1.Lung computed tomography patterns of a cluster of asymptomatic young males with COVID-19 admitted to a teaching hospital in Kuala Lumpur
Boon Hau Ng ; Nik Nuratiqah Nik Abeed ; Andrea Ban Yu Lin ; Mohamed Faisal Abdul Hamid ; Lydia Kamaruzaman ; Muhammad Yusuf Abu Shamsi ; Halim Gafor ; Norlaila Mustafa, ; Wan Nur Nafisah Wan Yahya ; Shahrul Azmin ; Khoo Ching Soong ; Hemalatha Munusamy ; Zhen Hao Ching ; Hsueh Jing Low ; Petrick Periyasamy
The Medical Journal of Malaysia 2020;75(4):368-371
Background and objective: Coronavirus Disease 2019 (COVID19) 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 thorax
for early diagnosis may be reserved for patients in the older age
groups, and not in younger patients.
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