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Radiologic Abnormalities in Prolonged SARS-CoV-2 Infection: A Systematic Review
Beck Kyongmin Sarah,Yoon Jeong-Hwa,Yoon Soon Ho 대한영상의학회 2024 Korean Journal of Radiology Vol.25 No.5
We systematically reviewed radiological abnormalities in patients with prolonged SARS-CoV-2 infection, defined as persistently positive polymerase chain reaction (PCR) results for SARS-CoV-2 for > 21 days, with either persistent or relapsed symptoms. We extracted data from 24 patients (median age, 54.5 [interquartile range, 44–64 years]) reported in the literature and analyzed their representative CT images based on the timing of the CT scan relative to the initial PCR positivity. Our analysis focused on the patterns and distribution of CT findings, severity scores of lung involvement on a scale of 0–4, and the presence of migration. All patients were immunocompromised, including 62.5% (15/24) with underlying lymphoma and 83.3% (20/24) who had received anti-CD20 therapy within one year. Median duration of infection was 90 days. Most patients exhibited typical CT appearance of coronavirus disease 19 (COVID-19), including ground-glass opacities with or without consolidation, throughout the follow-up period. Notably, CT severity scores were significantly lower during ≤ 21 days than during > 21 days (P < 0.001). Migration was observed on CT in 22.7% (5/22) of patients at ≤ 21 days and in 68.2% (15/22) to 87.5% (14/16) of patients at > 21 days, with rare instances of parenchymal bands in previously affected areas. Prolonged SARS-CoV-2 infection usually presents as migrating typical COVID-19 pneumonia in immunocompromised patients, especially those with impaired B-cell immunity.
Kyongmin Sarah Beck,Soh Yong Jeong,이교영,장기육,정정임 대한심장학회 2016 Korean Circulation Journal Vol.46 No.6
Eosinophilic myocarditis is a disease characterized by eosinophilic infiltration of the myocardium, consisting of acute necrotic stage, thrombotic stage, and fibrotic stage. Although T1 mapping has been increasingly used in various cardiac pathologies, there has been no report of T1 mapping in eosinophilic myocarditis. We report a case of 75-year-old female with eosinophilic myocarditis, whose cardiac magnetic resonance imaging included native T1 mapping, in which apical thrombi were distinctly seen as areas with decreased T1 values, next to areas of inflammation seen as increased T1 value in subendocardium.
Coronary-to-Pulmonary Artery Fistula in Adults: Natural History and Management Strategies
Hokun Kim,Kyongmin Sarah Beck,Yeon Hyeon Choe,정정임 대한영상의학회 2019 Korean Journal of Radiology Vol.20 No.11
Objective: To evaluate the natural course of coronary-to-pulmonary artery fistula (CPAF) detected on coronary computed tomography angiography (CCTA) and to propose potential treatment strategies. Materials and Methods: In this retrospective multicenter study, we assessed the CCTA reports of 188 CPAF patients evaluated between March 2009 and June 2016. Fifty-seven patients were excluded because their follow-up (FU) periods were less than 2 years. Information regarding demographic characteristics, past history, treatment method, and the occurrence of major adverse cardiac events (MACE) during the FU period was collected. We analyzed the morphologic features of CPAF and the various factors associated with surgical treatment. Patients who had undergone FU CCTA after being diagnosed with CPAF were assessed for the presence of morphological changes on FU imaging. Results: The median age of the study population was 63.0 years (range, 57.0–72.0 years), and the median FU period was 5.72 years (range, 4.08–6.96 years). The most common origin of the CPAF was both coronary arteries in 76 (58.0%) cases. An aneurysm or aneurysms was/were present in 41 (31.3%) cases. Fifty-four (41.2%) fistulas were less than 2 mm in size. Eight patients underwent surgery, and 123 (93.9%) patients received optimal medical treatment (OMT). The fistula size was significantly different between the two treatment groups (p = 0.013) and was the only factor associated with surgical treatment (odds ratio = 1.14, p = 0.021). Only one patient in the OMT group reported MACE during the FU period due to preexisting coronary artery disease. Twenty-nine patients (22.1%) underwent FU CCTA after CPAF diagnosis, with a median FU period of 3.81 years. None of the patients in the OMT group demonstrated morphological changes in the CPAF on FU imaging. Conclusion: Most CPAFs identified on CCTA have a favorable prognosis. Observation with OMT is usually an appropriate strategy. Fistula size is a possible determinant for surgical treatment.
( Jiwon Ryoo ),( Ji Young Kang ),( Hyeong Jun Cho ),( Jongmin Lee ),( Chinkook Rhee ),( Seung Joon Kim ),( Seok Chan Kim ),( Young Kyoon Kim ),( Kyongmin Sarah Beck ),( Jun-pyo Myong ) 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.-
Background On COVID-19 pandemic, patients who have respiratory symptoms have less access to hospital and early treatment is difficult. We investigated the clinical impact of COVID-19 on management in patients with tuberculosis in a longitudinal cohort analysis. Methods This study was conducted retrospectively in Seoul St. Mary hospital between January 2019 and December 2020. Among 500 TB subjects, 52 patients who did not take an initial diagnosis with TB in our hospital were excluded. Results Out of 448 patients, 267 (59.6%) were diagnosed as TB in 2019 and 181 (40.4%) were diagnosed in 2020. The duration of from symptom onset to diagnosis was not distinctive between in both group. But the proportion of hospital admission related with TB infection increased after COVID-19 epidemic (38.7% vs 62.4%, p <.0001). We further analyzed in subgroups diagnosed with pulmonary TB. The patients with pulmonary TB were higher in 2019 than in 2020 (59.12% vs 40.88%, p< 0001). The average age, history of tuberculosis were similar between two groups. The portion of having underlying diseases was increased in the 2020 group with pulmonary TB (59.04% in 2019 vs 70.77% in 2020, p= 0.0398). The percentage of AFB stain positivity and TB involved area in chest X-ray were higher and more severe in the 2020 group, diagnosed with pulmonary TB after COVID-19 pandemic. TB treatment outcome was contrasting between two groups. Favorable outcome including cure or completion of TB showed higher in the 2019 than in the 2020 (Cure, 12.5% vs 10%, p= 0.0027; treatment completion, 65.9% vs 50%, p=0.0027). Conclusions In pulmonary TB, higher mycobacterial TB burden, more extensive area of TB in Chest X-ray, lower rate of treatment outcome were revealed in the 2020 patients than in the 2019, suggesting that COVID-19 pandemic affected detrimental to the patients’ care with TB infection.