First report on clinical and radiological features of COVID-19 pneumonitis in a Caucasian population: Factors predicting fibrotic evolution.
Identifieur interne : 000D92 ( Main/Corpus ); précédent : 000D91; suivant : 000D93First report on clinical and radiological features of COVID-19 pneumonitis in a Caucasian population: Factors predicting fibrotic evolution.
Auteurs : Maurizio Marvisi ; Francesco Ferrozzi ; Laura Balzarini ; Chiara Mancini ; Sara Ramponi ; Mario UccelliSource :
- International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [ 1878-3511 ] ; 2020.
English descriptors
- KwdEn :
- Aged (MeSH), Aged, 80 and over (MeSH), Antiviral Agents (therapeutic use), Betacoronavirus (MeSH), COVID-19 (MeSH), Coronavirus Infections (complications), Coronavirus Infections (diagnostic imaging), Coronavirus Infections (pathology), Drug Combinations (MeSH), Female (MeSH), Humans (MeSH), Hydroxychloroquine (therapeutic use), Lopinavir (MeSH), Male (MeSH), Middle Aged (MeSH), Pandemics (MeSH), Pneumonia, Viral (complications), Pneumonia, Viral (diagnostic imaging), Pneumonia, Viral (pathology), Pulmonary Fibrosis (etiology), Radiography (MeSH), Retrospective Studies (MeSH), Ritonavir (MeSH), SARS-CoV-2 (MeSH), Tomography, X-Ray Computed (MeSH).
- MESH :
- chemical , therapeutic use : Antiviral Agents, Hydroxychloroquine.
- complications : Coronavirus Infections, Pneumonia, Viral.
- diagnostic imaging : Coronavirus Infections, Pneumonia, Viral.
- etiology : Pulmonary Fibrosis.
- pathology : Coronavirus Infections, Pneumonia, Viral.
- Aged, Aged, 80 and over, Betacoronavirus, COVID-19, Drug Combinations, Female, Humans, Lopinavir, Male, Middle Aged, Pandemics, Radiography, Retrospective Studies, Ritonavir, SARS-CoV-2, Tomography, X-Ray Computed.
Abstract
BACKGROUND
At the end of February, the Lombardy region (Northern Italy) was involved in the pandemic spread of the new COVID-19. We here summarize the clinical and radiological characteristics of 90 confirmed cases and analyze their role in predicting the evolution of fibrosis.
METHODS
We retrospectively analyzed the clinical and radiological data of 90 patients with COVID-19 pneumonitis. All subjects underwent an HRCT study on the day of admission and eight weeks later, and were treated with lopinavir + ritonavir (Kaletra) 400/100 mg two times a day or darunavir + ritonavir two times a day, and Hydroxychloroquine 200 mg two times a day. Pulmonary fibrosis was defined according to the Fleischner Society glossary of terms for thoracic imaging.
RESULTS
Twenty-three patients developed pulmonary fibrosis (25.5%): 15 were males, whose mean age was 75 ± 15. The majority were active smokers (60.8%) and had comorbidities (78.2%), above all, hypertension (47.8%), and diabetes (34.7%). Interestingly, in our series of cases, the "reversed halo sign" is frequent (63%) and seems to be a typical COVID-19 pneumonitis pattern. The patients showing fibrosis had a higher grade of systemic inflammation (ESR and PCR) and appeared to have bone marrow inhibition with a significant reduction in platelets, leukocytes, and hemoglobin.
CONCLUSIONS
To conclude, our data showed that the reversed halo sign associated with a ground-glass pattern may be a typical HRCT pattern of COVID-19 pneumonitis. The evolution to pulmonary fibrosis is frequent in older males and patients with comorbidities and bone marrow involvement.
