Übersicht über relevante radiologische Publikationen zu COVID-19

Übersicht über relevante radiologische Publikationen zu COVID-19

Die Literaturübersicht basiert auf einer standardisierten Suche nach Schlüsselwörtern im Kontext der Radiologie rund um das Thema COVID-19.

  • Datum:

Folgende Datenbanken wurden für die Suche benutzt: PubMed und Google Scholar

Folgende Begriffe wurden in die Suche aufgenommen: Radiology, image findings, CT, 2019-nCoV and COVID.

Pan, Y., Guan, H., Zhou, S. et al. Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China. Eur Radiol (2020). https://rdcu.be/b3aZx

Ziel: The purpose of this study was to observe the imaging characteristics of the novel coronavirus pneumonia.

Patienten: 63

Ergebnis: Imaging changes in novel viral pneumonia are rapid. The manifestations of the novel coronavirus pneumonia are diverse. Imaging changes of typical viral pneumonia and some specific imaging features were observed. Therefore, we need to strengthen the recognition of image changes to help clinicians to diagnose quickly and accurately.
Ye, Z., Zhang, Y., Wang, Y. et al. Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review. Eur Radiol (2020). https://doi.org/10.1007/s0033 0-020-06801-0

Ziel: To review the typical and relatively atypical CT manifestations with representative COVID- 19 and hope to strengthen the recognition of these features with radiologists and help them make a quick and accurate diagnosis.

Ergebnis: Ground glass opacities, consolidation, reticular pattern, and crazy paving pattern are typical CT manifestations of COVID-19.
  • Emerging atypical CT manifestations, including airway changes, pleural changes, fibrosis, nodules, etc., were demonstrated in COVID-19
  • CT manifestations may associate with the progression and prognosis of COVID-19.

Fang Y, Zhang H,Xie J et al. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR, Radiology February 2020. https://doi.org/10.1148/radiol.2020200432

Ziel: The purpose of this study was to compare the sensitivity of chest CT and viral nucleic acid assay at initial patient presentation.

Patienten: 51

Ergebnis: In a series of 51 patients with chest CT and RT-PCR performed in 3 days, the sensitivity of CT for COVID-19 was 98% compared to RT-PCR sensitivity of 71%.

Bernheim A,Mei X, Huang M et al. Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection, Radiology February 2020. https://doi.org/10.1148/radiol.202020046

Ziel: The hypothesis that certain CT findings may be more common depending on the time course of infection.

Patienten: 121

Ergebnis: The hallmarks of COVID-19 infection on imaging were bilateral and peripheral ground-glass and consolidative pulmonary opacities. Notably, 20/36 (56%) of early patients had a normal CT. With a longer time after the onset of symptoms, CT findings were more frequent, including consolidation, bilateral and peripheral disease, greater total lung involvement, linear opacities, “crazy- paving” pattern and the “reverse halo” sign. Bilateral lung involvement was observed in 10/36 early patients (28%), 25/33 intermediate patients (76%), and 22/25 late
patients (88%).
Li Y ,Xia L et al.Coronavirus Disease 2019 (COVID-19):Role of Chest CT in Diagnosis and Management. AJR March 2020. https://doi.org/10.2214/AJR.20.22954

Ziel: To determine the misdiagnosis rate of radiologists for coronavirus disease 2019 (COVID-19) and evaluate the performance of chest CT in the diagnosis and management of COVID-19.

Patienten: 51

Ergebnis: Chest CT had a low rate of missed diagnosis of COVID- 19 (3.9%, 2/51) and may be useful as a standard method for the rapid diagnosis of COVID-19 to optimize the management of patients. However, CT is still limited for identifying specific viruses and distinguishing between viruses.

Shi H, Han X et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet February 2020 https://doi.org/10.1016/S1473-3099(20)30086-4

Ziel: Aim to describe the CT findings across different time points throughout the disease course.


