CT karakteristike bolesti koronavirus 2019 (COVID-19) kod 330 bolesnika lečenih u Srbiji
CT karakteristike COVID- 19
Sažetak
Uvod/Cilj. Bolest koronavirus 2019 (COVID-19) primarno zahvata respiratorni sistem, tako da se radiološka dijagnostika pokazala neophodnom. Kompjuterizovana tomografija (CT) grudnog koša pokazala se kao najbolji modalitet za inicijalnu procenu osoba sumnjivih na COVID-19, pošto CT nalaz može biti pozitivan i pre pojave simptoma. Cilj ove studije bio je da se prikažu različite CT karakteristike obolelih od COVID-19, sa različitim vremenskim tokom i težinom bolesti. Metode. Sprovedena je prospektivna kohortna studija na 330 bolesnika (prosečne starosti 52,37 ± 15,36) sa dijagnozom COVID-19, potvrđenom putem laboratorijskog testiranja. Tokom hospitalizacije, svim bolesnicima uključenim u studiju urađen je CT pregled grudnog koša u cilju procene proširenosti promena u plućima. Promene na CT snimcima podeljene su u četiri kategorije: plućne, bronhijalne, pleuralne i medijastinalne promene. Na osnovu vremenskog intervala od pojave simptoma do CT pregleda, bolesnici su bili podeljeni u tri grupe: prva grupa (≤ 7 dana); druga grupa (7–14 dana); treća grupa (> 14 dana). U cilju što preciznijeg praćenja distribucije
lezija u plućima, pluća su podeljena na 12 ’plućnih’ zona. Svakoj zoni je dodeljen CT skor. Total severity score bio je izračunat kao suma skorova pojedinih zona. Rezultati. Kod 93,6% obolelih od COVID-19, CT nalaz je bio pozitivan. Oko 92,1% bolesnika imalo je više lezija. Lezije su bile bilateralne kod 87,6% bolesnika, periferno i centralno lokalizovane kod 63,3% bolesnika, a češće su se javljale u posteriornim segmentima (93%), kao i u donjim plućnim zonama (91,2%). Prosečan Total severity score bio je 11,00 (7,00– 16,00). Najčešći CT nalaz je bila opacifikacija po tipu „mlečnog stakla” (97,7%), retikularna šara (91,3%), konsolidacija (71,5%) i fibrozne trake (63,8%). Promene na CT snimku nađene su kod 80.0% bolesnika iz prve grupe, kod 95.0% iz druge grupe i kod 99.4% iz treće grupe. Zaključak. CT se pokazao kao veoma važna dijagnostička metoda kod bolesnika sa COVID-19 i zajedno sa kliničkim i laboratorijskim nalazima daje potpunu sliku stanja bolesnika čime značajno utiče na donošenje odluka o daljem lečenju.
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