DOI: 10.1016/j.ijid.2020.08.054
PubMed: 32841688
PubMed Central: PMC7443096
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pubmed:32841688Le document en format XML
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Electronic address: mmarvis@alice.it.</nlm:affiliation></affiliation></author><author><name sortKey="Ferrozzi, Francesco" sort="Ferrozzi, Francesco" uniqKey="Ferrozzi F" first="Francesco" last="Ferrozzi">Francesco Ferrozzi</name><affiliation><nlm:affiliation>Dept. of Radiology, Istituto Figlie di San Camillo, Cremona, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Balzarini, Laura" sort="Balzarini, Laura" uniqKey="Balzarini L" first="Laura" last="Balzarini">Laura Balzarini</name><affiliation><nlm:affiliation>Dept. of Internal Medicine and Pneumology, Istituto Figlie di San Camillo, Cremona, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Mancini, Chiara" sort="Mancini, Chiara" uniqKey="Mancini C" first="Chiara" last="Mancini">Chiara Mancini</name><affiliation><nlm:affiliation>Dept. of Internal Medicine and Pneumology, Istituto Figlie di San Camillo, Cremona, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Ramponi, Sara" sort="Ramponi, Sara" uniqKey="Ramponi S" first="Sara" last="Ramponi">Sara Ramponi</name><affiliation><nlm:affiliation>Dept. of Internal Medicine and Pneumology, Istituto Figlie di San Camillo, Cremona, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Uccelli, Mario" sort="Uccelli, Mario" uniqKey="Uccelli M" first="Mario" last="Uccelli">Mario Uccelli</name><affiliation><nlm:affiliation>Dept. of Radiology, Istituto Figlie di San Camillo, Cremona, Italy.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32841688</idno><idno type="pmid">32841688</idno><idno type="doi">10.1016/j.ijid.2020.08.054</idno><idno type="pmc">PMC7443096</idno><idno type="wicri:Area/Main/Corpus">000D92</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000D92</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">First report on clinical and radiological features of COVID-19 pneumonitis in a Caucasian population: Factors predicting fibrotic evolution.</title><author><name sortKey="Marvisi, Maurizio" sort="Marvisi, Maurizio" uniqKey="Marvisi M" first="Maurizio" last="Marvisi">Maurizio Marvisi</name><affiliation><nlm:affiliation>Dept. of Internal Medicine and Pneumology, Istituto Figlie di San Camillo, Cremona, Italy. Electronic address: mmarvis@alice.it.</nlm:affiliation></affiliation></author><author><name sortKey="Ferrozzi, Francesco" sort="Ferrozzi, Francesco" uniqKey="Ferrozzi F" first="Francesco" last="Ferrozzi">Francesco Ferrozzi</name><affiliation><nlm:affiliation>Dept. of Radiology, Istituto Figlie di San Camillo, Cremona, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Balzarini, Laura" sort="Balzarini, Laura" uniqKey="Balzarini L" first="Laura" last="Balzarini">Laura Balzarini</name><affiliation><nlm:affiliation>Dept. of Internal Medicine and Pneumology, Istituto Figlie di San Camillo, Cremona, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Mancini, Chiara" sort="Mancini, Chiara" uniqKey="Mancini C" first="Chiara" last="Mancini">Chiara Mancini</name><affiliation><nlm:affiliation>Dept. of Internal Medicine and Pneumology, Istituto Figlie di San Camillo, Cremona, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Ramponi, Sara" sort="Ramponi, Sara" uniqKey="Ramponi S" first="Sara" last="Ramponi">Sara Ramponi</name><affiliation><nlm:affiliation>Dept. of Internal Medicine and Pneumology, Istituto Figlie di San Camillo, Cremona, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Uccelli, Mario" sort="Uccelli, Mario" uniqKey="Uccelli M" first="Mario" last="Uccelli">Mario Uccelli</name><affiliation><nlm:affiliation>Dept. of Radiology, Istituto Figlie di San Camillo, Cremona, Italy.</nlm:affiliation></affiliation></author></analytic><series><title level="j">International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases</title><idno type="eISSN">1878-3511</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Antiviral Agents (therapeutic use)</term><term>Betacoronavirus (MeSH)</term><term>COVID-19 (MeSH)</term><term>Coronavirus Infections (complications)</term><term>Coronavirus Infections (diagnostic imaging)</term><term>Coronavirus Infections (pathology)</term><term>Drug Combinations (MeSH)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Hydroxychloroquine (therapeutic use)</term><term>Lopinavir (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (complications)</term><term>Pneumonia, Viral (diagnostic imaging)</term><term>Pneumonia, Viral (pathology)</term><term>Pulmonary Fibrosis (etiology)</term><term>Radiography (MeSH)</term><term>Retrospective Studies (MeSH)</term><term>Ritonavir (MeSH)</term><term>SARS-CoV-2 (MeSH)</term><term>Tomography, X-Ray Computed (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiviral Agents</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Pulmonary Fibrosis</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Betacoronavirus</term><term>COVID-19</term><term>Drug Combinations</term><term>Female</term><term>Humans</term><term>Lopinavir</term><term>Male</term><term>Middle Aged</term><term>Pandemics</term><term>Radiography</term><term>Retrospective Studies</term><term>Ritonavir</term><term>SARS-CoV-2</term><term>Tomography, X-Ray Computed</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>At the end of February, the Lombardy region (Northern Italy) was involved in the pandemic spread of the new COVID-19. We here summarize the clinical and radiological characteristics of 90 confirmed cases and analyze their role in predicting the evolution of fibrosis.