COVID-19 pneumonia manifests with chest CT imaging abnormalities, even in asymptomatic patients, with rapid evolution from focal unilateral to diffuse bilateral ground-glass opacities that progressed to or co-existed with consolidations within 1–3 weeks.
Han R, Huang L et al. Early Clinical and CT Manifestations of Coronavirus Disease 2019 (COVID-19) Pneumonia. https://www.arrs.org/downloads/ajr/Early-Clinical-CT-Manifestations-COVID-19-Pneumonia.pdf

Ziel: To investifate early clinical and CT manifestations of coronavirus disease (COVID-19) pneumonia.

Patienten: 180

Ergebnis: The early CT findings are patchy GGO with or without consolidation involving multiple lobes, mainly in the peripheral zone, accompanied by halo sign, vascular thickening, crazy paving pattern, or air bronchogram sign.
Wang Y, Dong C et al. Temporal Changes of CT Findings in 90 Patients with COVID-19 Pneumonia: A Longitudinal Study. Radiology March 2020. https://doi.org/10.1148/radiol.2020200843

Ziel: To perform a longitudinal study to analyze the serial CT findings over time in patients with COVID-19 pneumonia.

Patienten: 90

Ergebnis: The extent of lung abnormalities on CT peaked during illness days 6-11. The temporal changes of the diverse CT manifestations followed a specific pattern, which might indicate the progression and recovery of the illness.
Ai T, Yang Z et al. Correlation of Chest CT and RT-PCR Testing in Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology February 2020. https://doi.org/10.1148/radiol.2020200642

Ziel: To investigate the diagnostic value and consistency of chest CT as compared with comparison to RT-PCR assay in COVID-19.

Patienten: 1014

Ergebnis: 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.
Chen N, Zhou M, Dong X et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet February 2020. https://doi.org/10.1016/S0140-6736(20)30211-7

 Ziel: To clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia.

Patienten: 99

Ergebnis: The 2019-nCoV infection was of clustering onset, is more likely to affect older males with comorbidities, and can result in severe and even fatal respiratory diseases such as acute respiratory distress syndrome. In general, characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia.
Xie, X, Zhong, Z, Zhao, W, Zheng, C, Wang, F, Liu, J. Chest CT for typical 2019-nCoV pneumonia: relationship to negative RT-PCR testing. Radiology February 2020. https://doi.org/10.1148/radiol.2020200343

Ziel: To describe CT maging features of five patients with initial negative or weakly positive RT-PCR results but high suspicion of 2019-nCoV infection.

Patienten: 5

Ergebnis: In patients at high risk for 2019-nCoV infection, chest CT evidence of viral pneumonia may precede positive negative RT-PCR test results.
Song F, Shi N, Shan F et al. Emerging Coronavirus 2019-nCoV Pneumonia. Radiology 2020. https://doi.org/10.1148/radiol.2020200274

: To investigate the clinical, laboratory, and imaging findings of emerging 2019-nCoV pneumonia in humans.

Patienten: 51

Ergebnis: Patients with fever and/or cough and with conspicuous ground-glass opacity lesions in the peripheral and posterior lungs on CT images, combined with normal or decreased white blood cells and a history of epidemic exposure, are highly suspected of having 2019 Novel Coronavirus (2019-nCoV) pneumonia.
Pan F, Ye T et al. Time course of lung changes on chest CT during recovery from 2019 novel coronavirus (COVID-19) pneumonia. Radiology 2020. https://doi.org/10.1148/radiol.2020200370

Ziel: To determine the change in chest CT findings associated with COVID-19 pneumonia from initial diagnosis until patient recovery.

Patienten: 21

Ergebnis: In patients recovering from COVID-19 pneumonia (without severe respiratory distress during the disease course), lung abnormalities on chest CT showed greatest severity approximately 10 days after initial onset of symptoms.
Ng MY,Lee EYP et al. Imaging Profile of the COVID-19 Infection: Radiologic Findings and Literature Review. Radiology February 2020. https://doi.org/10.1148/ryct.2020200034

Ziel: 21 COVID-19 cases from two Chinese centers with CT and chest radiograph (CXR) findings, as well as follow-up imaging in 5 cases.

Patienten: 21

Ergebnis: The COVID-19 infection pulmonary manifestation is predominantly characterized by ground-glass opacification with occasional consolidation on CT.
Chung M, Bernheim A et al. CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV). Radiology February 2020. https://doi.org/10.1148/radiol.2020200230

Ziel: Describe and characterize the key CT findings in a group of 21 patients infected with 2019-nCoV in China, with the goal of familiarizing radiologists and clinical teams with the imaging manifestations of this new outbreak.

