1. Inflammatory burden and persistent CT lung abnormalities in COVID-19 patients
- Author
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Lucia Spaggiari, Fabio Sampaolesi, Pierpaolo Pattacini, Andrea Caruso, Annalisa Gallina, Nicola Sverzellati, Giulia Ghidoni, Stefania Croci, Elisabetta Teopompi, Tommaso Fasano, Carlo Salvarani, Stefania Costi, Marco Massari, Paolo Giorgi Rossi, Giovanni Dolci, Anna Simonazzi, Filippo Monelli, Nicola Facciolongo, Mauro Iori, Andrea Nitrosi, Giulia Besutti, Simone Canovi, Marta Ottone, Stefania Fugazzaro, and Efrem Bonelli
- Subjects
Male ,Pathology ,medicine.medical_specialty ,Multidisciplinary ,Lung ,Time Factors ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Patient Acuity ,COVID-19 ,Aged ,C-Reactive Protein ,Female ,Humans ,Middle Aged ,Pneumonia ,Retrospective Studies ,Risk Factors ,Tomography, X-Ray Computed ,medicine.anatomical_structure ,medicine ,business - Abstract
Inflammatory burden is associated with COVID-19 severity and outcomes. Residual computed tomography (CT) lung abnormalities have been reported after COVID-19. The aim was to evaluate the association between inflammatory burden during COVID-19 and residual lung CT abnormalities collected on follow-up CT scans performed 2–3 and 6–7 months after COVID-19, in severe COVID-19 pneumonia survivors. C-reactive protein (CRP) curves describing inflammatory burden during the clinical course were built, and CRP peaks, velocities of increase, and integrals were calculated. Other putative determinants were age, sex, mechanical ventilation, lowest PaO2/FiO2 ratio, D-dimer peak, and length of hospital stay (LOS). Of the 259 included patients (median age 65 years; 30.5% females), 202 (78%) and 100 (38.6%) had residual, predominantly non-fibrotic, abnormalities at 2-3 and 6-7 months, respectively. In age- and sex-adjusted models, best CRP predictors for residual abnormalities were CRP peak (odds ratio [OR] for one standard deviation [SD] increase=1.79; 95% confidence interval [CI]=1.23-2.62) at 2-3 months and CRP integral (OR for one SD increase=2.24; 95%CI=1.53-3.28) at 6-7 months. Hence, inflammation is associated with short- and medium-term lung damage in COVID-19. Other severity measures, including mechanical ventilation and LOS, but not D-dimer, were mediators of the relationship between CRP and residual abnormalities.
- Published
- 2021