An analysis of the radiological factors associated with respiratory failure in COVID-19 pneumonia and the CT features among different age categories

Abstract

Purpose To investigate CT patterns of COVID-19 pneumonia associated with respiratory failure (RF) focused on the distribution of lesions. Materials and methods Eighty-five patients with COVID-19 pneumonia were reviewed. CT findings were classified as follows: Type A; patchy ground glass attenuation (GGA) with/without air-space consolidation, Type B; non-segmental GGA with/without air-space consolidation in both the central and peripheral lung portions especially with subpleural spare, and Type C; non-segmental GGA with/without air-space consolidation predominantly distributed in the peripheral lung portion without subpleural spare. We analyzed CT patterns and clinical factors associated with RF, including age categories. Results The number of patients with Type A, B and C was 31 (37%), 24 (28%) and 30 (35%), respectively. Type C and hypertension were independently associated with RF. On comparing between Types B and C, the frequency of traction bronchiectasis was higher in Type C than in Type B ( P < 0.001). The ratio of Type C in patients ≥ 65 years old (66%) was higher than in patients < 40 years old ( P < 0.001) and 40–49 years old ( P = 0.001). Conclusion The Type C, increasing with age, was associated with RF. Traction bronchiectasis in the lesion was more frequent in Type C than in Type B. Secondary abstract A lesion adjacent to the pleura and hypertension is associated with respiratory failure in patients with COVID-19. The frequency of a lesion adjacent to the pleura increased with age. The distribution of lesions is a useful parameter to predict respiratory failure.

Association of subpleural ground-glass opacities with respiratory failure and RNAemia in COVID-19

“…The CTs showed subpleural GGOs extending beyond the segmental area, consistent with the radiological characteristics reported in previous studies. These subpleural GGOs appeared in the early to a progressive phase of infection (between day 0 and 8 after symptom onset) [ 10 ] and were a predictor of respiratory failure in patients with COVID-19 [ 14 ]. Furthermore, we also found that in some patients who improved without oxygen therapy, organizing pneumonia (OP)-like consolidation was the dominant pulmonary lesion.…”

COVID-19 chest CT and laboratory features of B.1.617.2 (Delta variant) vs B.1.1.7 (Alpha variant) surge: a single center case-control study

“…eases 2019 (COVID- 19), a clinical entity that may cause from pauci-symptomatic illness to severe bilateral interstitial pneumonia, also leading to acute respiratory distress syndrome [1][2][3][4]. Ground glass opacities, consolidation and crazy paving pattern are typical chest computed tomography (CT) findings of COVID-19 [3,[5][6][7][8][9][10][11]. Spontaneous mutations in viral genome, especially when they occur on the receptor binding domain, can be associated with the circulation of viral variant of concern (VOCs), leading to either increased transmissibility, disease severity, or reduction in antibody neutralization and response to vaccines and therapies [12][13][14].…”

Bronchiectasis and COVID-19 infection: a two-way street

“…[44] The frequency of BE in the acute phase of SARS-CoV-2 pneumonia depends on several factors, such as the severity and distribution of the pneumonic process, the need for admission to an intensive care unit, and the days elapsed between the onset of symptoms and the CT scan. [36,37,42] The probability of BE occurrence becomes greater as the number of days increases. Ding et al [36] examined 112 patients with COVID-19 and observed that the prevalence of BE increased as the time between the onset of symptoms and the CT scan increased, from a prevalence of 6.3% when the CT scan was performed 0 to 4 days after the onset of symptoms to 45.2% when the period between the onset of initial symptoms and the CT scan was >28 days.…”

“…The percentage of patients with BE observed in the early phase of pneumonia is highly variable, according to the studies undertaken (6.3–52.0%) [35–42] . Bao et al [20] performed a systematic review with meta-analysis to provide a more accurate estimate of the detection of COVID-19 by chest computed tomography (CT) and reported the most common findings in imaged chest CT.…”

“…In the first, the enlargement of the bronchi and evolution into BE occurred after 5 days of hospitalization, [43] whereas the second shows a rapid progression from pneumonitis to cystic BE [44] . The frequency of BE in the acute phase of SARS-CoV-2 pneumonia depends on several factors, such as the severity and distribution of the pneumonic process, the need for admission to an intensive care unit, and the days elapsed between the onset of symptoms and the CT scan [36,37,42] …”