Authors
1
The Iraqi Board for Medical Specializations
2
Radiology, Al-Yarmouk Teaching Hospital Baghdad- Iraq.
Abstract
BACKGROUND:
The coronavirus disease (COVID-19) pandemic has resulted in an unexpected high number of hospitalizations for pneumonia with multiorgan illness. It may be asymptomatic or may cause a wide range of symptoms. COVID-19 may cause inflammation in the larynx, trachea, bronchi, beside the lungs. In the diagnosis of COVID-19 patients, computed tomography (CT) with polymerase chain reaction tests has been reported to have a high sensitivity.
OBJECTIVE:
The study aimed to investigate the value of extended chest CT scan to the neck in adult COVID-19 patients.
PATIENTS AND METHODS:
This was a cross-sectional study including 120 patients who were admitted and treated at Al-Imamian Al-Kadhimiyain Medical City, Baghdad, Iraq, during the period from 1st April to 1st December 2021 due to signs and symptoms indicating for COVID-19 infection. Data was collected from patients or their relatives through direct interview and fulfilling prepared questionnaire. According to total severity score, the severity of COVID-19 disease in the chest was graded, also complete neck assessment was done especially lymph nodes (LNs), trachea and vocal cords by extended chest CT to the neck.
RESULTS:
There were two extended chest CT features differed significantly in COVID-19 patients from non-COVID-19 patients: higher number of thickened vocal cords and presence of cervical pathological lymph nodes (level II) in COVID 19 patients in compare to non-COVID -19 patients, also in comparison to mild and moderate cases, severe patients have three distinct characteristics. The mean internal tracheal diameter in severe cases was lower than either moderate or mild cases, the frequency of pathologic lymph nodes (level II) in severe was higher and all pathological cervical lymph nodes in severe cases were in right side and in comparison to mild or moderate cases there was a highly significant differences.
CONCLUSION:
The most important findings in extended chest CT scan to the neck in adult COVID-19 patients are frequent vocal cord thickening and pathological lymph nodes of level II. These findings mostly associated with severe COVID-19 cases in addition to unilateral involvement of neck lymph nodes.
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