tetano
Editor, Senior Moderator
Respir Res
. 2022 Apr 29;23(1):105.
doi: 10.1186/s12931-022-02025-6.
Usage of compromised lung volume in monitoring steroid therapy on severe COVID-19
Ying Su[SUP] #[/SUP][SUP] 1 [/SUP], Ze-Song Qiu[SUP] #[/SUP][SUP] 2 [/SUP], Jun Chen[SUP] #[/SUP][SUP] 3 [/SUP], Min-Jie Ju[SUP] 1 [/SUP], Guo-Guang Ma[SUP] 1 [/SUP], Jin-Wei He[SUP] 2 [/SUP], Shen-Ji Yu[SUP] 1 [/SUP], Kai Liu[SUP] 1 [/SUP], Fleming Y M Lure[SUP] 4 [/SUP], Guo-Wei Tu[SUP] 5 [/SUP], Yu-Yao Zhang[SUP] 6 [/SUP], Zhe Luo[SUP] 7 8 9 [/SUP]
Affiliations
Abstract
Background: Quantitative computed tomography (QCT) analysis may serve as a tool for assessing the severity of coronavirus disease 2019 (COVID-19) and for monitoring its progress. The present study aimed to assess the association between steroid therapy and quantitative CT parameters in a longitudinal cohort with COVID-19.
Methods: Between February 7 and February 17, 2020, 72 patients with severe COVID-19 were retrospectively enrolled. All 300 chest CT scans from these patients were collected and classified into five stages according to the interval between hospital admission and follow-up CT scans: Stage 1 (at admission); Stage 2 (3-7 days); Stage 3 (8-14 days); Stage 4 (15-21 days); and Stage 5 (22-31 days). QCT was performed using a threshold-based quantitative analysis to segment the lung according to different Hounsfield unit (HU) intervals. The primary outcomes were changes in percentage of compromised lung volume (%CL, - 500 to 100 HU) at different stages. Multivariate Generalized Estimating Equations were performed after adjusting for potential confounders.
Results: Of 72 patients, 31 patients (43.1%) received steroid therapy. Steroid therapy was associated with a decrease in %CL (- 3.27% [95% CI, - 5.86 to - 0.68, P = 0.01]) after adjusting for duration and baseline %CL. Associations between steroid therapy and changes in %CL varied between different stages or baseline %CL (all interactions, P < 0.01). Steroid therapy was associated with decrease in %CL after stage 3 (all P < 0.05), but not at stage 2. Similarly, steroid therapy was associated with a more significant decrease in %CL in the high CL group (P < 0.05), but not in the low CL group.
Conclusions: Steroid administration was independently associated with a decrease in %CL, with interaction by duration or disease severity in a longitudinal cohort. The quantitative CT parameters, particularly compromised lung volume, may provide a useful tool to monitor COVID-19 progression during the treatment process. Trial registration Clinicaltrials.gov, NCT04953247. Registered July 7, 2021, https://clinicaltrials.gov/ct2/show/NCT04953247.
Keywords: COVID-19; Compromised lung volume; Quantitative computed tomography; Steroid.
. 2022 Apr 29;23(1):105.
doi: 10.1186/s12931-022-02025-6.
Usage of compromised lung volume in monitoring steroid therapy on severe COVID-19
Ying Su[SUP] #[/SUP][SUP] 1 [/SUP], Ze-Song Qiu[SUP] #[/SUP][SUP] 2 [/SUP], Jun Chen[SUP] #[/SUP][SUP] 3 [/SUP], Min-Jie Ju[SUP] 1 [/SUP], Guo-Guang Ma[SUP] 1 [/SUP], Jin-Wei He[SUP] 2 [/SUP], Shen-Ji Yu[SUP] 1 [/SUP], Kai Liu[SUP] 1 [/SUP], Fleming Y M Lure[SUP] 4 [/SUP], Guo-Wei Tu[SUP] 5 [/SUP], Yu-Yao Zhang[SUP] 6 [/SUP], Zhe Luo[SUP] 7 8 9 [/SUP]
Affiliations
- PMID: 35488261
- DOI: 10.1186/s12931-022-02025-6
Abstract
Background: Quantitative computed tomography (QCT) analysis may serve as a tool for assessing the severity of coronavirus disease 2019 (COVID-19) and for monitoring its progress. The present study aimed to assess the association between steroid therapy and quantitative CT parameters in a longitudinal cohort with COVID-19.
Methods: Between February 7 and February 17, 2020, 72 patients with severe COVID-19 were retrospectively enrolled. All 300 chest CT scans from these patients were collected and classified into five stages according to the interval between hospital admission and follow-up CT scans: Stage 1 (at admission); Stage 2 (3-7 days); Stage 3 (8-14 days); Stage 4 (15-21 days); and Stage 5 (22-31 days). QCT was performed using a threshold-based quantitative analysis to segment the lung according to different Hounsfield unit (HU) intervals. The primary outcomes were changes in percentage of compromised lung volume (%CL, - 500 to 100 HU) at different stages. Multivariate Generalized Estimating Equations were performed after adjusting for potential confounders.
Results: Of 72 patients, 31 patients (43.1%) received steroid therapy. Steroid therapy was associated with a decrease in %CL (- 3.27% [95% CI, - 5.86 to - 0.68, P = 0.01]) after adjusting for duration and baseline %CL. Associations between steroid therapy and changes in %CL varied between different stages or baseline %CL (all interactions, P < 0.01). Steroid therapy was associated with decrease in %CL after stage 3 (all P < 0.05), but not at stage 2. Similarly, steroid therapy was associated with a more significant decrease in %CL in the high CL group (P < 0.05), but not in the low CL group.
Conclusions: Steroid administration was independently associated with a decrease in %CL, with interaction by duration or disease severity in a longitudinal cohort. The quantitative CT parameters, particularly compromised lung volume, may provide a useful tool to monitor COVID-19 progression during the treatment process. Trial registration Clinicaltrials.gov, NCT04953247. Registered July 7, 2021, https://clinicaltrials.gov/ct2/show/NCT04953247.
Keywords: COVID-19; Compromised lung volume; Quantitative computed tomography; Steroid.