Idiopathic Interstitial Pneumonias and COVID-19 Pneumonia: Review of the Main Radiological Features and Differential Diagnosis

Guarnera, Alessia; Santini, E.; Podda, Pierfrancesco

doi:10.3390/tomography7030035

Cited by 9 publications

(12 citation statements)

References 63 publications

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“…Absorption phase or phase four (14 days and beyond) is the final stage in which parenchymal bands and ground-glass opacities represent a process of parenchymal repair and reorganization mediated by organizing pneumonia [27] (Figure 1d).…”

Section: Covid-19 Pneumoniamentioning

confidence: 99%

“…Lung cancer therapy has been continuously evolving and is strictly dependent on neoplasm morphostructural, immunohistochemical, and molecular features [18]. On the other hand, oncological treatment is the cause of multiple acute and chronic lung diseases [27,[50][51][52][53][54]. Anamnesis and timing of clinical signs and symptoms is pivotal for an optimal differential diagnosis and proper treatment [50].…”

Section: Covid-19 Pneumonia and Treatment-induced Lung Disease: Diffe...mentioning

confidence: 99%

“…We will cite and classify the most common chemotherapy and immunotherapyinduced pulmonary diseases in relation to COVID-19 pneumonia phases [27,50,54]: 4.2.1. Ground-Glass and Crazy Paving NSIP (non-specific interstitial pneumonia): methotrexate, carmustine, chlorambucil; Hypersensitivity pneumonitis: immunosuppressants such as sirolimus and everolimus; Pulmonary hemorrhage: cytarabine, cyclophosphamide.…”

Section: Chemotherapy-and Immunotherapy-induced Lung Diseasementioning

confidence: 99%

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COVID-19 Pneumonia and Lung Cancer: A Challenge for the Radiologist Review of the Main Radiological Features, Differential Diagnosis and Overlapping Pathologies

2022

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The COVID-19 pneumonia pandemic represents the most severe health emergency of the 21st century and has been monopolizing health systems’ economic and human resources world-wide. Cancer patients have been suffering from the health systems’ COVID-19 priority management with evidence of late diagnosis leading to patients’ poor prognosis and late medical treatment. The radiologist plays a pivotal role as CT represents a non-invasive radiological technique which may help to identify possible overlap and differential diagnosis between COVID-19 pneumonia and lung cancer, which represents the most frequent cancer histology in COVID-19 patients. Our aims are: to present the main CT features of COVID-19 pneumonia; to provide the main differential diagnosis with lung cancer, chemotherapy-, immunotherapy-, and radiotherapy-induced lung disease; and to suggest practical tips and key radiological elements to identify possible overlap between COVID-19 pneumonia and lung cancer. Despite similarities or overlapping findings, the combination of clinics and some specific radiological findings, which are also identified by comparison with previous and follow-up CT scans, may guide differential diagnosis. It is crucial to search for typical COVID-19 pneumonia phase progression and typical radiological features on HRTC. The evidence of atypical findings such as lymphadenopathies and mediastinal and vessel invasion, as well as the absence of response to therapy, should arouse the suspicion of lung cancer and require contrast administration. Ground-glass areas and/or consolidations bound to radiotherapy fields or pneumonitis arising during and after oncological therapy should always arouse the suspicion of radiation-induced lung disease and chemo/immunotherapy-induced lung disease. The radiological elements we suggest for COVID-19 and lung cancer differential diagnosis may be used to develop AI protocols to guarantee an early and proper diagnosis and treatment to improve patients’ quality of life and life expectancy.

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Section: Covid-19 Pneumoniamentioning

confidence: 99%

Section: Covid-19 Pneumonia and Treatment-induced Lung Disease: Diffe...mentioning

confidence: 99%

Section: Chemotherapy-and Immunotherapy-induced Lung Diseasementioning

confidence: 99%

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COVID-19 Pneumonia and Lung Cancer: A Challenge for the Radiologist Review of the Main Radiological Features, Differential Diagnosis and Overlapping Pathologies

2022

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“…The differential diagnosis of COVID-19 pneumonia with IIP is challenging because these entities may share common radiological aspects. Therefore, a multidisciplinary approach is crucial to arrive at a final and correct diagnosis [ 70 , 71 ].…”

Section: Differential Diagnosis Of Covid-19 Pneumoniamentioning

confidence: 99%

Challenges in the Differential Diagnosis of COVID-19 Pneumonia: A Pictorial Review

