tetano
Editor, Senior Moderator
J Infect Chemother
. 2022 Feb 10;S1341-321X(22)00045-9.
doi: 10.1016/j.jiac.2022.02.005. Online ahead of print.
Early identification of novel coronavirus (COVID-19) pneumonia using clinical and radiographic findings
Naoyuki Miyashita[SUP] 1 [/SUP], Yasushi Nakamori[SUP] 2 [/SUP], Makoto Ogata[SUP] 3 [/SUP], Naoki Fukuda[SUP] 3 [/SUP], Akihisa Yamura[SUP] 3 [/SUP], Yoshihisa Ishiura[SUP] 4 [/SUP], Shosaku Nomura[SUP] 3 [/SUP]
Affiliations
Abstract
Introduction: The Japanese Respiratory Society (JRS) scoring system is a useful tool for identifying Mycoplasma pneumoniae pneumonia. Most COVID-19 pneumonia in non-elderly patients (aged <60 years) are classified as atypical pneumonia using the JRS scoring system. We evaluated whether physicians could distinguish between COVID-19 pneumonia and M. pneumoniae pneumonia using chest computed tomography (CT) findings. In addition, we investigated chest CT findings if there is a difference between the variant and non-variant strain.
Methods: This study was conducted at five institutions and assessed a total of 823 patients with COVID-19 pneumonia (335 had lineage B.1.1.7.) and 100 patients with M. pneumoniae pneumonia.
Results: In COVID-19 pneumonia, at the first CT examination, peripheral, bilateral ground-glass opacity (GGO) with or without consolidation or crazy-paving pattern was observed frequently. GGO frequently had a round morphology (39.2%). No differences were observed in the radiological findings between the non-B.1.1.7 groups and B.1.1.7 groups. The frequency of pleural effusion, lymphadenopathy, bronchial wall thickening and nodules (tree-in-bud and centrilobular) was low. In contrast to COVID-19 pneumonia, bronchial wall thickening (84%) was observed most frequently, followed by nodules (81%) in M. pneumoniae pneumonia. These findings were significantly higher in M. pneumoniae pneumonia than COVID-19 pneumonia.
Conclusions: Our results demonstrated that a combination of the JRS scoring system and chest CT findings is useful for the rapid presumptive diagnosis of COVID-19 pneumonia in patients aged <60 years. However, this clinical and radiographic diagnosis is not adapted to elderly people.
Keywords: COVID-19; Chest computed tomography; Community-acquired pneumonia; JRS scoring System; Mycoplasma pneumoniae; SARS-CoV-2.
. 2022 Feb 10;S1341-321X(22)00045-9.
doi: 10.1016/j.jiac.2022.02.005. Online ahead of print.
Early identification of novel coronavirus (COVID-19) pneumonia using clinical and radiographic findings
Naoyuki Miyashita[SUP] 1 [/SUP], Yasushi Nakamori[SUP] 2 [/SUP], Makoto Ogata[SUP] 3 [/SUP], Naoki Fukuda[SUP] 3 [/SUP], Akihisa Yamura[SUP] 3 [/SUP], Yoshihisa Ishiura[SUP] 4 [/SUP], Shosaku Nomura[SUP] 3 [/SUP]
Affiliations
- PMID: 35190258
- DOI: 10.1016/j.jiac.2022.02.005
Abstract
Introduction: The Japanese Respiratory Society (JRS) scoring system is a useful tool for identifying Mycoplasma pneumoniae pneumonia. Most COVID-19 pneumonia in non-elderly patients (aged <60 years) are classified as atypical pneumonia using the JRS scoring system. We evaluated whether physicians could distinguish between COVID-19 pneumonia and M. pneumoniae pneumonia using chest computed tomography (CT) findings. In addition, we investigated chest CT findings if there is a difference between the variant and non-variant strain.
Methods: This study was conducted at five institutions and assessed a total of 823 patients with COVID-19 pneumonia (335 had lineage B.1.1.7.) and 100 patients with M. pneumoniae pneumonia.
Results: In COVID-19 pneumonia, at the first CT examination, peripheral, bilateral ground-glass opacity (GGO) with or without consolidation or crazy-paving pattern was observed frequently. GGO frequently had a round morphology (39.2%). No differences were observed in the radiological findings between the non-B.1.1.7 groups and B.1.1.7 groups. The frequency of pleural effusion, lymphadenopathy, bronchial wall thickening and nodules (tree-in-bud and centrilobular) was low. In contrast to COVID-19 pneumonia, bronchial wall thickening (84%) was observed most frequently, followed by nodules (81%) in M. pneumoniae pneumonia. These findings were significantly higher in M. pneumoniae pneumonia than COVID-19 pneumonia.
Conclusions: Our results demonstrated that a combination of the JRS scoring system and chest CT findings is useful for the rapid presumptive diagnosis of COVID-19 pneumonia in patients aged <60 years. However, this clinical and radiographic diagnosis is not adapted to elderly people.
Keywords: COVID-19; Chest computed tomography; Community-acquired pneumonia; JRS scoring System; Mycoplasma pneumoniae; SARS-CoV-2.