Patienten: 21

Ergebnis: Of 21 patients with the 2019 novel coronavirus, 15 (71%) had involvement of more than two lobes at chest CT, 12 (57%) had ground-glass opacities, seven (33%) had opacities with a rounded morphology, seven (33%) had a peripheral distribution of disease, six (29%) had consolidation with ground-glass opacities, and four (19%) had crazy-paving pattern. Lung cavitation, discrete pulmonary nodules, pleural effusions, and lymphadenopathy were absent. Fourteen percent of patients (three of 21) presented with a normal CT scan.
Moosa-Basha M, Meltzer C et al. Radiology Department Preparedness for COVID-19: Radiology Scientific Expert Panel. Radiology March 2020. https://pubs.rsna.org/doi/10.1148/radiol.2020200988

Ziel: Radiology preparedness is a set of policies and procedures directly applicable to imaging departments designed (b) to support the care of patients with COVID-19, and (c) to maintain radiologic diagnostic and interventional support for the entirety of the hospital and health system.

Ergebnis:  Sensitivity and specificity of chest CT for COVID-19 are reported to range from 80%-90% and 60%-70%, respectively. CT Imaging is reserved for those cases where it will impact patient management and is clinically indicated or to evaluate for unrelated urgent/emergent indications.
Hosseiny M, Kooraki S et al. Radiology Perspective of Coronavirus Disease 2019 (COVID-19): Lessons from Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome. AJR February 2020. https://doi.org/10.2214/AJR.20.22969

Ziel: To review the lessons from imaging studies obtained during severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) outbreaks.

Ergebnis: Early evidence suggests that initial chest imaging will show abnormality in at least 85% of patients, with 75% of patients having bilateral lung involvement initially that most often manifests as subpleural and peripheral areas of ground-glass opacity and consolidation.
Salehi S, Abedi A et al. Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients. AJR February 2020. https://www.ajronline.org/doi/abs/10.2214/AJR.20.23034

Ziel: The search records were screened, 30 studies consisting of 19 case series and 11 case reports with a total of 919 patients were included in the final review.

Patienten: 919

Ergebnis: The characteristic patterns and distribution of CT manifestations: ground glass opacification (GGO) (88.0%), bilateral involvement (87.5%), peripheral distribution (76.0%), and multi-lobar (more than one lobe) involvement (78.8%).
Li L, Qin L et al. Artificial Intelligence Distinguishes COVID-19 from Community Acquired Pneumonia on Chest CT. Radiology March 2020. https://doi.org/10.1148/radiol.2020200905

Ziel: To develop a fully automatic framework to detect COVID-19 using chest CT and evaluate its performances.

Patienten: 3322

Ergebnis: Deep learning model can accurately detect COVID-19 and differentiate it from community acquired pneumonia and other lung diseases.
Yang W, Yan F. Patients with RT-PCR Confirmed COVID-19 and Normal Chest CT. Radiology March 2020. https://doi.org/10.1148/radiol.2020200702

: Patient with (RT- PCR) confirmed COVID-19 infection may have normal chest CT findings at admission.

Ergebnis: At present, RT-PCR test remains the reference standard to make a definitive diagnose of COVID-19 infection despite the false-negative rate.
ZU Z, Jiang M et al. Coronavirus Disease 2019 (COVID-19): A Perspective from China. Radiology February 2020. https://doi.org/10.1148/radiol.2020200490

Ziel: A review focusing on the etiology, epidemiology, and clinical symptoms of COVID-19, while highlighting the role of chest CT in prevention and disease control.

Ergebnis: Radiologists understanding of clinical and chest CT imaging features of coronavirus disease 2019 (COVID-19) will help to detect the infection early and assess the disease course.
Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72,314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. February 2020. http://jamanetwork.com/article.aspx?doi=10.1001/jama.2020.2648
Ziel: Chinese Center for Disease Control and Prevention recently published the largest case series to date of coronavirus disease 2019 (COVID-19) in mainland China (72 314 cases, updated through February 11, 2020).

