tetano
Editor, Senior Moderator
Intern Med J
. 2022 Aug 16.
doi: 10.1111/imj.15912. Online ahead of print.
Influence of radiologic pattern and the presence of diffuse parenchymal lung disease on outcome in ventilated patients with COVID-19 pneumonia: impact on prognosis
Tiago A Tonietto[SUP] 1 [/SUP], Carla S Lincho[SUP] 1 [/SUP], Leonardo D S Marques[SUP] 1 2 [/SUP], Janaina Elsing[SUP] 1 [/SUP], Fernando da Silveira[SUP] 1 3 [/SUP], Lucia C C Fendt[SUP] 1 [/SUP], Tiago H M Montes[SUP] 1 [/SUP], Matheus G Dos Passos[SUP] 1 [/SUP], Taiani Vargas[SUP] 1 [/SUP], Luiz G Marin[SUP] 1 [/SUP], Wagner L Nedel[SUP] 1 4 [/SUP]
Affiliations
Abstract
Background: Suspected organising pneumonia (OP) is a common finding in patients with severe coronavirus disease 2019 (COVID-19), but the impact on outcomes of the radiological patterns of diffuse parenchymal lung disease on outcome of these patients is still uncertain.
Aims: Investigate the presence of radiological images compatible with OP and its association with clinical outcomes in patients with COVID-19 submitted to invasive mechanical ventilation (IMV).
Methods: Retrospective, unicentric cohort study composed of patients who required IMV and underwent chest computerized tomography to investigate secondary complications of COVID-19. We compared patients with radiological findings characteristic of suspected OP with those without this condition. The main outcome was hospital mortality.
Results: Two hundred and ten patients were included, and 65 had signals compatible with OP. All patients with suspected OP were treated with corticosteroids. There was no difference in IVM-free days until day 28 between the groups (median, 0 days; interquartile range [IQR], 0-14.8) in the group with suspected OP vs 0 days (IQR, 0-11) in the group without suspected OP (P = 0.14). In univariate analysis, the presence of suspected OP was associated with lower hospital mortality; however, after correction for potential confounding variables, it was not associated with the outcome, even after matching by propensity score in patients without this condition.
Conclusion: OP radiologic pattern in patients with severe COVID-19 is not associated with worse outcomes.
Keywords: COVID-19; corticosteroids; intensive care unit; mechanical ventilation; organising pneumonia.
. 2022 Aug 16.
doi: 10.1111/imj.15912. Online ahead of print.
Influence of radiologic pattern and the presence of diffuse parenchymal lung disease on outcome in ventilated patients with COVID-19 pneumonia: impact on prognosis
Tiago A Tonietto[SUP] 1 [/SUP], Carla S Lincho[SUP] 1 [/SUP], Leonardo D S Marques[SUP] 1 2 [/SUP], Janaina Elsing[SUP] 1 [/SUP], Fernando da Silveira[SUP] 1 3 [/SUP], Lucia C C Fendt[SUP] 1 [/SUP], Tiago H M Montes[SUP] 1 [/SUP], Matheus G Dos Passos[SUP] 1 [/SUP], Taiani Vargas[SUP] 1 [/SUP], Luiz G Marin[SUP] 1 [/SUP], Wagner L Nedel[SUP] 1 4 [/SUP]
Affiliations
- PMID: 36053990
- DOI: 10.1111/imj.15912
Abstract
Background: Suspected organising pneumonia (OP) is a common finding in patients with severe coronavirus disease 2019 (COVID-19), but the impact on outcomes of the radiological patterns of diffuse parenchymal lung disease on outcome of these patients is still uncertain.
Aims: Investigate the presence of radiological images compatible with OP and its association with clinical outcomes in patients with COVID-19 submitted to invasive mechanical ventilation (IMV).
Methods: Retrospective, unicentric cohort study composed of patients who required IMV and underwent chest computerized tomography to investigate secondary complications of COVID-19. We compared patients with radiological findings characteristic of suspected OP with those without this condition. The main outcome was hospital mortality.
Results: Two hundred and ten patients were included, and 65 had signals compatible with OP. All patients with suspected OP were treated with corticosteroids. There was no difference in IVM-free days until day 28 between the groups (median, 0 days; interquartile range [IQR], 0-14.8) in the group with suspected OP vs 0 days (IQR, 0-11) in the group without suspected OP (P = 0.14). In univariate analysis, the presence of suspected OP was associated with lower hospital mortality; however, after correction for potential confounding variables, it was not associated with the outcome, even after matching by propensity score in patients without this condition.
Conclusion: OP radiologic pattern in patients with severe COVID-19 is not associated with worse outcomes.
Keywords: COVID-19; corticosteroids; intensive care unit; mechanical ventilation; organising pneumonia.