Interstitial Lung Disease at High Resolution CT after SARS-CoV-2-Related Acute Respiratory Distress Syndrome According to Pulmonary Segmental Anatomy
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. HRCT Imaging Findings
3.1.1. Ground Glass Opacities
3.1.2. Consolidations
3.1.3. Linear Bands
3.1.4. Reticulations
3.1.5. Bronchiectasis/Bronchiolectasis
3.1.6. Loss of Pulmonary Volume
3.1.7. Other Findings
3.2. Correlation with Respiratory Function Tests
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristic | Patients (N = 44) |
---|---|
Age (years) | |
Mean (SD) | 64 (12) |
Gender (N,%) | |
Males | 32 (72.7) |
Females | 12 (27.3) |
Smoking habit (N,%) | |
Never smoker | 22 (51.2) |
Yes, current smoker | 11 (25.6) |
Yes, former smoker | 10 (23.3) |
Comorbidities (N,%) | |
None | 11 (25.0) |
One | 14 (31.8) |
≥2 | 19 (43.2) |
Type of Comorbidity (N,%) | |
Arterial hypertension | 18 (40.9) |
Diabetes | 12 (27.3) |
COPD | 6 (13.6) |
Cardiovascular diseases | 9 (20.5) |
Obesity | 15 (34.1) |
PiO2:FiO2 (N,%) | |
<100 | 7 (16.3) |
100–200 | 33 (76.7) |
≥200 | 3 (7) |
N/A | 1 |
Pharmacological treatments (N,%) | |
Corticosteroids | 42 (95.5) |
Antiviral agents | 14 (31.8) |
Hydroxychloroquine | 20 (45.5) |
Antibiotics | 29 (65.9) |
Remdesivir | 0 |
Tocilizumab | 4 (9.1) |
Intensive therapy (N,%) | 12 (27.3) |
NIV (N,%) | 43 (98.3) |
IMV (N,%) | 13 (29.5) |
Pronation (N,%) | 12 (27.3) |
Time between first positive swab and swab negativization (days) | |
Median (Min-Max) | 23 (3–64) |
Hospitalization days | |
Median (Min-Max) | 26.5 (14–194) |
Time between ARDS diagnosis and HRCT (months) | |
Median (Min-Max) | 2.8 (1.9–3.7) |
Time between swab negativization and HRCT (days) | |
Median (Min-Max) | 61.5 (17–168) |
Spirometry values (N/total number of patients, %) | |
Within normal limits | 15/30 (50.0) |
Mild obstructive deficit | 3/30 (10.0) |
Mild restrictive deficit | 5/30 (16.7) |
Reduction of DLCO | 12/30 (40.0) |
Status of patients | |
Discharged | 41 (93.2) |
Deceased | 3 (6.8) |
LEFT LUNG | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
HRCT Finding | Upper Lobe | Lingula | Lower Lobe | ||||||||||
Apicopost. | Ant. | Superior | Inferior | Superior | Anteromed. | Lat. | Post. | ||||||
Ground Glass Opacities (N,%) | 22 (50) | 12 (27.3) | 18 (40.9) | 17 (38.6) | 17 (38.6) | 18 (40.9) | 18 (40.9) | 21 (47.7) | |||||
Reticulations (N,%) | 5 (11.4) | 6 (13.6) | 8 (18.2) | 8 (18.2) | 6 (13.6) | 7 (15.9) | 7 (15.9) | 7 (15.9) | |||||
Linear bands, indifferent course (N,%) | 6 (13.6) | 6 (13.6) | 2 (4.5) | 8 (18.2) | 6 (13.6) | 7 (15.9) | 7 (15.9) | 11 (25) | |||||
Linear bands, subpleural (N,%) | 3 (6.8) | 1 (2.3) | 1 (2.3) | 1 (2.3) | 1 (2.3) | 6 (13.6) | 7 (15.9) | 6 (13.6) | |||||
Linear bands, perilobular (N,%) | 0 | 0 | 2 (4.5) | 3 (6.8) | 2 (4.5) | 2 (4.5) | 4 (9.1) | 6 (13.6) | |||||
Linear bands, subpleural and perilobular (N,%) | 0 | 0 | 0 | 0 | 1 (2.3) | 2 (4.5) | 3 (6.8) | 3 (6.8) | |||||
Bronchiectasis | 4 (9.1) | 4 (9.1) | 5 (11.4) | 4 (9.1) | 5 (11.4) | 3 (6.8) | 5 (11.4) | 5 (11.4) | |||||
