16 (59%) of 27 patients 11-20 days after the initial CXRs. Bilateral diffuse involvement was seen in five (63%) of eight patients 31-40 days after the initial CXRs. A bilateral diffuse CXR pattern had an odds ratio for mortality of 13 (95% CI=2-78) on worst and 18 (95% CI=3-119) on final CXRs (P-value <0.05). Conclusion Initially, normal CXRs are common in MERS-CoV patients. Peripherally located ground-glass and mixed opacities are common on initial and follow-up imaging. The risk of mortality is higher when bilateral diffuse radiographic abnormalities are detected.
Keywords: chest x-ray; consolidation; ground-glass opacities; mers-cov; middle east respiratory coronavirus.