The characteristics and evolution of pulmonary fibrosis in COVID-19 patients as assessed by AI-assisted chest HRCT

Zou, Jia Ni; Sun, Lu; Wang, Bin Ru; Zou, You; Xu, Shunqing; Ding, Yong Jun; Li, Shen; Huang, Wen; Jiang, Xiao Jing; Chen, Shi‐Ming

doi:10.1371/journal.pone.0248957

Cited by 99 publications

(125 citation statements)

References 22 publications

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“…Pulmonary function testing in these subjects revealed a correlation between reduced DLCO and severity of illness with women and elderly patients having a higher likelihood of having a diffusion impairment. Other studies have found that higher inflammatory markers (C-reactive protein, LDH and interleukin-6) ( 102 , 110 – 112 ), high d-dimer ( 113 ), white blood cell count ( 110 ), albumin level ( 102 ), older age ( 74 , 113 ), male sex ( 113 , 114 ), underlying co-morbidities ( 113 ), ICU admission ( 114 ), longer hospital stay ( 74 , 111 ), the need for mechanical ventilation ( 73 , 112 ), the duration of mechanical ventilation ( 112 ) and a diagnosis of ARDS ( 73 , 74 ) have been associated with worse fibrosis on follow-up scan. Recently, shorter leukocyte telomere length, a risk factor for other fibrotic lung diseases including idiopathic pulmonary fibrosis (IPF), has been associated with post-COVID fibrotic changes on CT ( 112 ).…”

Section: Post-acute Sequelae Of Covid-19mentioning

confidence: 94%

CT of Post-Acute Lung Complications of COVID-19

et al. 2021

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The acute course of coronavirus disease 2019 (COVID-19) is variable and ranges from asymptomatic infection to fulminant respiratory failure. Patients recovering from COVID-19 can have persistent symptoms and computed tomography (CT) abnormalities of variable severity. At 3 months after acute infection, a subset of patients will have CT abnormalities that include ground glass abnormalities (GGO) and subpleural bands with concomitant pulmonary function abnormalities. At 6 months after acute infection, some patients have persistent CT changes to include the resolution of GGOs seen in the early recovery phase and the persistence or development of changes suggestive of fibrosis such as reticulation with or without parenchymal distortion. Predictors of post-COVID lung disease include need for intensive care unit (ICU) admission, mechanical ventilation, higher inflammatory markers, longer hospital stay and a diagnosis of acute respiratory distress syndrome (ARDS). Treatments of post-COVID lung disease are being investigated with anti-fibrotic agents being investigated for the prevention of post-COVID lung fibrosis. The etiology of post-COVID lung disease may be a sequela of prolonged mechanical ventilation, COVID-induced ARDS or direct injury from the virus. Future research is needed to determine the long-term persistence of post-COVID lung disease, its impact on patients and ways to prevent or treat it.

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Section: Post-acute Sequelae Of Covid-19mentioning

confidence: 94%

CT of Post-Acute Lung Complications of COVID-19

et al. 2021

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“…By the end of the treatment, the GGO and peripheral involvement were absorbed, leaving only the fibrotic lesion. Zou et al (2021) 25 studied the outcome and found improvement and sometimes the resolution of fibrosis occurs after 3 months in COVID-19 patients. In another study, however, in most patients, the pulmonary fibrosis was settled in three months 26 .…”

Section: Discussionmentioning

confidence: 99%

Investigation of HRCT Chest Severity in Patients with COVID-19: A Study of Tertiary Care Hospital in Pakistan

