Interstitial Lung Disease at High Resolution CT after SARS-CoV-2-Related Acute Respiratory Distress Syndrome According to Pulmonary Segmental Anatomy

Abstract

Background: The purpose of this study was to evaluate High-Resolution CT (HRCT) findings in SARS-CoV-2-related ARDS survivors treated with prolonged low-dose methylprednisolone after hospital discharge. Methods: A total of 44 consecutive patients (M: 32, F: 12, average age: 64), hospitalised in our department from April to September 2020 for SARS-CoV-2-related ARDS, who had a postdischarge CT scan, were enrolled into this retrospective study. We reviewed the electronic medical charts to collect laboratory, clinical, and demographic data. The CT findings were evaluated and classified according to lung segmental distribution. The imaging findings were correlated with spirometry results and included ground glass opacities (GGOs), consolidations, reticulations, bronchiectasis/bronchiolectasis, linear bands, and loss of pulmonary volume. Results: Alterations in the pulmonary parenchyma were observed in 97.7% of patients at HRCT (median time lapse between ARDS diagnosis and HRCT: 2.8 months, range 0.9 to 6.7). The most common findings were linear bands (84%), followed by GGOs (75%), reticulations (34%), bronchiolectasis (32%), consolidations (30%), bronchiectasis (30%) and volume loss (25%). They had a symmetric distribution, and both lower lobes were the most affected areas. Conclusions: A reticular pattern with a posterior distribution was observed 3 months after discharge from severe COVID-19 pneumonia, and this differs from previously described postCOVID-19 fibrotic-like changes. We hypothesized that the systematic use of prolonged low-dose of corticosteroid could be the main reason of this different CT scan appearance.

An updated overview of recent advances, challenges, and clinical considerations of IL-6 signaling blockade in severe coronavirus disease 2019 (COVID-19)

“…The radiologic findings may show bilateral ground-glass opacifications (GGO) in the peripheral sites of the lung in moderate cases. Moreover, consolidation and\or white lung can be observed in lung CT of severe cases [4] , [5] . The prognosis of COVID-19 is worsened as age increases.…”

Portal Vein Thrombosis Might Develop by COVID-19 Infection or Vaccination: A Systematic Review of Case-Report Studies

“…The clinical presentations of COVID-19 vary depending upon the immune system, gender, and age of the patients. General symptoms including fever, cough, and fatigue are common in many patients, but several complications such as thrombosis, severe respiratory symptoms, heart, kidney, and multiorgan failure are less prevalent (4)(5)(6). The incidence rate of some symptoms was determined by a meta-analysis in 50,466 patients, as followed; fever 89.1, cough 72.2, fatigue 42.5, and abnormal CT in 96.6% of the cases (7).…”

Inhibiting ACSL1-Related Ferroptosis Restrains Murine Coronavirus Infection

“…Therefore, it is urgent to explore effective approaches to the treatments of COVID-19, especially COVID-19 pneumonia. Studying the interaction between coronavirus and hosts can help understand the mechanism within the infection process, and provide new opinions on clinical treatment [2,3]. Murine hepatitis virus strain A59 (MHV-A59) is a well-studied coronavirus infection model [4].…”