tetano
Editor, Senior Moderator
BMC Pulm Med
. 2023 Oct 27;23(1):408.
doi: 10.1186/s12890-023-02692-1. Frequency of subclinical interstitial lung disease in COVID-19 autopsy cases: potential risk factors of severe pneumonia
Hiromichi Iwashita[SUP] 1 [/SUP], Yoshinori Kawabata[SUP] 2 [/SUP], Hiroyuki Hayashi[SUP] 3 [/SUP], Shoichiro Matsushita[SUP] 4 [/SUP], Tsuneo Yamashiro[SUP] 4 [/SUP], Mai Matsumura[SUP] 1 [/SUP], Yukihiro Yoshimura[SUP] 5 [/SUP], Toshiaki Kataoka[SUP] 1 [/SUP], Hideaki Mitsui[SUP] 1 [/SUP], Takehisa Suzuki[SUP] 1 [/SUP], Toshihiro Misumi[SUP] 6 [/SUP], Tomonori Tanaka[SUP] 7 [/SUP], Sosuke Ishijima[SUP] 8 [/SUP], Junya Fukuoka[SUP] 8 [/SUP], Tae Iwasawa[SUP] 9 [/SUP], Takashi Ogura[SUP] 10 [/SUP], Koji Okudela[SUP] 11 [/SUP]
Affiliations
Risk factors of severe coronavirus disease 2019 (COVID-19) have been previously reported; however, histological risk factors have not been defined thus far. The aim of this study was to clarify subclinical hidden interstitial lung disease (ILD) as a risk factor of severe pneumonia associated with COVID-19. We carefully examined autopsied lungs and chest computed tomography scanning (CT) images from patients with COVID-19 for interstitial lesions and then analyzed their relationship with disease severity. Among the autopsy series, subclinical ILD was found in 13/27 cases (48%) in the COVID-19 group, and in contrast, 8/65 (12%) in the control autopsy group (p = 0.0006; Fisher's exact test). We reviewed CT images from the COVID-19 autopsy cases and verified that subclinical ILD was histologically detectable in the CT images. Then, we retrospectively examined CT images from another series of COVID-19 cases in the Yokohama, Japan area between February-August 2020 for interstitial lesions and analyzed the relationship to the severity of COVID-19 pneumonia. Interstitial lesion was more frequently found in the group with the moderate II/severe disease than in the moderate I/mild disease (severity was evaluated according to the COVID-19 severity classification system of the Ministry of Health, Labor, and Welfare [Japan]) (moderate II/severe, 11/15, 73.3% versus moderate I/mild, 108/245, 44.1%; Fisher exact test, p = 0.0333). In conclusion, it was suggested that subclinical ILD could be an important risk factor for severe COVID-19 pneumonia. A benefit of these findings could be the development of a risk assessment system using high resolution CT images for fatal COVID-19 pneumonia.
Keywords: Acute exacerbation; Coronavirus disease 2019 (COVID-19); Interstitial lung abnormalities; Interstitial lung disease; Usual interstitial pneumonia.
. 2023 Oct 27;23(1):408.
doi: 10.1186/s12890-023-02692-1. Frequency of subclinical interstitial lung disease in COVID-19 autopsy cases: potential risk factors of severe pneumonia
Hiromichi Iwashita[SUP] 1 [/SUP], Yoshinori Kawabata[SUP] 2 [/SUP], Hiroyuki Hayashi[SUP] 3 [/SUP], Shoichiro Matsushita[SUP] 4 [/SUP], Tsuneo Yamashiro[SUP] 4 [/SUP], Mai Matsumura[SUP] 1 [/SUP], Yukihiro Yoshimura[SUP] 5 [/SUP], Toshiaki Kataoka[SUP] 1 [/SUP], Hideaki Mitsui[SUP] 1 [/SUP], Takehisa Suzuki[SUP] 1 [/SUP], Toshihiro Misumi[SUP] 6 [/SUP], Tomonori Tanaka[SUP] 7 [/SUP], Sosuke Ishijima[SUP] 8 [/SUP], Junya Fukuoka[SUP] 8 [/SUP], Tae Iwasawa[SUP] 9 [/SUP], Takashi Ogura[SUP] 10 [/SUP], Koji Okudela[SUP] 11 [/SUP]
Affiliations
- PMID: 37891495
- PMCID: PMC10612296
- DOI: 10.1186/s12890-023-02692-1
Risk factors of severe coronavirus disease 2019 (COVID-19) have been previously reported; however, histological risk factors have not been defined thus far. The aim of this study was to clarify subclinical hidden interstitial lung disease (ILD) as a risk factor of severe pneumonia associated with COVID-19. We carefully examined autopsied lungs and chest computed tomography scanning (CT) images from patients with COVID-19 for interstitial lesions and then analyzed their relationship with disease severity. Among the autopsy series, subclinical ILD was found in 13/27 cases (48%) in the COVID-19 group, and in contrast, 8/65 (12%) in the control autopsy group (p = 0.0006; Fisher's exact test). We reviewed CT images from the COVID-19 autopsy cases and verified that subclinical ILD was histologically detectable in the CT images. Then, we retrospectively examined CT images from another series of COVID-19 cases in the Yokohama, Japan area between February-August 2020 for interstitial lesions and analyzed the relationship to the severity of COVID-19 pneumonia. Interstitial lesion was more frequently found in the group with the moderate II/severe disease than in the moderate I/mild disease (severity was evaluated according to the COVID-19 severity classification system of the Ministry of Health, Labor, and Welfare [Japan]) (moderate II/severe, 11/15, 73.3% versus moderate I/mild, 108/245, 44.1%; Fisher exact test, p = 0.0333). In conclusion, it was suggested that subclinical ILD could be an important risk factor for severe COVID-19 pneumonia. A benefit of these findings could be the development of a risk assessment system using high resolution CT images for fatal COVID-19 pneumonia.
Keywords: Acute exacerbation; Coronavirus disease 2019 (COVID-19); Interstitial lung abnormalities; Interstitial lung disease; Usual interstitial pneumonia.