tetano
Editor, Senior Moderator
Clin Imaging
. 2020 May 15.
doi: 10.1016/j.clinimag.2020.05.001. Online ahead of print.
Analysis of Thin-Section CT in Patients With Coronavirus Disease (COVID-19) After Hospital Discharge
Jiangping Wei[SUP] 1 [/SUP], Pinggui Lei[SUP] 2 [/SUP], Hong Yang[SUP] 3 [/SUP], Bing Fan[SUP] 1 [/SUP], Yingying Qiu[SUP] 1 [/SUP], Bingliang Zeng[SUP] 1 [/SUP], Peng Yu[SUP] 4 [/SUP], Jian Lv[SUP] 3 [/SUP], Yinchao Jian[SUP] 1 [/SUP], Chengfeng Wan[SUP] 1 [/SUP], Peipei Pang[SUP] 5 [/SUP]
Affiliations
Abstract
Purpose: To analyze clinical and thin-section computed tomographic (CT) data from the patients with coronavirus disease (COVID-19) to predict the development of pulmonary fibrosis after hospital discharge.
Materials and methods: Fifty-nine patients (31 males, 28 females; mean age: 41 years, range: 25 to 70 years) with confirmed COVID-19 infection performed follow-up thin-section CT of the thorax. After 31.5 days of hospital admission, the results of thin-section CT were analyzed for parenchymal abnormality (ground-glass opacification, interstitial thickening, and consolidation) and evidence of fibrosis (parenchymal band, traction bronchiectasis, and irregular interfaces). Patients were analyzed based on the evidence of fibrosis and divided into two groups, group A (with CT evidence of fibrosis) and group B (without CT evidence of fibrosis). Patient demographics, length of stay (LOS), rate of intensive care unit (ICU) admission, peak C-reactive protein level, and CT score were compared between the two groups.
Results: Among the 59 patients, 89.8% (53/59) patients had a typical transition from early phase to advanced phase and advanced phase to dissipating phase. Out of 59 patients, 39% (23/59) patients developed fibrosis (group A), whereas 61% (36/59) patients did not show definite fibrosis (group B). Patients in group A were older (mean age, 45.4 vs. 33.8 years), with longer LOS (19.1 vs. 15.0 days), higher rate of ICU admission (21.7% (5/23) vs. 5.6% (2/36)), higher peak C-reactive protein level (30.7 vs. 18.1 mg/L), and higher maximal CT score (5.2 vs. 4.0) than those in group B.
Conclusions: Pulmonary fibrosis may develop early in patients with COVID-19 after hospital discharge. Older patients with severe illness during treatment were more prone to develop fibrosis according to thin-section CT results.
Keywords: COVID-19; Coronavirus; Severe acute respiratory syndrome; Tomography, X-ray computed.
. 2020 May 15.
doi: 10.1016/j.clinimag.2020.05.001. Online ahead of print.
Analysis of Thin-Section CT in Patients With Coronavirus Disease (COVID-19) After Hospital Discharge
Jiangping Wei[SUP] 1 [/SUP], Pinggui Lei[SUP] 2 [/SUP], Hong Yang[SUP] 3 [/SUP], Bing Fan[SUP] 1 [/SUP], Yingying Qiu[SUP] 1 [/SUP], Bingliang Zeng[SUP] 1 [/SUP], Peng Yu[SUP] 4 [/SUP], Jian Lv[SUP] 3 [/SUP], Yinchao Jian[SUP] 1 [/SUP], Chengfeng Wan[SUP] 1 [/SUP], Peipei Pang[SUP] 5 [/SUP]
Affiliations
- PMID: 32425336
- PMCID: PMC7227562
- DOI: 10.1016/j.clinimag.2020.05.001
Abstract
Purpose: To analyze clinical and thin-section computed tomographic (CT) data from the patients with coronavirus disease (COVID-19) to predict the development of pulmonary fibrosis after hospital discharge.
Materials and methods: Fifty-nine patients (31 males, 28 females; mean age: 41 years, range: 25 to 70 years) with confirmed COVID-19 infection performed follow-up thin-section CT of the thorax. After 31.5 days of hospital admission, the results of thin-section CT were analyzed for parenchymal abnormality (ground-glass opacification, interstitial thickening, and consolidation) and evidence of fibrosis (parenchymal band, traction bronchiectasis, and irregular interfaces). Patients were analyzed based on the evidence of fibrosis and divided into two groups, group A (with CT evidence of fibrosis) and group B (without CT evidence of fibrosis). Patient demographics, length of stay (LOS), rate of intensive care unit (ICU) admission, peak C-reactive protein level, and CT score were compared between the two groups.
Results: Among the 59 patients, 89.8% (53/59) patients had a typical transition from early phase to advanced phase and advanced phase to dissipating phase. Out of 59 patients, 39% (23/59) patients developed fibrosis (group A), whereas 61% (36/59) patients did not show definite fibrosis (group B). Patients in group A were older (mean age, 45.4 vs. 33.8 years), with longer LOS (19.1 vs. 15.0 days), higher rate of ICU admission (21.7% (5/23) vs. 5.6% (2/36)), higher peak C-reactive protein level (30.7 vs. 18.1 mg/L), and higher maximal CT score (5.2 vs. 4.0) than those in group B.
Conclusions: Pulmonary fibrosis may develop early in patients with COVID-19 after hospital discharge. Older patients with severe illness during treatment were more prone to develop fibrosis according to thin-section CT results.
Keywords: COVID-19; Coronavirus; Severe acute respiratory syndrome; Tomography, X-ray computed.