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      CT Manifestations of Novel Coronavirus Pneumonia: A Case Report

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          Abstract

          Background:

          Since December 2019, the outbreak of the novel coronavirus has impacted nearly >90,000 people in more than 75 countries. In this case report, we aim to define the chest computed tomography findings of 2019-novel coronavirus associated with pneumonia and its successful resolution after treatment.

          Case Report:

          A fifty-year-old female patient, who is a businesswoman, presented with chief complaints of “fever for one week, diarrhea, anorexia, and asthenia.” Initially, she was given Tamiflu. The influenza A virus serology was negative. Three days later, levofloxacin was started because the patient’s symptoms did not improve. The novel coronavirus nucleic acid test was negative. It was noted that before the onset of the disease, the patient went to Wuhan on a business trip. Despite the given treatment, her body temperature rose to 39.2°C and she was referred to our clinic for further evaluation. Then, chest computed tomography was performed and showed bilateral multifocal ground glass opacities with consolidation which suggested viral pneumonia as a differential diagnosis, and the subsequent 2019-novel coronavirus pneumonia nucleic acid test was positive.

          Conclusion:

          Chest computed tomography offers fast and convenient evaluation of patients with suspected 2019-novel coronavirus pneumonia.

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          Most cited references6

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          A Novel Coronavirus from Patients with Pneumonia in China, 2019

          Summary In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.)
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            Correlation of Chest CT and RT-PCR Testing in Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases

            Background Chest CT is used for diagnosis of 2019 novel coronavirus disease (COVID-19), as an important complement to the reverse-transcription polymerase chain reaction (RT-PCR) tests. Purpose To investigate the diagnostic value and consistency of chest CT as compared with comparison to RT-PCR assay in COVID-19. Methods From January 6 to February 6, 2020, 1014 patients in Wuhan, China who underwent both chest CT and RT-PCR tests were included. With RT-PCR as reference standard, the performance of chest CT in diagnosing COVID-19 was assessed. Besides, for patients with multiple RT-PCR assays, the dynamic conversion of RT-PCR results (negative to positive, positive to negative, respectively) was analyzed as compared with serial chest CT scans for those with time-interval of 4 days or more. Results Of 1014 patients, 59% (601/1014) had positive RT-PCR results, and 88% (888/1014) had positive chest CT scans. The sensitivity of chest CT in suggesting COVID-19 was 97% (95%CI, 95-98%, 580/601 patients) based on positive RT-PCR results. In patients with negative RT-PCR results, 75% (308/413) had positive chest CT findings; of 308, 48% were considered as highly likely cases, with 33% as probable cases. By analysis of serial RT-PCR assays and CT scans, the mean interval time between the initial negative to positive RT-PCR results was 5.1 ± 1.5 days; the initial positive to subsequent negative RT-PCR result was 6.9 ± 2.3 days). 60% to 93% of cases had initial positive CT consistent with COVID-19 prior (or parallel) to the initial positive RT-PCR results. 42% (24/57) cases showed improvement in follow-up chest CT scans before the RT-PCR results turning negative. Conclusion Chest CT has a high sensitivity for diagnosis of COVID-19. Chest CT may be considered as a primary tool for the current COVID-19 detection in epidemic areas. A translation of this abstract in Farsi is available in the supplement. - ترجمه چکیده این مقاله به فارسی، در ضمیمه موجود است.
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              A Novel Coronavirus Emerging in China — Key Questions for Impact Assessment

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                Author and article information

                Journal
                Balkan Med J
                Balkan Med J
                BMJ
                Balkan Medical Journal
                Galenos Publishing
                2146-3123
                2146-3131
                May 2020
                10 April 2020
                : 37
                : 3
                : 163-165
                Affiliations
                [1 ]Department of Radiology, Xiangyang First People’s Hospital Affiliated to Hubei Medical College, Hubei, China
                [2 ]Department of Infectious Disease and Respiratory and Critical Care, Xiangyang First People’s Hospital Affiliated to Hubei Medical College, Hubei, China
                [# ]An and Song contributed equally to this work
                Author notes
                * Address for Correspondence: Department of Infectious Disease and Respiratory and Critical Care, Xiangyang First People’s Hospital Affiliated to Hubei Medical College, Hubei, China | Department of Radiology, Xiangyang First People’s Hospital Affiliated to Hubei Medical College, Hubei, China Phone: +86315871014208 E-mail: wangyxyyy@ 123456126.com - lianxyyy2015@ 123456163.com
                Author information
                https://orcid.org/0000-0003-1237-4838
                https://orcid.org/0000-0002-8131-6343
                Article
                37278
                10.4274/balkanmedj.galenos.2020.2020.2.15
                7161622
                32157862
                a4d64d6f-060d-4903-8fda-3eecb418c3d9
                ©Copyright 2020 by Trakya University Faculty of Medicine

                The Balkan Medical Journal published by Galenos Publishing House.

                History
                : 5 February 2020
                : 4 March 2020
                Categories
                Case Report

                computed tomography,diagnosis,influenza,novel coronavirus pneumonia,pulmonary complications

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