tetano
Editor, Senior Moderator
BMJ Open Respir Res
. 2024 Oct 4;11(1):e002538.
doi: 10.1136/bmjresp-2024-002538. Pulmonary fibrosis followed by severe pneumonia in patients with COVID-19 infection requiring mechanical ventilation: a prospective multicentre study
Junghyun Kim[SUP] 1 [/SUP], Ganghee Chae[SUP] 2 [/SUP], Won-Young Kim[SUP] 3 [/SUP], Chi-Ryang Chung[SUP] 4 [/SUP], Young-Jae Cho[SUP] 5 [/SUP], Jinwoo Lee[SUP] 6 [/SUP], Yangjin Jegal[SUP] 2 [/SUP], Joon-Sung Joh[SUP] 7 [/SUP], Tae Yun Park[SUP] 8 [/SUP], Jung Hwa Hwang[SUP] 9 [/SUP], Bo Da Nam[SUP] 9 [/SUP], Hee-Young Yoon[SUP] 10 [/SUP], Jin Woo Song[SUP] 11 [/SUP]
Affiliations
Backgrounds: The management of lung complications, especially fibrosis, after COVID-19 pneumonia, is an important issue in the COVID-19 post-pandemic era. We aimed to investigate risk factors for pulmonary fibrosis development in patients with severe COVID-19 pneumonia.
Methods: Clinical and radiological data were prospectively collected from 64 patients who required mechanical ventilation due to COVID-19 pneumonia and were enrolled from eight hospitals in South Korea. Fibrotic changes on chest CT were evaluated by visual assessment, and extent of fibrosis (mixed disease score) was measured using automatic quantification system.
Results: 64 patients were enrolled, and their mean age was 58.2 years (64.1% were males). On chest CT (median interval: 60 days [IQR; 41-78 days] from enrolment), 35 (54.7%) patients showed ≥3 fibrotic lesions. The most frequent fibrotic change was traction bronchiectasis (47 patients, 73.4 %). Median extent of fibrosis measured by automatic quantification was 10.6% (IQR, 3.8-40.7%). In a multivariable Cox proportional hazard model, which included nine variables with a p value of <0.10 in an unadjusted analysis as well as age, sex and Body Mass Index, male sex (HR, 3.01; 95% CI, 1.27 to 7.11) and higher initial Sequential Organ Failure Assessment (SOFA) score (HR, 1.18; 95% CI, 1.02 to 1.37) were independently associated with pulmonary fibrosis (≥3 fibrotic lesions).
Conclusion: Our data suggests that male gender and higher SOFA score at intensive care unit admission were associated with pulmonary fibrosis in patients with severe COVID-19 pneumonia requiring mechanical ventilation.
Keywords: COVID-19; Idiopathic Pulmonary Fibrosis; Pneumonia.
. 2024 Oct 4;11(1):e002538.
doi: 10.1136/bmjresp-2024-002538. Pulmonary fibrosis followed by severe pneumonia in patients with COVID-19 infection requiring mechanical ventilation: a prospective multicentre study
Junghyun Kim[SUP] 1 [/SUP], Ganghee Chae[SUP] 2 [/SUP], Won-Young Kim[SUP] 3 [/SUP], Chi-Ryang Chung[SUP] 4 [/SUP], Young-Jae Cho[SUP] 5 [/SUP], Jinwoo Lee[SUP] 6 [/SUP], Yangjin Jegal[SUP] 2 [/SUP], Joon-Sung Joh[SUP] 7 [/SUP], Tae Yun Park[SUP] 8 [/SUP], Jung Hwa Hwang[SUP] 9 [/SUP], Bo Da Nam[SUP] 9 [/SUP], Hee-Young Yoon[SUP] 10 [/SUP], Jin Woo Song[SUP] 11 [/SUP]
Affiliations
- PMID: 39366721
- DOI: 10.1136/bmjresp-2024-002538
Backgrounds: The management of lung complications, especially fibrosis, after COVID-19 pneumonia, is an important issue in the COVID-19 post-pandemic era. We aimed to investigate risk factors for pulmonary fibrosis development in patients with severe COVID-19 pneumonia.
Methods: Clinical and radiological data were prospectively collected from 64 patients who required mechanical ventilation due to COVID-19 pneumonia and were enrolled from eight hospitals in South Korea. Fibrotic changes on chest CT were evaluated by visual assessment, and extent of fibrosis (mixed disease score) was measured using automatic quantification system.
Results: 64 patients were enrolled, and their mean age was 58.2 years (64.1% were males). On chest CT (median interval: 60 days [IQR; 41-78 days] from enrolment), 35 (54.7%) patients showed ≥3 fibrotic lesions. The most frequent fibrotic change was traction bronchiectasis (47 patients, 73.4 %). Median extent of fibrosis measured by automatic quantification was 10.6% (IQR, 3.8-40.7%). In a multivariable Cox proportional hazard model, which included nine variables with a p value of <0.10 in an unadjusted analysis as well as age, sex and Body Mass Index, male sex (HR, 3.01; 95% CI, 1.27 to 7.11) and higher initial Sequential Organ Failure Assessment (SOFA) score (HR, 1.18; 95% CI, 1.02 to 1.37) were independently associated with pulmonary fibrosis (≥3 fibrotic lesions).
Conclusion: Our data suggests that male gender and higher SOFA score at intensive care unit admission were associated with pulmonary fibrosis in patients with severe COVID-19 pneumonia requiring mechanical ventilation.
Keywords: COVID-19; Idiopathic Pulmonary Fibrosis; Pneumonia.