Bronchiolectasis | 5 (11.4) | 3 (6.8) | 3 (6.8) | 4 (9.1) | 3 (6.8) | 4 (9.1) | 5 (11.4) | 7 (15.9) | |||||
RIGHT LUNG | |||||||||||||
HRCT finding | Upper Lobe | Middle Lobe | Lower Lobe | ||||||||||
Apical | Post. | Ant. | Lat. | Med. | Sup. | Ant. | Lat. | Post. | Med. | ||||
Ground Glass Opacities (N,%) | 13 (29.5) | 23 (52.3) | 14 (31.8) | 18 (40.9) | 9 (20.5) | 18 (40.9) | 19 (43.2) | 23 (52.3) | 25 (56.8) | 18 (40.9) | |||
Reticulations (N,%) | 8 (18.2) | 6 (13.6) | 6 (13.6) | 8 (18.2) | 5 (11.4) | 10 (22.7) | 5 (11.4) | 8 (18.2) | 10 (22.7) | 7 (15.9) | |||
Linear bands, Indifferent course (N,%) | 5 (11.4) | 7 (15.9) | 7 (15.9) | 8 (18.2) | 8 (18.2) | 5 (11.4) | 5 (11.4) | 7 (15.9) | 12 (27.3) | 4 (9.1) | |||
Linear bands, subpleural (N,%) | 0 | 2 (4.5) | 1 (2.3) | 2 (4.5) | 1 (2.3) | 1 (2.3) | 2 (4.5) | 7 (15.9) | 8 (18.2) | 0 | |||
Linear bands, perilobular (N,%) | 0 | 0 | 0 | 1 (2.3) | 1 (2.3) | 0 | 0 | 1 (2.3) | 2 (4.5) | 0 | |||
Linear bands, subpleural and perilobular (N,%) | 0 | 1 (2.3) | 0 | 3 (6.8) | 1 (2.3) | 2 (4.5) | 3 (6.8) | 5 (11.4) | 5 (11.4) | 0 | |||
Bronchiectasis | 4 (9.1) | 5 (11.4) | 5 (11.4) | 7 (15.9) | 7 (15.9) | 2 (4.5) | 4 (9.1) | 6 (13.6) | 8 (18.2) | 3 (6.8) | |||
Bronchiolectasis | 2 (4.5) | 4 (9.1) | 3 (6.8) | 4 (9.1) | 4 (9.1) | 3 (6.8) | 6 (13.6) | 6 (13.6) | 9 (20.5) | 5 (11.4) |
Right Lung | Left Lung | |||||
---|---|---|---|---|---|---|
TC Patterns | Never Smokers (n = 22) | Smokers (n = 21) | p-Value | Never Smokers (n = 22) | Smokers (n = 21) | p-Value |
Ground Glass Opacities | 17 (77.3%) | 16 (76.2%) | 0.93 | 17 (77.3%) | 16 (76.2%) | 0.93 |
Linear Bands | 14 (63.6%) | 19 (90.5%) | 0.04 | 15 (68.2%) | 17 (86.0%) | 0.34 |
Reticulations | 8 (36.4%) | 5 (23.8%) | 0.37 | 5 (22.7%) | 5 (23.8%) | 0.93 |
Consolidations | 6 (27.3%) | 6 (28.6%) | 0.92 | 4 (18.2%) | 4 (19.1%) | 0.94 |
Loss of pulmunary Volume | 3 (13.6%) | 6 (28.6%) | 0.23 | 3 (13.6%) | 7 (33.3%) | 0.13 |
Bronchiectasis | 5 (22.7%) | 6 (28.6%) | 0.66 | 3 (13.6%) | 6 (28.6%) | 0.23 |
Bronchiolectasis | 4 (18.2%) | 8 (38.1%) | 0.15 | 4 (18.2%) | 6 (28.6%) | 0.42 |
Total patterns Median (25p–75p) | 2 (1–4) | 3 (2–5) | 0.31 | 2 (1–3) | 3 (1–5) | 0.35 |
Pulmonary artery diameter a.p. Median (25p–75p) | 27 (26–30) | 27 (26–29) | 0.79 | |||
PA/AA ratio Median (25p–75p) | 0.77 (0.72–0.91) | 0.79 (0.72–0.90) | 0.86 |
Right Lung | Left Lung | |||||
---|---|---|---|---|---|---|
TC Patterns | Not-IMV (n = 31) | IMV (n = 13) | p-Value | Not-IMV (n = 31) | IMV (n = 13) | p-Value |
Ground Glass Opacities | 24 (77.4%) | 9 (69.2%) | 0.57 | 24 (77.4%) | 9 (69.2%) | 0.57 |
Linear Bands | 21 (67.7%) | 12 (92.3%) | 0.09 | 21 (67.7%) | 11 (84.6%) | 0.25 |
Reticulations | 9 (29.0%) | 5 (38.5%) | 0.54 | 8 (5.8%) | 3 (23.1%) | 0.85 |
Consolidations | 10 (32.3%) | 3 (23.1%) | 0.54 | 6 (19.4%) | 3 (23.1%) | 0.78 |
Loss of pulmunary Volume | 5 (16.1%) | 5 (38.5%) | 0.11 | 6 (19.4%) | 5 (38.5%) | 0.18 |
Bronchiectasis | 5 (16.1%) | 7 (53.9%) | 0.02 | 6 (19.4%) | 4 (30.8%) | 0.41 |
