Assessment of Changes and Complications Caused by Coronavirus Infection in The Lungs Using Computed Tomography

CENTRAL ASIAN JOURNAL OF MEDICAL AND NATURAL
SCIENCES
Volume: 03 Issue: 03 | May-Jun 2022 ISSN: 2660-4159

www. cajmns.centralasianstudies.org/index.php
ASSESSMENT OF CHANGES AND

COMPLICATIONS CAUSED BY CORONAVIRUS
INFECTION IN THE LUNGS USING COMPUTED
TOMOGRAPHY
Jonibekov Jasurbek Jonibekovich ABSTRACT: Pathogenetically COVID-19 is characterized by

viremia, local and systemic immuno-inflammatory process,
EMAIL : hyperactivity of the coagulation cascade, endotheliopathy,
hypoxia, which leads to the development of micro- and
Received 26th Aprel 2022,
macrothrombosis; proceeds from asymptomatic to clinically
Accepted 17th May 2022,
Online 16th June 2022 pronounced forms with intoxication, fever, vascular
endothelium damage, lungs, heart, kidneys, gastrointestinal
tract, central and peripheral nervous systems with the risk of
Bukhara State Medical Institute complications (ODN, ARDS, PE, sepsis, shock, SPON). The
main target of SARS CoV-2 is the lungs. In pathogenesis, 2
mechanisms should be distinguished that mutually burden each
other and can lead to the development of ARDS
(pathomorphologically diffuse alveolar damage): direct viral
damage to alveocytes with the development of immuno-
inflammatory syndrome; the development of micro- and
macrothrombosis of pulmonary vessels and obstructive
thrombo-inflammatory syndrome. Therefore, the disease was
named microCLOTS – microCOVID Lung Obstructive
Trombovascular Syndrome1. As in the whole world, the
incidence of COVID 19 pneumonia in the Republic of
Uzbekistan is more than 193,000 people, while there is a steady
increase [1.3.5.7.9].
KEYWORDS: endotheliopathy, macrothrombosis, alveocytes,

COVID-19, syndrome.
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Copyright (c) 2022 Author (s). This is an open-access article distributed under the terms of Creative Commons
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CAJMNS Volume: 03 Issue: 03 | May-Jun 2022
INTRODUCTION
The severity and severity of the clinical manifestations of COVID-19 depends on the massiveness of
infection (the infecting dose of the virus) on the one hand and the individual characteristics of the
macroorganism on the other (age, gender, strength of the immune response, the presence of concomitant
diseases-risk factors, etc.). In radiation diagnostics, various variants of changes in the lungs in patients with
confirmed coronavirus pneumonia detected using various methods of medical imaging (computed
tomography, magnetic resonance imaging, X-ray and ultrasound diagnostics) during primary radiation
examination are considered.
The existing ideas about the possibilities of various methods of radiation diagnostics, knowledge of
terminology and understanding of the radiation picture allow doctors of clinical specialties to increase the
effectiveness of using medical imaging in the examination of patients with coronavirus pneumonia.
Computed tomography is generally considered to be the main method of assessing the lesion of the
pulmonary parenchyma, but MRI also provides informative data on the presence of changes characteristic
of coronavirus pneumonia, and can be used as an alternative [2.4.6].
Magnetic resonance imaging is an informative and minimally invasive imaging method that does not
carry a radiation load on the patient. In the diagnosis of coronavirus infection, MRI can be performed as an
alternative method of examination in the absence of the technical possibility of CT, as well as in a
contingent whose exposure to radiation exposure is undesirable (pregnant women and children), in cases
where there are no absolute contraindications to the use of this method (MR incompatible metal prostheses,
artificial pacemakers, etc.)
According to numerous foreign authors, CT pictures of coronavirus pneumonia, the most frequent
and characteristic sign is the presence of a “frosted glass” symptom, while the symptoms of “cobblestone
pavement”, halo, reticular changes and consolidation are manifested in patients depending on the duration
and severity of the disease and the presence of an attached bacterial infection (Richard Ha. with co-author,
2015; Kirsi Holli-Helenius. with co-author, 2017; Li Qinmei. et al., 2019; Wei Li. et al., 2019) [10.11].
The aim of the study is to study the relationship between the results of chest CT and the clinical
manifestations of COVID-19 pneumonia.
Objectives of the study:
- to study changes in the lungs associated with coronavirus infection based on radiological criteria
- to evaluate the stages and characteristics of the degree of changes in the lungs associated with
coronavirus infection based on CT signs
- optimize CT and X-ray methods in the presence of COVID 19 pneumonia in cases where the
PCR test result is negative.
- to determine the indications for the use of CT diagnostics for changes in the lungs associated with
coronavirus infection.
The object of the study were 56 patients examined at the Bukhara Infectious Diseases Hospital.
The subject of the study was the results of radiography, and computed tomography, as well as PCR
studies in patients with pneumonia associated with coronavirus infection.
Research methods. X-ray, computed tomography, laboratory and statistical methods of research
were used in the performance of the work.
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- indications for the appointment of chest CT in addition to radiography in the examination of

