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PLoS One . Quantitative determination of pulmonary emphysema in follow-up LD-CTs of patients with COVID-19 infection

tetano

Editor, Senior Moderator
PLoS One


. 2022 Feb 3;17(2):e0263261.
doi: 10.1371/journal.pone.0263261. eCollection 2022.
Quantitative determination of pulmonary emphysema in follow-up LD-CTs of patients with COVID-19 infection


Erkan Celik[SUP] 1 [/SUP], Christian Nelles[SUP] 1 [/SUP], Jonathan Kottlors[SUP] 1 [/SUP], Philipp Fervers[SUP] 1 [/SUP], Lukas Goertz[SUP] 1 [/SUP], Daniel Pinto Dos Santos[SUP] 1 [/SUP], Tobias Achenbach[SUP] 2 [/SUP], David Maintz[SUP] 1 [/SUP], Thorsten Persigehl[SUP] 1 [/SUP]



Affiliations

Abstract

Purpose: To evaluate the association between the coronavirus disease 2019 (COVID-19) and post-inflammatory emphysematous lung alterations on follow-up low-dose CT scans.
Methods: Consecutive patients with proven COVID-19 infection and a follow-up CT were retrospectively reviewed. The severity of pulmonary involvement was classified as mild, moderate and severe. Total lung volume, emphysema volume and the ratio of emphysema/-to-lung volume were quantified semi-automatically and compared inter-individually between initial and follow-up CT and to a control group of healthy, age- and sex-matched patients. Lung density was further assessed by drawing circular regions of interest (ROIs) into non-affected regions of the upper lobes.
Results: A total of 32 individuals (mean age: 64 ± 13 years, 12 females) with at least one follow-up CT (mean: 52 ± 66 days, range: 5-259) were included. In the overall cohort, total lung volume, emphysema volume and the ratio of lung-to-emphysema volume did not differ significantly between the initial and follow-up scans. In the subgroup of COVID-19 patients with > 30 days of follow-up, the emphysema volume was significantly larger as compared to the subgroup with a follow-up < 30 days (p = 0.045). Manually measured single ROIs generally yielded lower attenuation values prior to COVID-19 pneumonia, but the difference was not significant between groups (all p > 0.05).
Conclusion: COVID-19 patients with a follow-up CT >30 days showed significant emphysematous lung alterations. These findings may help to explain the long-term effect of COVID-19 on pulmonary function and warrant validation by further studies.
 
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