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Lung CT Segmentation to Identify Consolidations and Ground Glass Areas for Quantitative Assesment of SARS-CoV Pneumonia
Published on: December 19, 2020
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Inflammatory burden and persistent CT lung abnormalities in COVID-19 patients
Giulia Besutti1,2, Paolo Giorgi Rossi3, Marta Ottone3
1Radiology Unit, Department of Diagnostic Imaging and Laboratory Medicine, Azienda USL - IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123, Reggio Emilia, Italy. giulia.besutti@ausl.re.it.
Scientific Reports
|March 12, 2022
Summary
High inflammation during COVID-19, measured by C-reactive protein (CRP) peaks and integrals, predicts residual lung CT abnormalities in survivors. This highlights inflammation
Area of Science:
- Pulmonary Medicine
- Infectious Diseases
- Radiology
Background:
- COVID-19 survivors often exhibit persistent lung abnormalities on CT scans.
- Inflammatory burden during acute infection is linked to COVID-19 severity and outcomes.
- Understanding factors predicting residual lung damage is crucial for patient management.
Purpose of the Study:
- To investigate the association between inflammatory burden during COVID-19 and residual lung CT abnormalities.
- To identify specific inflammatory markers that predict lung damage at 2-3 and 6-7 months post-infection.
- To explore the role of other clinical factors as mediators in this relationship.
Main Methods:
- Analysis of C-reactive protein (CRP) curves, including peaks, velocities, and integrals, to quantify inflammatory burden.
- Inclusion of clinical data: age, sex, mechanical ventilation, lowest PaO2/FiO2 ratio, D-dimer peak, and length of hospital stay (LOS).
- Follow-up CT scans at 2-3 and 6-7 months post-COVID-19 to assess residual lung abnormalities in 259 severe pneumonia survivors.
Main Results:
- 78% and 38.6% of patients had residual lung abnormalities at 2-3 and 6-7 months, respectively.
- Higher CRP peak predicted abnormalities at 2-3 months (OR=1.79), while higher CRP integral predicted abnormalities at 6-7 months (OR=2.24).
- Mechanical ventilation and LOS mediated the relationship between CRP and residual lung abnormalities, but D-dimer did not.
Conclusions:
- Inflammatory burden during COVID-19 is significantly associated with short- and medium-term lung damage.
- CRP peak and integral are key predictors of residual lung CT abnormalities after severe COVID-19 pneumonia.
- Inflammation's impact on lung sequelae is partly mediated by other indicators of disease severity.
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