Sarfraz¹,

Waheed²,

Akhtar³

et al. 2021

PJMHS

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Background: High-resolution computed tomography (HRCT) chest has a key role in diagnosis COVID-19, as it provides specific imaging features, i.e., bilateral, peripheral and sub-pleural, ground-glass opacity (GGO), consolidation and many associated findings. Aim: To provide the detailed chest HRCT findings along with clinical information in patients with COVID-19. Methods: A cross-sectional study was conducted in the Department of Radiology SZPGMI, Lahore. Information on clinical data, chest radiography appearance and comorbidities were recorded ona designed proforma. HRCT chest findings were recorded in terms of pattern, distribution, laterality, and other findings. HRCT chest severity was calculated using a 25 point CT severity score. Kendall’s Tau test applied to investigate the correlation between the severity of HRCT chest with clinical severity levels of COVID-19. Results: Fever (74%) was the most reported presenting symptom, followed by dry cough (70%). The majority of patients had abnormal chest X-ray (57%) as well as abnormal HRCT chest (90%). The majority of patients were in mild clinical scoring levels of disease (61%) and mild category (49%) of HRCT chest severity. In majority of the patients (46%), all five pulmonary lobes were involved, whereas the right lower lobe was most frequently affected. The pattern of ground-glass opacity (GGO) was found in 82% of patients. Most common distribution was ‘peripheral’, reported in 90% patients. Multiple lobe involvement was found in 82% of patients. The unilateral pulmonary involvement was observed in 12% of patients, whereas, bilateral was found in 78% of patients. Reticulations were reported in 22% followed by atelectasis in 18% patients. Conclusion: COVID-19 patients usually present with abnormal HRCT chest, mostly with a benign course. Multiple pulmonary lobes are commonly involved, especially basal lobes with ground glass opacities. Clinical severity of the disease is reflected in HRCT findings. Keywords: COVID-19 Pandemic, HRCT Chest Findings, Ground Glass Opacity (GGO), Consolidation

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“…In addition, Ang II plays a role in tissue fibrosis through angiotensin type 1 receptor (AT1) in cardiac, renal, pulmonary, abdominal tissues, and systemic sclerosis (Murphy et al, 2015). Pulmonary fibrosis impairs pulmonary function affecting the oxygen exchange in Covid-19 patients (Razzaque and Taguchi, 2003;Zou et al, 2021). Using pathway analysis, we demonstrate that pancreatic secretions are associated with RAS dysfunction, causing the immune system's hyperactivation and coagulation abnormalities leading to multi-organ failure.…”

Section: Role Of Upregulated Pancreatic Secretomementioning

confidence: 91%

Deciphering the role of the Pancreatic Secretome in Covid-19 associated Multi-Organ Dysfunctions

Pathak

Mishra

2021

Preprint

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Emerging evidence indicates an intricate relationship between the SARS-CoV-2 infection and Multi-Organ Dysfunctions (MODs). Here, we have investigated the role of the Secretome of the SARS-CoV-2 infected pancreas and mechanistically linked it with the multi-organ dysfunction using the scRNA-seq analysis. We found that acinar-specific PRSS2, REG3A, REG1A, SPINK1, and ductal-specific SPP1, MMP7 genes are upregulated in alpha, beta, delta, and mesenchyme cells. Using extensive documented experimental evidence, we validated the association of upregulated pancreatic Secretome with coagulation cascade, complement activation, renin angiotensinogen system dysregulation, endothelial cell injury and thrombosis, immune system dysregulation, and fibrosis. Our finding suggests the influence of upregulated Secretome on multi-organ systems such as Nervous, Cardiovascular, Immune, Digestive, and Urogenital systems. In addition, we report that the secretory proteins IL1B, AGT, ALB, SPP1, CRP, SERPINA1, C3, TFRC, TNFSF10, and MIF are associated with diverse diseases. Thus, suggest the role of the pancreatic Secretome in SARS-CoV-2 associated MODs.

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The characteristics and evolution of pulmonary fibrosis in COVID-19 patients as assessed by AI-assisted chest HRCT

Cited by 99 publications

References 22 publications

CT of Post-Acute Lung Complications of COVID-19

CT of Post-Acute Lung Complications of COVID-19

Investigation of HRCT Chest Severity in Patients with COVID-19: A Study of Tertiary Care Hospital in Pakistan

Deciphering the role of the Pancreatic Secretome in Covid-19 associated Multi-Organ Dysfunctions

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