Ergebnis: This Viewpoint summarizes key findings from this report and discusses emerging understanding of and lessons from the COVID-19 epidemic.
Lei et al. CT Imaging of the 2019 Novel Coronavirus (2019-nCoV) Pneumonia. Radiology 2020. https://pubs.rsna.org/doi/10.1148/radiol.2020200236

Ziel: Case report

Ergebnis: First case report demonstrating ground-glass opacities in both lungs the published in Radiology.
Yoon SH, Lee KH et al. Chest Radiographic and CT findings of the 2019 Novel Coronavirus Disease (COVID-19): Analysis of Nine Patients treated in Korea. Korean J Radiol 2020;21(4):494-500 https://doi.org/10.3348/kjr.2020.0132

Ziel: This study presents a preliminary report on the chest radiographic and computed tomography (CT) findings of the 2019 novel coronavirus disease (COVID-19) pneumonia in Korea.

Patienten: 9 

Ergebnis: Chest CT images showed bilateral involvement in eight of the nine patients, and a unilobar reversed halo sign in the other patient. COVID-19 pneumonia in Korea primarily manifested as pure to mixed ground-glass opacities with a patchy to confluent or nodular shape in the bilateral peripheral posterior lungs. A considerable proportion of patients with COVID-19 pneumonia had normal chest radiographs.
Jin Y-H, Cai L et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res 2020;7:4. https://mmrjournal.biomedcentral.com/articles/10.1186/s40779-020-0233-6

Ziel: Based on the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently.

Ergebnis: This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control (including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.
Zheng Y-Y, Ma Y-T et al. COVID-19 and the cardiovascular system. Nature Reviews Cardiology. https://www.nature.com/articles/s41569-020-0360-5

Ziel: Understanding the damage caused by SARS- CoV-2 to the cardiovascular system and the underlying mechanisms is of the greatest importance, so that treatment of these patients can be timely and effective, and mortality reduced.

Ergebnis: Severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) infects host cells through ACE2 receptors, leading to coronavirus disease (COVID-19)-related pneumonia, while also causing acute myocardial injury and chronic damage to the cardiovascular system. Particular attention should be given to cardiovascular protection during treatment for COVID-19.
Bai H, Ben H, Xiong Z et al. Performance of radiologists in differentiating COVID-19 from viral pneumonia on chest CT. Radiology March 2020. https://doi.org/10.1148/radiol.2020200823

Ziel: To assess the performance of United States (U.S.) and Chinese radiologists in differentiating COVID-19 from viral pneumonia on chest CT.

Patienten: 424

Ergebnis: Radiologists in China and the United States distinguished COVID-19 from viral pneumonia on chest CT with high specificity but moderate sensitivity. Three Chinese radiologists had sensitivities of 72%, 72% and 94% and specificities of 94%, 88% and 24% in differentiating 219 COVID-19 from 205 non-COVID-19 pneumonia. Four United States radiologists had sensitivities of 93%, 83%, 73% and 73% and specificities of 100%, 93%, 93% and 100%. The most discriminating features for COVID-19 pneumoniaincluded a peripheral distribution (80% vs. 57%, p<0.001), ground-glass opacity (91% vs. 68%, p<0.001) and vascular thickening (58% vs. 22%, p<0.001).
Zhao W, Zhong Z, Xie X et al. Relation Between Chest CT Findings and Clinical Conditions of Coronavirus Disease (COVID-19) Pneumonia: A Multicenter Study. AJR March 2020. https://www.ajronline.org/doi/abs/10.2214/AJR.20.22976

Ziel: To investigate the relation between chest CT findings and the clinical conditions of COVID-19 pneumonia.

