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Ng BH, Nuratiqah NA, Andrea YLB, Faisal AH, Soo CI, Najma K, Shahizon MM, Isa AZ, Kamazuraman L, Yusuf AS, Abdul GH, Mustafa N, Nafisah WY, Azmin S, Khoo CS, Hemalatha M, Ching ZH, Low HJ, Periyasamy P. Lung computed tomography patterns of a cluster of asymptomatic young males with COVID-19 admitted to a teaching hospital in Kuala Lumpur. Med J Malaysia 2020; 75:368-371. [PMID: 32723996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND OBJECTIVE Coronavirus Disease 2019 (COVID- 19) was first reported in Malaysia in March 2020. We describe here the clinical characteristics and computed tomography (CT) patterns in asymptomatic young patients who had laboratory-confirmed COVID-19. METHODS This is a retrospective observational study where 25 male in-patients with laboratory-confirmed COVID-19 in Hospital Canselor Tuanku Muhriz. Demographics, clinical data and CT images of these patients were reviewed by 2 senior radiologists. RESULTS In total there were 25 patients (all males; mean age [±SD], 21.64±2.40 years; range, 18-27 years). Patients with abnormal chest CT showed a relatively low normal absolute lymphocytes count (median: 2.2 x 109/L) and absolute monocyte count (median: 0.5 x 109/L). Lactate dehydrogenase was elevated in 5 (20%) of the patients. The procalcitonin level was normal while elevated levels of alanine aminotransferase, total bilirubin, platelet and C-reactive protein were common. Baseline chest CT showed abnormalities in 6 patients. The distribution of the lesions were; upper lobe 3 (12%) lower lobe 3 (12%) with peripheral distribution 4 (16%). Of the 25 patients included, 4 (16%) had ground glass opacification (GGO), 1 (4%) had a small peripheral subpleural nodule, and 1 (4%) had a dense solitary granuloma. Four patients had typical CT features of COVID-19. CONCLUSION We found that the CT imaging showed peripheral GGO in our patients. They remained clinically stable with no deterioration of their respiratory symptoms suggesting stability in lung involvement. We postulate that rapid changes in CT imaging may not be present in young, asymptomatic, non-smoking COVID-19 patients. Thus the use of CT thoraxfor early diagnosis may be reserved for patients in the older agegroups, and not in younger patients.
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Affiliation(s)
- B H Ng
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Pulmonology Unit, Kuala Lumpur, Malaysia
| | - N A Nuratiqah
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Pulmonology Unit, Kuala Lumpur, Malaysia
| | - Y L B Andrea
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Pulmonology Unit, Kuala Lumpur, Malaysia.
| | - A H Faisal
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Pulmonology Unit, Kuala Lumpur, Malaysia
| | - C I Soo
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Pulmonology Unit, Kuala Lumpur, Malaysia
| | - K Najma
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Infectious Diseases Unit, Kuala Lumpur, Malaysia
| | - M M Shahizon
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Radiology, Kuala Lumpur, Malaysia
| | - A Z Isa
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Radiology, Kuala Lumpur, Malaysia
| | - L Kamazuraman
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Nephrology Unit, Kuala Lumpur, Malaysia
| | - A S Yusuf
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Nephrology Unit, Kuala Lumpur, Malaysia
| | - G H Abdul
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Nephrology Unit, Kuala Lumpur, Malaysia
| | - N Mustafa
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Endocrine Unit, Kuala Lumpur, Malaysia
| | - W Y Nafisah
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Neurology Unit, Kuala Lumpur, Malaysia
| | - S Azmin
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Neurology Unit, Kuala Lumpur, Malaysia
| | - C S Khoo
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Neurology Unit, Kuala Lumpur, Malaysia
| | - M Hemalatha
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Pulmonology Unit, Kuala Lumpur, Malaysia
| | - Z H Ching
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Pulmonology Unit, Kuala Lumpur, Malaysia
| | - H J Low
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Anaesthesiology and critical care, Kuala Lumpur, Malaysia
| | - P Periyasamy
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Infectious Diseases Unit, Kuala Lumpur, Malaysia
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