Mărginean

Popescu²,

Vasile³

et al. 2022

Diagnostics

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COVID-19 pneumonia represents a maximum medical challenge due to the virus’s high contagiousness, morbidity, and mortality and the still limited possibilities of the health systems. The literature has primarily focused on the diagnosis, clinical-radiological aspects of COVID-19 pneumonia, and the most common possible differential diagnoses. Still, few studies have investigated the rare differential diagnoses of COVID-19 pneumonia or its overlap with other pre-existing lung pathologies. This article presents the main radiological features of COVID-19 pneumonia and the most common alternative diagnoses to establish the vital radiological criteria for a differential diagnosis between COVID-19 pneumonia and other lung pathologies with similar imaging appearance. The differential diagnosis of COVID-19 pneumonia is challenging because there may be standard radiologic features such as ground-glass opacities, crazy paving patterns, and consolidations. A multidisciplinary approach is crucial to define a correct final diagnosis, as an overlap of COVID-19 pneumonia with pre-existing lung diseases is often possible and suggests possible differential diagnoses. An optimal evaluation of HRTC can help limit the clinical evolution of the disease, promote therapy for patients and ensure an efficient allocation of human and economic resources.

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“…The HRCT features of COVID-19-associated pulmonary fibrosis include thickened interlobular septa, architectural distortion, reticular opacities, and even traction bronchiectasis or honeycombing, which is similar to IPF. However, traction bronchiectasis and honeycombing are more common in IPF and thickened interlobular septa, and reticular opacities might be reduced in some patients with COVID-19 after discharge ( Raghu et al, 2011 ; Hariri et al, 2020 ; Lu et al, 2020 ; Guarnera et al, 2021 ; Li et al, 2021a ). And IPF was identified as one of the most serious risk factors for COVID-19 ( Sheng et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

A novel gene signature based on the hub genes of COVID-19 predicts the prognosis of idiopathic pulmonary fibrosis

et al. 2022

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Background: Increasing evidence has demonstrated that there was a strong correlation between COVID-19 and idiopathic pulmonary fibrosis (IPF). However, the studies are limited, and the real biological mechanisms behind the IPF progression were still uncleared.Methods: GSE70866 and GSE 157103 datasets were downloaded. The weight gene co-expression network analysis (WGCNA) algorithms were conducted to identify the most correlated gene module with COVID-19. Then the genes were extracted to construct a risk signature in IPF patients by performing Univariate and Lasso Cox Regression analysis. Univariate and Multivariate Cox Regression analyses were used to identify the independent value for predicting the prognosis of IPF patients. What’s more, the Kyoto Encyclopedia of Genes and Genomes (KEGG), Gene Ontology (GO), and gene set enrichment analysis (GSEA) were conducted to unveil the potential biological pathways. CIBERSORT algorithms were performed to calculate the correlation between the risk score and immune cells infiltrating levels.Results: Two hundred thirty three differentially expressed genes were calculated as the hub genes in COVID-19. Fourteen of these genes were identified as the prognostic differentially expressed genes in IPF. Three (MET, UCHL1, and IGF1) of the fourteen genes were chosen to construct the risk signature. The risk signature can greatly predict the prognosis of high-risk and low-risk groups based on the calculated risk score. The functional pathway enrichment analysis and immune infiltrating analysis showed that the risk signature may regulate the immune-related pathways and immune cells.Conclusion: We identified prognostic differentially expressed hub genes related to COVID-19 in IPF. A risk signature was constructed based on those genes and showed great value for predicting the prognosis in IPF patients. What’s more, three genes in the risk signature may be clinically valuable as potential targets for treating IPF patients and IPF patients with COVID-19.

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Idiopathic Interstitial Pneumonias and COVID-19 Pneumonia: Review of the Main Radiological Features and Differential Diagnosis

Cited by 9 publications

References 63 publications

COVID-19 Pneumonia and Lung Cancer: A Challenge for the Radiologist Review of the Main Radiological Features, Differential Diagnosis and Overlapping Pathologies

COVID-19 Pneumonia and Lung Cancer: A Challenge for the Radiologist Review of the Main Radiological Features, Differential Diagnosis and Overlapping Pathologies

Challenges in the Differential Diagnosis of COVID-19 Pneumonia: A Pictorial Review

A novel gene signature based on the hub genes of COVID-19 predicts the prognosis of idiopathic pulmonary fibrosis

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