Frequency of subclinical interstitial lung disease in COVID-19 autopsy cases: potential risk factors of severe pneumonia.

Autor: Iwashita, Hiromichi, Kawabata, Yoshinori, Hayashi, Hiroyuki, Matsushita, Shoichiro, Yamashiro, Tsuneo, Matsumura, Mai, Yoshimura, Yukihiro, Kataoka, Toshiaki, Mitsui, Hideaki, Suzuki, Takehisa, Misumi, Toshihiro, Tanaka, Tomonori, Ishijima, Sosuke, Fukuoka, Junya, Iwasawa, Tae, Ogura, Takashi, Okudela, Koji
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Zdroj: BMC Pulmonary Medicine; 10/27/2023, Vol. 23 Issue 1, p1-12, 12p
Abstrakt: 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. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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