COVID-19 in pregnancy: a systematic review of chest CT findings and associated clinical features in 427 patients

Autor: Ali Gholamrezanezhad, Brandon K.K. Fields, Natalie L. Demirjian, Rachel R. Oshay, Daniel Mosallaei, Ryan S. Lee, Michael Chen
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Adult
Lung Diseases
medicine.medical_specialty
Coronavirus disease 2019 (COVID-19)
Pleural effusion
Population
MERS
Middle East Respiratory Syndrome
Chest ct
WHO
World Health Organization
030218 nuclear medicine & medical imaging
03 medical and health sciences
COVID-19 Testing
0302 clinical medicine
Opacities NOS
Opacities Not-Otherwise-Specified
Pregnancy
Internal medicine
medicine
Humans
Radiology
Nuclear Medicine and imaging
Cardiothoracic Imaging
SARS-CoV
Severe Acute Respiratory Syndrome Coronavirus
education
Lung
Computed tomography
GGOs
Ground-Glass Opacities
education.field_of_study
RT-PCR
Reverse Transcriptase Polymerase Chain Reaction
business.industry
SARS-CoV-2
Infant
Newborn
COVID-19
CT
Computed Tomography
Pneumonia
medicine.disease
Neutrophilia
Neonatal infection
Radiology Nuclear Medicine and imaging
030220 oncology & carcinogenesis
COVID-19
Coronavirus Disease 2019
Female
medicine.symptom
Tomography
X-Ray Computed
business
Zdroj: Clinical Imaging
ISSN: 0899-7071
DOI: 10.1016/j.clinimag.2021.01.004
Popis: Purpose Our purpose was to conduct a comprehensive systematic review of all existing literature regarding imaging findings on chest CT as well as associated clinical features in pregnant patients diagnosed with COVID-19. Materials & methods A literature search was conducted on April 21, 2020 and updated on July 24, 2020 using PubMed, Embase, World Health Organization, and Google Scholar. Only studies which described chest CT findings of COVID-19 in pregnant patients were included for analysis. Results A total of 67 articles and 427 pregnant patients were analyzed. The most frequently encountered pulmonary findings on chest CT of pregnant patients diagnosed with COVID-19 were ground-glass opacities (77.2%, 250/324), posterior involvement (72.5%, 50/69), multilobar involvement (71.8%, 239/333), bilateral lung involvement (69.4%, 231/333), peripheral distribution (68.1%, 98/144), and consolidation (40.9%, 94/230). Pregnant patients were also found to present more frequently with consolidation (40.9% vs. 21.0–31.8%) and pleural effusion (30.0% vs. 5.0%). Clinical findings included antepartum fever (198 cases), lymphopenia (128 cases), and neutrophilia (97 cases). Of the 251 neonates delivered to mothers with COVID-19, 96.8% of the neonates had negative RT-PCR and/or IgG antibody testing. In the eight cases (3.2%) of reported neonatal infection, tests were either conducted up to 72 h after birth or were found negative on all subsequent RT-PCR tests. Conclusion Pregnant patients appear to present with more advanced COVID-19 CT findings than those of the general adult population. The changes in laboratory values found in pregnant patients also mirror those found in the general patient population. Lastly, results from neonatal testing suggest low risk of vertical transmission. Summary statement The initial chest CT scans of 427 pregnant patients with COVID-19 showed higher rates of consolidation and pleural effusion in comparison to the general population.
Highlights • Pregnant patients with COVID-19 were most often found to have bilateral, peripheral lung involvement. • Pregnant patients with COVID-19 frequently presented with consolidation (40.9%) and pleural effusion (30.0%). • Adoption of a standardized lexicon for reporting findings of COVID-19 is recommended to avoid heterogeneous and inconsistent use of morphological descriptors.
Databáze: OpenAIRE
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