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Submitted: 01 May 2021
Accepted: 16 Aug 2021
ePublished: 04 Mar 2022
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J Renal Inj Prev. 2023;12(3): e31946.
doi: 10.34172/jrip.2022.31946

Scopus ID: 85166335940
  Abstract View: 2075
  PDF Download: 725

Original

Pattern and prevalence of different findings in high resolution computed tomography images in patients with coronavirus disease and kidney injury; a pilot study

Amir-Reza Dalili 1 ORCID logo, Elham Ramezanzadeh 2,3* ORCID logo, Fahime Soleimani Farsani 1 ORCID logo, Elahe Saffari 1 ORCID logo, Azin Vakilpour 4 ORCID logo, Eshagh Mohammadyari 4 ORCID logo, Sara Samiee 5 ORCID logo, Masumeh Namdar 3 ORCID logo

1 Radiology Department, Razi Hospital, Guilan University of medical sciences, Rasht, Iran
2 Razi Clinical Research Development Center, School of Medicine, Razi hospital, Guilan University of Medical Sciences, Rasht, Iran
3 Nephrology Department, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
4 Cardiovascular diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
5 Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
*Corresponding Author: Elham Ramezanzadeh, Email: rz.elham58@gmail.com, , Email: E.ramezanzade@gums.ac.ir

Abstract

Introduction: Since December 2019, an outbreak of pneumonia caused by a new coronavirus has emerged. The standard diagnostic method for COVID-19 infection is the real-time reverse transcriptase-polymerase chain reaction (RT-PCR). High-resolution computed tomography (HRCT) has been proven as a sensitive, feasible and accessible test in Iran. In addition to respiratory system, other organs could also be involved in this disease. The exact mechanism of renal involvement is unknown; however, acute kidney injury (AKI) occurs in almost 5-15% of cases. Different HRCT patterns might be associated with AKI presence and severity of the disease.

Objectives: To investigate patterns and prevalence of different HRCT findings in COVID-19 patients with concurrent AKI.

Patients and Methods: In this retrospective study, we reviewed all hospitalized patients with COVID-19 infection, from February to April 2020 in Razi hospital, Rasht. Twenty-two cases who had AKI were enrolled. The HRCT findings of the patients were reviewed independently by two radiologists. Percentage and prevalence of HRCT findings were analyzed in SPSS 21 software.

Results: All 22 cases had multifocal distribution on HRCT. Around 95.5% had peripheral involvement, 86.4% had central zones opacity while 72.2% of cases had peribronchovascular pattern. Bilateral lung involvement was found in 90.9%, but only 9.1% had unilateral involvement. There was 59.1% of lower lobe predominance for COVID-19 involvement since sub-pleural regions were spared in 18.2% of individuals. All the patients’ HRCTs showed ground glass opacity. Reticular pattern (81.8%), consolidation (77.3%), vascular enlargement in involved zones (68.2%) and airway changes (68.2%) were the next more prevalent findings. Half of the subjects showed crazy paving, 45.5% had pleural effusion and 13.6% had also lymphadenopathy. We found 40.9% of the patients had arcade-like sign. Less frequent findings were nodular opacities (13.6%), halo sign (9.1%) and reverse-halo sign (9.1%), respectively.

Conclusion: This study demonstrated that atypical patterns are likely to be more common in COVID-19 patients with kidney injury.


Implication for health policy/practice/research/medical education:

In this retrospective study, we reviewed patients with COVID-19 infection, who had also acute kidney injury. All 22 cases had multifocal distribution on high-resolution computed tomography (HRCT). About 95.5% of cases had peripheral involvement, 86.4% had central zones opacity while 72.2% had peribronchovascular involvement. Bilateral lung involvement was found in 90.9%; however, only 9.1% had unilateral involvement. There was 59.1% lower lobe predominance. We found the reticular pattern in 81.8% of cases, consolidation in 77.3%, vascular enlargement in involved zones in 68.2% of patients and airway changes in 68.2% of participants. Half of the subjects showed crazy paving, 45.5% pleural effusion and 13.6% lymphadenopathy. We also detected, 40.9% of the patients had arcade-like sign. Less frequent findings were nodular opacities (13.6%), halo sign (9.1%) and reverse-halo sign (9.1%) respectively. Our study showed that atypical patterns are likely to be more common in COVID-19 patients with acute kidney injury.

Please cite this paper as: Dalili AR, Ramezanzade E, Soleimani Farsani F, Saffari E, Vakilpour A, Mohammadyari E, et al. Pattern and prevalence of different findings in high resolution computed tomography images in patients with coronavirus disease and kidney injury; a pilot study. J Renal Inj Prev. 2023; 12(3): e31946. doi: 10.34172/jrip.2022.31946.

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