Correlation between Pneumonia Severity and Pulmonary Complications in Middle East Respiratory Syndrome

Park, Wan Beom; Jun, Kang Il; Kim, Gayeon; Choi, Jeongyong; Rhee, Ji-Young; Cheon, Shinhye; Lee, Chang Hyun; Park, Jun-Sun; Kim, Yeonjae; Joh, Joon Sung; Chin, Bum Sik; Choe, Pyoeng Gyun; Bang, Ji Hwan; Park, Sang-Won; Kim, Nam Joong; Lim, Dong-Gyun; Kim, So Hyun; Oh, Myoung Don; Shin, Hyoung-Shik

doi:10.3346/jkms.2018.33.e169

Cited by 101 publications

(99 citation statements)

References 16 publications

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“…In this regard, elevated C-reactive protein may be predictive of radiological sequelae. Prior studies indicated that radiological sequelae from SARS and MERS may suggest the abnormal or repaired lung function (30,32). Despite the slight residuals in COVID-19, a long-term follow-up is required to further trace the resolution and associations with lung function.…”

Section: Discussionmentioning

confidence: 99%

A Pattern Categorization of CT Findings to Predict Outcome of COVID-19 Pneumonia

Jin

Tian

Wang

et al. 2020

Front. Public Health

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Background: As global healthcare system is overwhelmed by novel coronavirus disease (COVID-19), early identification of risks of adverse outcomes becomes the key to optimize management and improve survival. This study aimed to provide a CT-based pattern categorization to predict outcome of COVID-19 pneumonia. Methods: One hundred and sixty-five patients with COVID-19 (91 men, 4-89 years) underwent chest CT were retrospectively enrolled. CT findings were categorized as Pattern 0 (negative), Pattern 1 (bronchopneumonia pattern), Pattern 2 (organizing pneumonia pattern), Pattern 3 (progressive organizing pneumonia pattern), and Pattern 4 (diffuse alveolar damage pattern). Clinical findings were compared across different categories. Time-dependent progression of CT patterns and correlations with clinical outcomes, i.e." discharge or adverse outcome (admission to ICU, requiring mechanical ventilation, or death), with pulmonary sequelae (complete absorption or residuals) on CT after discharge were analyzed. Results: Of 94 patients with outcome, 81 (86.2%) were discharged, 3 (3.2%) were admitted to ICU, 4 (4.3%) required mechanical ventilation, 6 (6.4%) died. 31 (38.3%) had complete absorption at median day 37 after symptom onset. Significant differences between pattern-categories were found in age, disease severity, comorbidity and laboratory results (all P < 0.05). Remarkable evolution was observed in Pattern 0-2 and Pattern 3-4 within 3 and 2 weeks after symptom-onset, respectively; most of patterns remained thereafter. After controlling for age, CT pattern significantly correlated with adverse outcomes [Pattern 4 vs. Pattern 0-3 [reference]; hazard-ratio [95% CI], 18.90 [1.91-186.60], P = 0.012]. CT pattern [Pattern 3-4 vs. Pattern 0-2 [reference]; 0.26 [0.08-0.88], P = 0.030] and C-reactive protein [>10 vs. ≤10 mg/L [reference]; 0.31 [0.13-0.72], P = 0.006] were risk factors associated with pulmonary residuals. Jin et al. CT Pattern Categorization of COVID-19 Conclusion: CT pattern categorization allied with clinical characteristics within 2 weeks after symptom onset would facilitate early prognostic stratification in COVID-19 pneumonia.

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Section: Discussionmentioning

confidence: 99%

A Pattern Categorization of CT Findings to Predict Outcome of COVID-19 Pneumonia

Jin

Tian

Wang

et al. 2020

Front. Public Health

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“…A recent report portrayed that discharged patients with COVID-19 pneumonia are still having residual abnormalities in chest CT scans, with ground-glass opacity as the most common pattern 4 . Persistent impairment of pulmonary function and exercise capacity have been known to last for months or even years [5][6][7][8] in the recovered survivors with other coronavirus pneumonia (severe acute respiratory syndrome/SARS and middle east respiratory syndrome/MERS). However, until now, there is no report in regard to pulmonary function in discharged COVID-19 survivors.…”