patients with clinical suspicion of pneumonia were determined;
- the possibility of examining patients with pneumonia caused by a new coronavirus infection has
been established, which, in turn, serves to more accurately determine the patient's further
treatment tactics;
- an algorithm for the application of radiation examination methods for the diagnosis of pneumonia
with the association of coronavirus infection is proposed.
The CT picture of lung damage was compared with the severity of clinical symptoms (fever, dry
cough, nasal congestion, weakness, etc.). In 3 (2.7%) patients at the time of CT, there was no clinical
picture of the disease, despite the CT signs of COVID-19-associated pneumonia and confirmation of the
presence of SARS-CoV-2 by polymerase chain reaction.
Based on the analysis of the data obtained, various CT signs of viral pneumonia caused by SARS-
CoV-2 were identified. In the initial study, “frosted glass" prevailed. Thus, a frequent common symptom
in lung CT was "frosted glass" in all subjects. This sign is represented by a small compaction of the
parenchyma without its volumetric change, with partial preservation of pneumatization, due to which
bronchial and vascular structures are observed. In some foci, areas of high density were formed, clearly
standing out against the background of "frosted glass".
High-resolution computed tomograms of the lungs. The patient is 55 years old. The dorsal parts
of the lungs are more affected. The PCR test is positive.
When analyzing the images, we determined the change in the transparency of the lung tissue: the
presence of emphysematous bloating, hypo- and hyperventilation zones. Along with pulmonary changes,
the presence of ribbon-like seals reflecting scarring changes, as well as damage to the pleura: its thickening,
compaction and the presence of pleuropulmonary adhesions were determined. Particular attention was paid
to the assessment of peribronchial and perivascular changes: deformation of the bronchi and thickening of
their walls, the presence of bronchiectasis, signs of bronchiolitis in the form of uneven pneumatization,
centrilobular seals, interstitial interstitial infiltration. The following changes in the vascular pattern were
revealed: its impoverishment at the periphery and displacement of vessels by bullae, deformation and
dilation of vessels, an increase in the ratio of segmental artery /bronchus more than 1
To assess the diagnostic effectiveness of the methods used, sensitivity and specificity indicators were
used; for which each individual result was classified as true-positive, false-positive, true-negative and false-
negative. Statistical studies were conducted on the basis of standard clinical recommendations.
The CT picture of lung damage was compared with the severity of clinical symptoms (fever, dry
cough, nasal congestion, weakness, etc.). In 3 (2.7%) patients at the time of CT, there was no clinical
picture of the disease, despite the CT signs of COVID-19-associated pneumonia and confirmation of the
presence of SARS-CoV-2 by polymerase chain reaction.
Based on the analysis of the data obtained, various CT signs of viral pneumonia caused by SARS-
CoV-2 were identified. In the initial study, “frosted glass" prevailed. Thus, a frequent common symptom
in lung CT was "frosted glass" in all subjects. This sign is represented by a small compaction of the
parenchyma without its volumetric change, with partial preservation of pneumatization, due to which
bronchial and vascular structures are observed.
The CT semiotics of COVID-19 viral pneumonia described in the literature (numerous peripheral
compaction of lung tissue by the type of “frosted glass", consolidation of lung tissue, reticular changes,
thickening of the pleura, subpleural enlightenment (by the type of air bands), symptom of an air
bronchogram, thickening of the interlobular interstitium by the type of “cobblestone pavement” (Eng.
“crazy-paving” sign), “halo”, the reverse “halo” was clearly traced in our patients.
The different prevalence and semiotics of COVID-19-associated pneumonia indicate a different body
response to infection. The need to comply with certain methodological requirements during MSCT in
patients with pneumonia caused by SARS-CoV-2 is emphasized. The effect of an air bronchogram against
the background of consolidations in our patients has always been preserved. That is, the bronchi and
bronchioles in COVID-19 are passable and are almost not involved in the process in the absence of bacterial
infection[8.9.10.11].
It should be borne in mind that CT signs of COVID-19-associated pneumonia may lag behind or
outstrip the clinical symptoms of the disease in time of manifestation. According to a number of authors,
the pathomorphological substrate of changes in the lungs in the first days of the development of pneumonia
against the background of SARS-CoV-2 infection is dilation and stagnation in the capillaries of the alveoli,
fluid exudation into the alveolar cavity, swelling of the interlobular interstitium, which is displayed on the
MSCT in the form of single or multiple changes of the "frosted glass" type.
The most typical CT signs of pneumonia associated with coronavirus infection are dilation and
stagnation in the capillaries of the alveoli, fluid exudation into the alveolar cavity, swelling of the
interlobular interstitium, which is displayed on the MSCT in the form of single or multiple changes in the
type of "frosted glass", mesh seal of the interstitium, drain characteristic changes and the appearance of
foci of high density on the background "frosted glass".. CT sensitivity in the detection of breast cancer was
98.3%, specificity -96.3%, diagnostic accuracy – 95.0%.
The diagnostic capabilities of MRI in breast cancer differentiation are significantly increased when
using, in addition to anatomical MRI, a functional study with dynamic contrast enhancement, in which
breast cancer is more often, in 87.1%, manifested by type III curve, which is characterized by rapid
achievement of the maximum of the MR signal after contrast administration, followed by its rapid decrease,
less often, in 12.9% type II – plateau after reaching the maximum. In patients with benign tumors of the
mammary glands, type I of the curve of a constant increase in the intensity of the signal of formations after
administration of a contrast agent was mainly observed. The multimodal approach in radiation diagnostics
to assess the stages and complicated pneumonia with the association of coronavirus infection provides for
the modification of the use of various imaging methods and allows us to formulate the most complete
conclusion in the diagnosis of complications of pneumonia.
LITERATURE
1. Jonibekov J.J., Ismailova M.Kh. Role of computer tomography in diagnostics of coronaviral