Bronchiolectasis | 8 (25.8%) | 5 (38.5%) | 0.40 | 7 (22.6%) | 4 (30.8%) | 0.57 |
Total patterns Median (25p–75p) | 2 (1–4) | 4 (2–5) | 0.13 | 2 (1–4) | 2 (2–5) | 0.39 |
Pulmonary artery diameter a.p. Median (25p–75p) | 27 (26–29) | 27 (25–31) | 0.65 | |||
PA/AA ratio Median (25p–75p) | 0.80 (0.73–0.91) | 0.732 (0.63–0.84) | 0.07 |
Right Lung | Left Lung | |||||
---|---|---|---|---|---|---|
TC Patterns | No Pronated (n = 32) | Pronated (n = 12) | p-Value | No Pronated (n = 32) | Pronated (n = 12) | p-Value |
Ground Glass Opacities | 23 (71.9%) | 10 (83.3%) | 0.43 | 23 (71.9%) | 10 (83.3%) | 0.43 |
Linear Bands | 23 (71.9%) | 10 (83.3%) | 0.43 | 23 (71.9%) | 9 (75.0%) | 0.84 |
Reticulations | 8 (25.0%) | 6 (50.0%) | 0.11 | 6 (18.8%) | 5 (41.7%) | 0.12 |
Consolidations | 8 (25.0%) | 5 (41.7%) | 0.28 | 6 (18.8%) | 3 (25.0%) | 0.65 |
Loss of pulmunary Volume | 7 (21.9%) | 3 (25.0%) | 0.83 | 8 (25.0%) | 3 (25.0%) | 0.99 |
Bronchiectasis | 6 (18.8%) | 6 (50.0%) | 0.04 | 6 (18.8%) | 4 (33.3%) | 0.30 |
Bronchiolectasis | 6 (18.8%) | 7 (58.3%) | 0.02 | 6 (18.8%) | 5 (42.7%) | 0.12 |
Total patterns Median (25p–75p) | 2 (1–3.5) | 4.5 (2.5–5) | 0.03 | 2 (1–3) | 3 (2–5) | 0.18 |
Pulmonary artery diameter a.p. Median (25p–75p) | 27 (25–29) | 30 (27–31.5) | 0.03 | |||
PA/AA ratio Median (25p–75p) | 0.76 (0.71–0.88) | 0.88 (0.79–0.94) | 0.06 |
RIGHT LUNG | |
---|---|
Main HRCT findings | Spirometry values |
Ground Glass Opacities | p = 0.36 |
Consolidations | p = 0.18 |
Reticulations | p = 0.66 |
Lobar volume reduction | p = 0.12 |
Bronchiectasis | p= 0.009 |
Bronchiolectasis | p= 0.0123 |
Linear Bands | p = 0.09 |
LEFT LUNG | |
Main HRCT findings | Spirometry values |
Ground Glass Opacities | p = 0.36 |
Consolidations | p = 0.27 |
Reticulations | p = 0.18 |
Lobar volume reduction | p = 0.026 |
Bronchiectasis | p = 0.002 |
Bronchiolectasis | p = 0.03 |
Linear Bands | p = 0.67 |
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Baratella, E.; Ruaro, B.; Marrocchio, C.; Starvaggi, N.; Salton, F.; Giudici, F.; Quaia, E.; Confalonieri, M.; Cova, M.A. Interstitial Lung Disease at High Resolution CT after SARS-CoV-2-Related Acute Respiratory Distress Syndrome According to Pulmonary Segmental Anatomy. J. Clin. Med. 2021, 10, 3985. https://doi.org/10.3390/jcm10173985
Baratella E, Ruaro B, Marrocchio C, Starvaggi N, Salton F, Giudici F, Quaia E, Confalonieri M, Cova MA. Interstitial Lung Disease at High Resolution CT after SARS-CoV-2-Related Acute Respiratory Distress Syndrome According to Pulmonary Segmental Anatomy. Journal of Clinical Medicine. 2021; 10(17):3985. https://doi.org/10.3390/jcm10173985
Chicago/Turabian StyleBaratella, Elisa, Barbara Ruaro, Cristina Marrocchio, Natalia Starvaggi, Francesco Salton, Fabiola Giudici, Emilio Quaia, Marco Confalonieri, and Maria Assunta Cova. 2021. "Interstitial Lung Disease at High Resolution CT after SARS-CoV-2-Related Acute Respiratory Distress Syndrome According to Pulmonary Segmental Anatomy" Journal of Clinical Medicine 10, no. 17: 3985. https://doi.org/10.3390/jcm10173985