Patterns of organizing pneumonia and microinfarcts as surrogate for endothelial disruption and microangiopathic thromboembolic events in patients with coronavirus disease 2019
| Autor: | Christian Blüthgen, Thomas Frauenfelder, Friedrich Thienemann, Katharina Martini, Thi Dan Linh Nguyen-Kim, J. Walter |
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| Přispěvatelé: | University of Zurich, Martini, Katharina, Frauenfelder, Thomas |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Viral Diseases Pulmonology 030204 cardiovascular system & hematology Gastroenterology Vascular Medicine Diagnostic Radiology 0302 clinical medicine Medical Conditions Medicine and Health Sciences Pulmonary Arteries Lung Tomography Aged 80 and over Multidisciplinary 10042 Clinic for Diagnostic and Interventional Radiology Radiology and Imaging Arteries Venous Thromboembolism Middle Aged Pulmonary Imaging Hospitals Pulmonary embolism Intensive Care Units medicine.anatomical_structure Infectious Diseases Cohort Medicine Female Anatomy Coronavirus Infections Research Article Adult medicine.medical_specialty Coronavirus disease 2019 (COVID-19) Imaging Techniques Science Pneumonia Viral Neuroimaging 610 Medicine & health 1100 General Agricultural and Biological Sciences Pulmonary Artery COVID-19 Thromboembolism Pulmonary imaging Pulmonary arteries Intensive care units Computed axial tomography Pneumonia Research and Analysis Methods 03 medical and health sciences Diagnostic Medicine 1300 General Biochemistry Genetics and Molecular Biology Internal medicine medicine.artery medicine Humans Pandemics Aged Retrospective Studies 1000 Multidisciplinary business.industry Pulmonary Infarction Biology and Life Sciences Retrospective cohort study Covid 19 medicine.disease Computed Axial Tomography Health Care Health Care Facilities Pulmonary artery Cardiovascular Anatomy Blood Vessels 10029 Clinic and Policlinic for Internal Medicine business Tomography X-Ray Computed Pulmonary Embolism 030217 neurology & neurosurgery Neuroscience |
| Zdroj: | PLOS ONE, 15(10):e0240078 PLoS ONE, Vol 15, Iss 10, p e0240078 (2020) PLoS ONE |
| Popis: | BackgroundTo evaluate chest-computed-tomography (CT) scans in coronavirus-disease-2019 (COVID-19) patients for signs of organizing pneumonia (OP) and microinfarction as surrogate for microscopic thromboembolic events.MethodsReal-time polymerase-chain-reaction (RT-PCR)-confirmed COVID-19 patients undergoing chest-CT (non-enhanced, enhanced, pulmonary-angiography [CT-PA]) from March-April 2020 were retrospectively included (COVID-19-cohort). As control-groups served 175 patients from 2020 (cohort-2020) and 157 patients from 2019 (cohort-2019) undergoing CT-PA for pulmonary embolism (PE) during the respective time frame at our institution. Two independent readers assessed for presence and location of PE in all three cohorts. In COVID-19 patients additionally parenchymal changes typical of COVID-19 pneumonia, infarct pneumonia and OP were assessed. Inter-reader agreement and prevalence of PE in different cohorts were calculated.ResultsFrom 68 COVID-19 patients (42 female [61.8%], median age 59 years [range 32-89]) undergoing chest-CT 38 obtained CT-PA. Inter-reader-agreement was good (k = 0.781). On CT-PA, 13.2% of COVID-19 patients presented with PE whereas in the control-groups prevalence of PE was 9.1% and 8.9%, respectively (p = 0.452). Up to 50% of COVID-19 patients showed changes typical for OP. 21.1% of COVID-19 patients suspected with PE showed subpleural wedge-shaped consolidation resembling infarct pneumonia, while only 13.2% showed visible filling defects of the pulmonary artery branches on CT-PA.ConclusionDespite the reported hypercoagulability in critically ill patients with COVID-19, we did not encounter higher prevalence of PE in our patient cohort compared to the control cohorts. However, patients with suspected PE showed a higher prevalence of lung changes, resembling patterns of infarct pneumonia or OP and CT-signs of pulmonary-artery hypertension. |
| Databáze: | OpenAIRE |
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