Dr Adrian Wong speaks to Prof Satoru Hashimoto on the #COVID19 situation in Japan in this ESICM podcast.
Dr Adrian Wong is a consultant in critical care in King’s College Hospital, London. He is the chair of the Editorial and Publishing Committee of the ESICM and is passionate about critical care ultrasound and medical education.
Twitter – @avkwong
Professor Satoru Hashimoto is a director of Intensive Care Medicine at the university hospital of Kyoto Prefectural University of Medicine. He is an intensivist and at the same time contributing to hospital information technology. He also organized JIPAD (Japanese Intensive Care Patients Database) project as a leader. JIPAD is currently sponsored by Japanese Society of Intensive Care Medicine and now recruiting more than 50 ICUs in Japan and 150 more ICUs will participate this project soon.
FOAMecmo ‘s brilliant summary
Q&A with Prof Hashimoto
Join Dr. David Lyness as he discusses the current evidence on ‘#COVID19 in Intensive Care’.
All of the links, articles and resources mentioned in the video, can be found here.
This video was made on the 2/3/20 – so make sure you have kept up to date with developments since then by following @ESICM on Twitter.
You can follow David on Twitter – here.
Prof. Bin Du is Director of the Medical ICU, Peking Union Medical College since 2004 and Postgraduate instructor in the Peking Union Medical College since 2003. Currently President of the Chinese Association of Critical Care Physicians and the Immediate Past President of the Chinese Society of Critical Care Medicine.
He gave his first-hand experience of the situation in China and answered questions during this one-hour interactive session.
Prof. Jozef KESECIOGLU, Head of Intensive Care Medicine at the Department of Intensive Care Medicine, University Medical Center Utrecht and President of the ESICM.
Prof. Maurizio CECCONI, Head of the Anaesthesia and Intensive Care Department at the Humanitas Research Hospital, Milan and President elect of the ESICM.
Prof. Bin Du’s slideset
Excellent summary thread from Dr Aoife Abbey
And obviously FOAMecmo ‘s amazing infographic
And finally … The Q&A
Lancet Infect Dis 2020 Published Online February 24, 2020
Lee, Ng and Khong’s paper on “COVID-19 pneumonia: what has CT taught us?” gives us a new insight into CT appearances manifesting from the virus. We know that there are similarities between other coronaviridae SARS and MERS and COVID-19 – and this has allowed us to observe the CT changes of these patients with a comparative lens. In COVID-19, the predominant CT findings included ground-glass opacification, consolidation, bilateral involvement, and peripheral and diffuse distribution. They also point out that an asymptomatic (subclinical) group of patients showed early CT changes, supporting what was first observed in a familial cluster with COVID-19 pneumonia. Conversely, other studies have shown positive RT-PCR results for SARS-CoV-2 in the absence of CT changes, or abnormal CT findings with initial false negative RT-PCR results. As the epidemic evolves, we are starting to observe the varied presentations of COVID-19 pneumonia, with symptomatic patients showing concordant CT and RT-PCR findings. As the predominant pattern seen in COVID-19 pneumonia is ground-glass opacification, detecting COVID-19 with use of chest radiography—on which this type of abnormality is often imperceivable, particularly in patients with few symptoms or low severity—is likely to be challenging. By contrast, chest radiographs were used frequently in the diagnosis of SARS as both ground-glass opacification and consolidation were present early. Finally, the authors note an interesting skew in the demographics of available data on COVID-19 radiology due to China’s predilection for CT vs chest radiograph. Therefore, it is unclear whether the threshold for performing CT evaluation of potential lung changes should be lower when chest radiographs are normal. This is clearly an evolving clinical area, nevertheless, this small number of individuals with COVID-19 pneumonia poses a diagnostic dilemma given the varied manifestations.