Patienten: 101

Ergebnis: Patients with confirmed COVID-19 pneumonia have typical imaging features that can be helpful in early screening of highly suspected cases and in evaluation of the severity and extent of disease. Most patients with COVID-19 pneumonia have GGO or mixed GGO and consolidation and vascular enlargement in the lesion. Lesions are more likely to have peripheral distribution and bilateral involvement and be lower lung predominant and multifocal. CT involvement score can help in evaluation of the severity and extent of the disease.
Hurt B, Kligerman S, et al. Deep Learning Localization of Pneumonia 2019 Coronavirus (COVID-19) Outbreak. J Thorac Imaging. April 2020 https://journals.lww.com/thoracicimaging/Citation/9000/Deep_Learning_Localization_of_Pneumonia__2019.99441.aspx 

Ziel: Study describes a deep learning approach to augment radiographs with a color probability overlay to improve the diagnosis of pneumonia.

Ergebnis: Algorithm predicted and consistently localized areas of pneumonia with increasing likelihood, as the subtle airspace opacities increased over time. It is worth noting that each radiograph was analyzed by the algorithm independently without awareness of the time course or relationship of previous films. In each case, the predicted probability map correctly localizes the findings and assigns likelihoods that mirror the severity of the imaging findings.
Raptis C, Hammer M et al. Chest CT and Coronavirus Disease (COVID-19): A Critical Review of the Literature to Date. AJR April 2020 https://www.ajronline.org/doi/full/10.2214/AJR.20.23202

Ziel: The purpose of this article is to critically review some of the most frequently cited studies on the use of CT for detecting COVID-19.

Ergebnis: To date, the radiology literature on COVID-19 has consisted of limited retrospective studies that do not substantiate the use of CT as a diagnostic test for COVID-19. Research describing CT features of COVID-19 has consisted mostly of retrospective reviews and case studies, and it should be "considered low quality" according to the authors.
Weinstock et al. Chest X-Ray Findings in 636 Ambulatory Patients with COVID-19 Presenting to an Urgent Care Center: A Normal Chest X-Ray Is no Guarantee. JUCM April 2020 https://www.jucm.com/documents/jucm-covid-19-studyepub-april-2020.pdf/?utm_campaignnews

Ziel: To determine what percentage of urgent care (UC) patients with confirmed COVID-19 had normal vs abnormal chest x-rays (CXR) and to describe specific
imaging characteristics and the frequency of each abnormal findings on plain film radiography

Patienten: 636

Ergebnis: Most patients (566/636) had either normal or only mildly abnormal CXRs (89%), despite being symptomatic enough to warrant imaging as determined by the treating UC provider. Chest x-rays obtained from confirmed and symptomatic COVID-19 patients presenting to the UC were normal in 58.3% of cases, and normal or only mildly abnormal in 89% of patients. When abnormal, the most common findings were present in the lower lobes and the pattern was interstitial and/or multifocal. Pleural effusions and lymphadenopathy were uncommon.
Murphy et al., COVID-19 on the Chest Radiograph: A Multi-Reader Evaluation of an AI System. Radiology May 2020 https://pubs.rsna.org/doi/10.1148/radiol.2020201874

Ziel: To evaluate the performance of an artificial intelligence (AI) system for detection of COVID-19 pneumonia on chest radiographs.

Ergebnis: Using RT-PCR test results as the reference standard, the AI system correctly classified CXR images as COVID-19 pneumonia with an AUC of 0.81. The system significantly outperforms each reader at their highest possible sensitivities. At their lowest sensitivities, only one reader can significantly outperform the AI system (p=0.04). In conclusions, an AI system for detection of COVID-19 on chest radiographs was comparable to six independent readers. 
Prokop et al. CO-RADS – A categorical CT assessment scheme for patients with suspected COVID-19: definition and evaluation. Radiology April 2020 https://pubs.rsna.org/doi/10.1148/radiol.2020201473

Ziel: To introduce the COVID-19 Reporting and Data System (CORADS) for standardized assessment of pulmonary involvement of COVID-19 on nonenhanced
chest CT and report its initial interobserver agreement and performance.