Section: To the Editorsmentioning

confidence: 99%

Abnormal pulmonary function in COVID-19 patients at time of hospital discharge

et al. 2020

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Disease 2019 (COVID-19) as a pandemic. As of 22 April, more than 2.4 million cases have been confirmed worldwide 1 . In light of the widely documented lung injuries related with COVID-19 2-3 , concerns are raised regarding the assessment of the lung injury for discharged patients. A recent report portrayed that discharged patients with COVID-19 pneumonia are still having residual abnormalities in chest CT scans, with ground-glass opacity as the most common pattern 4 . Persistent impairment of pulmonary function and exercise capacity have been known to last for months or even years [5][6][7][8] in the recovered survivors with other coronavirus pneumonia (severe acute respiratory syndrome/SARS and middle east respiratory syndrome/MERS). However, until now, there is no report in regard to pulmonary function in discharged COVID-19 survivors. Our manuscript aims to describe the characteristics of pulmonary function in these subjects.We recruited laboratory confirmed non-critical COVID-19 cases, from February 5th to March 17th from admitted patients. According to the WHO interim guidance 9 and the guidance from china 10 , disease severity were categorized as mild illness(mild symptoms without radiographic appearance of pneumonia), pneumonia(having symptoms and the radiographic evidence of pneumonia, with no requirement for supplemental oxygen), severe pneumonia(having pneumonia, including one of the following: respiratory rate > 30 breaths/minute; severe respiratory distress; or SpO2 ≤ 93% on room air at rest), and critical cases (e.g. respiratory failure requiring mechanical ventilation, Septic shock, other organ failure occurrence or admission into the ICU). Critical cases were excluded from our study.Spirometry and pulmonary diffusion capacity test (Cosmed PFT Quark, Rome, Italy) were performed following the ATS-ERS guidelines on the day of or one day before discharge. To minimize cross infections, carbon monoxide diffusion capacity (DLCO) was measured by the single-breath method. Written informed consent was obtained from all patients, and the study was approved by the ethics committee of The Guangzhou Eighth People's Hospital.One-hundred and ten discharged cases were recruited, which included 24 cases of mild illness, 67 cases of pneumonia and 19 cases of severe pneumonia (Table 1). The mean age of these cases was 49.1 years and fifty-five of them were females. Forty-four (40%) patients had at least one underlying comorbidity, of which 23.6% had hypertension and 8.2% had diabetes. Only 3 patients (2.7%) were reported having chronic respiratory diseases (one patient with asthma, one with chronic bronchitis and one with bronchiectasis). No significant differences were found among the three groups of cases, in the relation to gender, smoking status, underlying disease and the BMI value. The duration from onset of disease to pulmonary function test was 20±6 days in cases with mild illness, 29±8 days in cases with pneumonia and 34±7 days in cases that presented severe pneumonia. On the day of discharge, the SpO2% on ro...

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“…Post-acute early rehabilitation of coronavirus survivors would foremost involve recovery of body structure and function. Impairment of respiratory function [9][10][11], exercise tolerance [12] and neuromuscular functions [13] have been reported to be present in coronavirus survivors beyond 3 months post-infection, with improvement to some degree in many of these individuals. However, improvement in these impairments of body structure and function may not necessarily translate into recovery from disability and role limitation [14,15].…”

Section: Introductionmentioning

confidence: 99%

Applying the WHO ICF Framework to the Outcome Measures Used in the Evaluation of Long-Term Clinical Outcomes in Coronavirus Outbreaks

Patel

Straudi

Sien

et al. 2020

IJERPH

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(1) Objective: The World Health Organization’s (WHO) International Classification of Functioning, Disability and Health (ICF) classification is a unified framework for the description of health and health-related states. This study aimed to use the ICF framework to classify outcome measures used in follow-up studies of coronavirus outbreaks and make recommendations for future studies. (2) Methods: EMBASE, MEDLINE, CINAHL and PsycINFO were systematically searched for original studies assessing clinical outcomes in adult survivors of severe acute respiratory distress syndrome (SARS), middle east respiratory syndrome (MERS) and coronavirus disease-19 (COVID-19) after hospital discharge. Individual items of the identified outcome measures were linked to ICF second-level and third-level categories using ICF linking rules and categorized according to an ICF component. (3) Results: In total, 33 outcome measures were identified from 36 studies. Commonly used (a) ICF body function measures were Pulmonary Function Tests (PFT), Impact of event scale (IES-R) and Hospital Anxiety and Depression Scale (HADS); (b) ICF activity was 6-Minute Walking Distance (6MWD); (c) ICF participation measures included Short Form-36 (SF-36) and St George’s Respiratory Questionnaire (SGRQ). ICF environmental factors and personal factors were rarely measured. (4) Conclusions: We recommend future COVID-19 follow-up studies to use the ICF framework to select a combination of outcome measures that capture all the components for a better understanding of the impact on survivors and planning interventions to maximize functional return.

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Correlation between Pneumonia Severity and Pulmonary Complications in Middle East Respiratory Syndrome

Cited by 101 publications

References 16 publications

A Pattern Categorization of CT Findings to Predict Outcome of COVID-19 Pneumonia

A Pattern Categorization of CT Findings to Predict Outcome of COVID-19 Pneumonia

Abnormal pulmonary function in COVID-19 patients at time of hospital discharge

Applying the WHO ICF Framework to the Outcome Measures Used in the Evaluation of Long-Term Clinical Outcomes in Coronavirus Outbreaks

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