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

Autor: Hiromichi Iwashita, Yoshinori Kawabata, Hiroyuki Hayashi, Shoichiro Matsushita, Tsuneo Yamashiro, Mai Matsumura, Yukihiro Yoshimura, Toshiaki Kataoka, Hideaki Mitsui, Takehisa Suzuki, Toshihiro Misumi, Tomonori Tanaka, Sosuke Ishijima, Junya Fukuoka, Tae Iwasawa, Takashi Ogura, Koji Okudela
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: BMC Pulmonary Medicine, Vol 23, Iss 1, Pp 1-12 (2023)
Druh dokumentu: article
ISSN: 1471-2466
DOI: 10.1186/s12890-023-02692-1
Popis: Abstract 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.
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