Ergebnis: CO-RADS is a categorical assessment scheme for pulmonary involvement of COVID-19 on non-enhanced chest CT providing very good performance for predicting COVID-19 in patients with moderate to severe symptoms and has a substantial interobserver agreement, especially for categories 1 and 5.
Kandemirli et al., Brain MRI Findings in Patients in the Intensive Care Unit with COVID-19 Infection. Radiology May 2020 https://pubs.rsna.org/doi/10.1148/radiol.2020201697

Ziel: To describe MRI findings of patients in the ICU with COVID-19 pneumonia

Patienten: 27

Ergebnis: 50 of 235 ICU patients developed neurological symptoms. Brain MRI was performed in 27 ICU patients, of which 44% (12/27) of the patients had abnormal MRI findings. In 10/27 (37%) patients, cortical FLAIR signal abnormality was present. Accompanying subcortical and deep white matter signal
abnormality on FLAIR images were each present in 3 patients. Abnormalities involved the frontal lobe in 4, parietal lobe in 3, occipital lobe in 1, insular cortex in 3
and cingulate gyrus in 3 patients.
Grillet et al., Acute Pulmonary Embolism Associated with COVID-19 Pneumonia Detected by Pulmonary CT Angiography. Radiology April 2020  https://pubs.rsna.org/doi/10.1148/radiol.2020201544

Ziel: The main objective of our study was to evaluate pulmonary embolus in association with COVID-19 infection using pulmonary CT angiography.

Patienten: 100

Ergebnis: Finally, 100 patients with COVID-19 infection and severe clinical features were included were examined with contrast enhanced CT. Of 100 patients meeting inclusion criteria, 23 (23%, [95%CI, 15-33%]) patients had acute pulmonary embolism.
Ting DSW, Carin L et al. Digital technology and COVID-19. Nature Medicine March 2020 https://www.nature.com/articles/s41591-020-0824-5

Ziel: To explore the potential application of four inter-related digital technologies (the IoT, big-data analytics, AI and blockchain) to augmenting two traditional publichealth strategies for tackling COVID-19: (1) monitoring, surveillance, detection and prevention of COVID-19; and (2) mitigation of the impact to healthcare
indirectly related to COVID-19

Ergebnis: There is a wide range of digital technology that can be used to augment and enhance these public-health strategies. The immediate use and  successful application of digital technology to tackle a major, global public-health challenge in 2020 will probably increase the public and governmental acceptance of such technologies for other areas of healthcare, including chronic disease in the future. 
Leung et al., Respiratory virus shedding in exhaled breath and efficacy of face masks. Nature Medicine March 2020 https://doi.org/10.1038/s41591-020-0843-2

Ziel: To identify human coronaviruses, influenza viruses and rhinoviruses in exhaled breath and coughs of children and adults with acute respiratory illness.

Patienten: 123

Ergebnis: Viral RNA was identified from respiratory droplets and aerosols for all three viruses. Surgical face masks significantly reduced detection of influenza virus RNA in respiratory droplets and coronavirus RNA in aerosols, with a trend toward reduced detection of coronavirus RNA in respiratory droplets.
Van Doremalen et al., Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. NEJM March 2020 https://www.nejm.org/doi/10.1056/NEJMc2004973

Ziel: To evaluate the stability of SARS-CoV-2 and SARS-CoV-1 in aerosols and on various surfaces and estimated their decay rates using a Bayesian regression

Ergebnis: Results indicate that aerosol and fomite transmission of SARS-CoV-2 is plausible, since the virus can remain viable and infectious in aerosols for hours and on surfaces up to days (depending on the inoculum shed). These findings echo those with SARS-CoV-1, in which these forms of transmission were associated with nosocomial spread and super-spreading events, and they provide information for pandemic mitigation efforts.
Pan et al., Association of Public Health Interventions With the Epidemiology of the COVID-19 Outbreak in Wuhan, China. JAMA March 2020 https://jamanetwork.com/journals/jama/fullarticle/2764658

Ziel: To evaluate the association of public health interventions with the epidemiological features of the COVID-19 outbreak in Wuhan by 5 periods according to key events and interventions.

Ergebnis: A series of multifaceted public health interventions was temporally associated with improved control of the COVID-19 outbreak in Wuhan, China. Findings may inform public health policy in other countries and regions.
Foust et al., International Expert Consensus Statement on Chest Imaging in Pediatric COVID-19 Patient Management: Imaging Findings, Imaging Study Reporting and Imaging Study Recommendations. Radiology April 2020 https://pubs.rsna.org/doi/10.1148/ryct.2020200214

Ziel: To specifically address concerns around pediatric patients, a group of international experts in pediatric thoracic imaging from 5 continents convened to create a consensus statement describing the imaging manifestations, reporting and recommendations.

