Current and Emerging Knowledge in COVID-19.

Radiology

From the Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea (Y.J.J.); Division of Infectious Diseases, Department of Internal Medicine (Y.M.W., S.H.K.) and Department of Radiology (K.S.L.), Samsung Changwon Hospital, Sungkyunkwan University School of Medicine (SKKU-SOM), Changwon 51353, Korea; Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon, Korea (H.P.); Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Korea (H.P.); and Department of Radiology, Chonnam National University Hospital, Gwangju, Korea (J.E.L.).

Published: February 2023

AI Article Synopsis

  • - COVID-19 has caused a major global health crisis, with distinct phases of infection—early, pulmonary, and hyperinflammatory—each having unique clinical and imaging characteristics that influence treatment strategies.
  • - In the early phase, CT scans often show peripheral ground-glass opacities, where targeted treatments for SARS-CoV-2 are most effective, while later phases involve different CT patterns like organizing pneumonia, where anti-inflammatory therapies work better.
  • - Vaccination, especially through the fourth mRNA dose, provides protection against severe illness, but post-COVID-19 conditions (long COVID) raise new challenges in patient care and radiological assessment despite improved understanding of disease imaging and treatment.

Article Abstract

COVID-19 has emerged as a pandemic leading to a global public health crisis of unprecedented morbidity. A comprehensive insight into the imaging of COVID-19 has enabled early diagnosis, stratification of disease severity, and identification of potential sequelae. The evolution of COVID-19 can be divided into early infectious, pulmonary, and hyperinflammatory phases. Clinical features, imaging features, and management are different among the three phases. In the early stage, peripheral ground-glass opacities are predominant CT findings, and therapy directly targeting SARS-CoV-2 is effective. In the later stage, organizing pneumonia or diffuse alveolar damage pattern are predominant CT findings and anti-inflammatory therapies are more beneficial. The risk of severe disease or hospitalization is lower in breakthrough or Omicron variant infection compared with nonimmunized or Delta variant infections. The protection rates of the fourth dose of mRNA vaccination were 34% and 67% against overall infection and hospitalizations for severe illness, respectively. After acute COVID-19 pneumonia, most residual CT abnormalities gradually decreased in extent, but they may remain as linear or multifocal reticular or cystic lesions. Advanced insights into the pathophysiologic and imaging features of COVID-19 along with vaccine benefits have improved patient care, but emerging knowledge of post-COVID-19 condition, or long COVID, also presents radiology with new challenges.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9846833PMC
http://dx.doi.org/10.1148/radiol.222462DOI Listing

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