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>We retrospectively analyzed the clinical and radiological data of 90 patients with COVID-19 pneumonitis. All subjects underwent an HRCT study on the day of admission and eight weeks later, and were treated with lopinavir + ritonavir (Kaletra) 400/100 mg two times a day or darunavir + ritonavir two times a day, and Hydroxychloroquine 200 mg two times a day. Pulmonary fibrosis was defined according to the Fleischner Society glossary of terms for thoracic imaging.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Twenty-three patients developed pulmonary fibrosis (25.5%): 15 were males, whose mean age was 75 ± 15. The majority were active smokers (60.8%) and had comorbidities (78.2%), above all, hypertension (47.8%), and diabetes (34.7%). Interestingly, in our series of cases, the "reversed halo sign" is frequent (63%) and seems to be a typical COVID-19 pneumonitis pattern. The patients showing fibrosis had a higher grade of systemic inflammation (ESR and PCR) and appeared to have bone marrow inhibition with a significant reduction in platelets, leukocytes, and hemoglobin.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>To conclude, our data showed that the reversed halo sign associated with a ground-glass pattern may be a typical HRCT pattern of COVID-19 pneumonitis. The evolution to pulmonary fibrosis is frequent in older males and patients with comorbidities and bone marrow involvement.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">32841688</PMID><DateCompleted><Year>2020</Year><Month>10</Month><Day>28</Day></DateCompleted><DateRevised><Year>2021</Year><Month>01</Month><Day>10</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1878-3511</ISSN><JournalIssue CitedMedium="Internet"><Volume>99</Volume><PubDate><Year>2020</Year><Month>Oct</Month></PubDate></JournalIssue><Title>International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases</Title><ISOAbbreviation>Int J Infect Dis</ISOAbbreviation></Journal><ArticleTitle>First report on clinical and radiological features of COVID-19 pneumonitis in a Caucasian population: Factors predicting fibrotic evolution.</ArticleTitle><Pagination><MedlinePgn>485-488</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S1201-9712(20)30683-4</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.ijid.2020.08.054</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">At the end of February, the Lombardy region (Northern Italy) was involved in the pandemic spread of the new COVID-19. We here summarize the clinical and radiological characteristics of 90 confirmed cases and analyze their role in predicting the evolution of fibrosis.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We retrospectively analyzed the clinical and radiological data of 90 patients with COVID-19 pneumonitis. All subjects underwent an HRCT study on the day of admission and eight weeks later, and were treated with lopinavir + ritonavir (Kaletra) 400/100 mg two times a day or darunavir + ritonavir two times a day, and Hydroxychloroquine 200 mg two times a day. Pulmonary fibrosis was defined according to the Fleischner Society glossary of terms for thoracic imaging.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Twenty-three patients developed pulmonary fibrosis (25.5%): 15 were males, whose mean age was 75 ± 15. The majority were active smokers (60.8%) and had comorbidities (78.2%), above all, hypertension (47.8%), and diabetes (34.7%). Interestingly, in our series of cases, the "reversed halo sign" is frequent (63%) and seems to be a typical COVID-19 pneumonitis pattern. The patients showing fibrosis had a higher grade of systemic inflammation (ESR and PCR) and appeared to have bone marrow inhibition with a significant reduction in platelets, leukocytes, and hemoglobin.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">To conclude, our data showed that the reversed halo sign associated with a ground-glass pattern may be a typical HRCT pattern of COVID-19 pneumonitis. The evolution to pulmonary fibrosis is frequent in older males and patients with comorbidities and bone marrow involvement.</AbstractText><CopyrightInformation>Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Marvisi</LastName><ForeName>Maurizio</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Dept. of Internal Medicine and Pneumology, Istituto Figlie di San Camillo, Cremona, Italy. Electronic address: mmarvis@alice.it.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ferrozzi</LastName><ForeName>Francesco</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Dept. of Radiology, Istituto Figlie di San Camillo, Cremona, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Balzarini</LastName><ForeName>Laura</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Dept. of Internal Medicine and Pneumology, Istituto Figlie di San Camillo, Cremona, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mancini</LastName><ForeName>Chiara</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Dept. of Internal Medicine and Pneumology, Istituto Figlie di San Camillo, Cremona, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ramponi</LastName><ForeName>Sara</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Dept. of Internal Medicine and Pneumology, Istituto Figlie di San Camillo, Cremona, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Uccelli</LastName><ForeName>Mario</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Dept. of Radiology, Istituto Figlie di San Camillo, Cremona, Italy.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>08</Month><Day>22</Day></ArticleDate></Article><MedlineJournalInfo><Country>Canada</Country><MedlineTA>Int J Infect Dis</MedlineTA><NlmUniqueID>9610933</NlmUniqueID><ISSNLinking>1201-9712</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000998">Antiviral Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D004338">Drug 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