Ergebnis: Results were compiled into two structured reporting algorithms (one for CXR and one for chest CT) and 8 consensus recommendations for utilization of chest imaging in pediatric COVID-19 infection.
Zhou et al., Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet March 2020 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30566-3/fulltext

Ziel: To report risk factors for mortality and a detailed clinical course of illness, including viral shedding

Ergebnis: Potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future.
Oudkerk et al., Diagnosis, Prevention, and Treatment of Thromboembolic Complications in COVID-19: Report of the National Institute for Public Health of the Netherlands. Radiology April 2020 https://pubs.rsna.org/doi/10.1148/radiol.2020201629

Ziel: A potential link between mortality, Ddimer values and a prothrombotic syndrome has been reported in patients with COVID-19 infection.

Ergebnis: This report summarizes evidence for thromboembolic disease, potential diagnostic and preventive actions as well as recommendations for patients with COVID-19 infection.
Nair et al., A British Society of Thoracic Imaging statement: considerations in designing local imaging diagnostic algorithms for the COVID-19 pandemic. Clinical Radiology March 2020 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7128118/

: They considered how a CXR would also fit into diagnostic algorithms, and in particular, how the use of CT would alter management in settings where a CXR
was or was not available.

Ergebnis: A high pre-test probability is assumed for symptomatic cases, based on one or more of: clinical presentation (Pyrexia of 37.8); acute onset persistent
cough, hoarseness, nasal discharge or congestion, shortness of breath, sore throat, wheezing, sneezing; and compatible laboratory abnormalities (relative
lymphopenia, elevated C-reactive protein [CRP] 
Borghesi et al., Radiographic severity index in COVID‑19 pneumonia: relationship to age and sex in 783 Italian patients. La radiologia medica May 2020  https://link.springer.com/content/pdf/10.1007/s11547-020-01202-1.pdf

Ziel: To improve the risk stratification of patients infected with SARS-CoV-2, an experimental chest Xray (CXR) scoring system for quantifying lung abnormalities 
was introduced in our Diagnostic Imaging Department.

Patienten: 783

Ergebnis: The CXR score was significantly higher in males than in females only in groups aged 50 to 79 years. A significant correlation was observed between the CXR score and age in both males and females. Males aged 50 years or older and females aged 80 years or older with coronavirus disease 2019 showed the highest CXR score (median ≥ 8). In conclusion, males aged 50 years or older and females aged 80 years or older showed the highest risk of developing severe lung disease. Our results may help to identify the highest-risk patients and those who require specific treatment strategies. 
Jones et al., COVID-19 and Kawasaki Disease: Novel Virus and Novel Case. Hospital Pediatrics April 2020  https://hosppeds.aappublications.org/content/early/2020/04/06/hpeds.2020-0123

Ziel: This study looked at a total of 2143 patients, 1412 of whom had suspected but unconfirmed COVID-19 infection, but there was little description of co-incidence of other clinical conditions, and no cases reported of concurrent Kawasaki disease (KD). Authors describe the case of a pediatric patient diagnosed and treated for classic KD in the setting of confirmed COVID-19 infection, published with parental permission.

Patienten: 2143

Ergebnis: This is the first described case of KD with concurrent COVID-19 infection. KD is an acute vasculitis of childhood and the leading cause of acquired heart disease in children in developed countries, with 50% of cases occurring in those <2 years of age, and 80% in those <5 years of age.4 The diagnosis of “classic” KD is considered in patients presenting with fever for 5 days together with at least 4 out of 5 clinical criteria in the absence of an alternate diagnosis.
Although the clinical significance of our patient’s positive COVID-19 testing in the setting of her KD is not clear, her testing for COVID-19 appears accurate.
This case report may serve as a useful reference to other clinicians caring for pediatric patients affected by COVID-19 as understanding of the clinical presentation patterns continue to evolve. Further description of the clinical course of pediatric patients diagnosed with COVID-19 remains necessary, particularly regarding the potential association with KD.