tetano
Editor, Senior Moderator
J Xray Sci Technol
. 2020 May 26.
doi: 10.3233/XST-200685. 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]
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 and 28 females ranging from 25 to 70 years old) with confirmed COVID-19 infection performed follow-up thin-section thorax CT. After 31.5?7.9 days (range, 24 to 39 days) of hospital admission, the results of 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 namely, groups A and B (with and without CT evidence of fibrosis), respectively. 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) had a typical transition from early phase to advanced phase and advanced phase to dissipating phase. Also, 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?16.9 vs. 33.8?10.2 years) (P = 0.001), with longer LOS (19.1?5.2 vs. 15.0?2.5 days) (P = 0.001), higher rate of ICU admission (21.7% (5/23) vs. 5.6% (2/36)) (P = 0.061), higher peak C-reactive protein level (30.7?26.4 vs. 18.1?17.9 mg/L) (P = 0.041), and higher maximal CT score (5.2?4.3 vs. 4.0?2.2) (P = 0.06) 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; X-ray computed; coronavirus; severe acute respiratory syndrome; tomography.
. 2020 May 26.
doi: 10.3233/XST-200685. 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]
Affiliations
- PMID: 32474479
- DOI: 10.3233/XST-200685
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 and 28 females ranging from 25 to 70 years old) with confirmed COVID-19 infection performed follow-up thin-section thorax CT. After 31.5?7.9 days (range, 24 to 39 days) of hospital admission, the results of 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 namely, groups A and B (with and without CT evidence of fibrosis), respectively. 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) had a typical transition from early phase to advanced phase and advanced phase to dissipating phase. Also, 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?16.9 vs. 33.8?10.2 years) (P = 0.001), with longer LOS (19.1?5.2 vs. 15.0?2.5 days) (P = 0.001), higher rate of ICU admission (21.7% (5/23) vs. 5.6% (2/36)) (P = 0.061), higher peak C-reactive protein level (30.7?26.4 vs. 18.1?17.9 mg/L) (P = 0.041), and higher maximal CT score (5.2?4.3 vs. 4.0?2.2) (P = 0.06) 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; X-ray computed; coronavirus; severe acute respiratory syndrome; tomography.