etiology of pneumonia // Journal of Hunan University（Natural Sciences）Vol. 48. No. 7. July
2021.
2. Jonibekov J.J. The Role of Computed Tomography in Pneumonia in Patients with Associated
Coronavirus Infection // Middle european scientific bulletin, volume 13 june 2021
3. Жонибеков Ж.Ж. Мультимодальная лучевая диагностика пневмонии при новой
коронавирусной инфекции (covid-19) // Tibbiyotda yangi kun 2 (34) 2021 г
4. Jonibekov J.J., Ismailova M.Kh. Diagnostic capabilities of ultrasound diagnostics of lung

changes in the causative agent of coronavirus infection compared to CT // GCCSA-2021- 6th
Global Congress on Contemporary Sciences & Advancements Hosted online from Rome, Italy
June 5th, 2021
5. Jonibekov J.J., Ismailova M.Kh. X-RAY examination in pneumonia with the association of
covid 19 // GCCSA-2021- 6th Global Congress on Contemporary Sciences & Advancements
Hosted online from Rome, Italy June 5th, 2021
6. Jonibekov J.J., Ismailova M.Kh. PREVENTIVE MEASURES ANDMODERN THERAPY OF
CORONAVIRUS INFECTION // EUROPEAN JOURNAL OF MODERN MEDICINE AND
PRACTICE Vol. 2 No. 1 (2022) EJMMP ISSN: 2795-921X
7. Jonibekov J.J., Ismailova M.Kh. Headache and other Neurological Symptoms in the Structure of
the New Clinical Picture Corona Virus Infection (Covid-19) // International Journal of Culture
and Modernity ISSN 2697-2131, Volume 12
8. Jonibekov J.J. X-RAY EXAMINATION IN PNEUMONIA WITH THE ASSOCIATION OF
COVID 19 // GCCSA-2021- 7th Global Congress on Contemporary Sciences & Advancements
Hosted online from, New york, USA www.econferenceglobe.com June 25th, 2021
9. Jonibekov J.J. DIAGNOSTIC CAPABILITIES OF ULTRASOUND DIAGNOSTICS OF
LUNG CHANGES IN THE CAUSATIVE // GCCSA-2021- 6th Global Congress on
Contemporary Sciences & Advancements Hosted online from Rome, Italy online-
conferences.com
10. Ismailova M. X, Jonibekov J. J. PREVENTIVE MEASURES ANDMODERN THERAPY OF
CORONAVIRUS INFECTION // EUROPEAN JOURNAL OF MODERN MEDICINE AND
PRACTICE Vol. 2 No. 1 (2022) ISSN: 2795-921X. Р.31-35
11. Ismailova M. X, Jonibekov J. J. Headache and other Neurological Symptoms in the Structure of
the New Clinical Picture Corona Virus Infection (Covid-19) // InternationalJournalof Cultureand
Modernity ISSN 2697-2131, Volume 12 Р.22-32

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CENTRAL ASIAN JOURNAL OF MEDICAL AND NATURAL

Volume: 03 Issue: 03 | May-Jun 2022 ISSN: 2660-4159

ASSESSMENT OF CHANGES AND

Jonibekov Jasurbek Jonibekovich ABSTRACT: Pathogenetically COVID-19 is characterized by

KEYWORDS: endotheliopathy, macrothrombosis, alveocytes,

568 Published by “CENTRAL ASIAN STUDIES" http://www.centralasianstudies.org

569 Published by “CENTRAL ASIAN STUDIES" http://www.centralasianstudies.org

- indications for the appointment of chest CT in addition to radiography in the examination of

570 Published by “CENTRAL ASIAN STUDIES" http://www.centralasianstudies.org

571 Published by “CENTRAL ASIAN STUDIES" http://www.centralasianstudies.org

1. Jonibekov J.J., Ismailova M.Kh. Role of computer tomography in diagnostics of coronaviral

572 Published by “CENTRAL ASIAN STUDIES" http://www.centralasianstudies.org

4. Jonibekov J.J., Ismailova M.Kh. Diagnostic capabilities of ultrasound diagnostics of lung

573 Published by “CENTRAL ASIAN STUDIES" http://www.centralasianstudies.org

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