Diagnostics of complicated course of community-acquired pneumonia of viral etiology (COVID-19) via using chest computed tomography

Lynnyk, М.І.; Іgnatieva, V. I.; Гуменюк, Г. Л.; Svyatnenko, V.А.; Tarasenko, Olga; Bororova, O. L.

doi:10.32902/2663-0338-2021-2-11-18

2021

DOI: 10.32902/2663-0338-2021-2-11-18

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Diagnostics of complicated course of community-acquired pneumonia of viral etiology (COVID-19) via using chest computed tomography

М.І. Lynnyk¹,

V. I. Іgnatieva²,

Г. Л. Гуменюк

et al.

Abstract: BACKGROUND. To date, radiological criteria for the diagnosis of viral pneumonia associated with SARS-CoV-2 have been established, and treatment regimens for patients depending on the severity of coronavirus disease (COVID-19) have been developed for both outpatient and inpatient settings. Many patients, regardless of the form and severity of the coronavirus infection, suffer from a range of symptoms for weeks or even months that reduce their quality of life. Therefore, the diagnostics of complicated course of … Show more

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Cited by 5 publications

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Diagnosis of disappearing lung syndrome as a complication of non-hospital pneumonia of viral etiology (COVID-19)

Feshchenko¹,

Lynnyk²,

Gumeniuk³

et al. 2021

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BACKGROUND. Particularly dangerous coronavirus disease (COVID-19) continues to be one of the urgent problems of mankind. Researchers around the world have noted that in the third wave of the COVID-19 pandemic, the disease became more aggressive. Physicians more often began to pay attention to the occurrence of progressive lung degradation, in particular bullous-emphysematous changes in the lungs, and in those patients who did not have a history of chronic lung disease. Due to the fact that in the acute phase of coronavirus infectious computed tomography (CT) of the chest according to the national protocol is not required, the timing of this complication remains unknown. OBJECTIVE. To study the timing of the onset of disappearing lung syndrome as one of the complications of communityacquired pneumonia of viral etiology (COVID-19) and to demonstrate on clinical observations according to CT. MATERIALS AND METHODS. A group of patients referred for treatment to the SI “National institute of phthisiology and pulmonology named after F.G. Yanovsky of the NAMS of Ukraine”. Among the examined according to CT of the chest identified 21 patients (15 men and 6 women aged 24 to 67 years) with radiological signs of disappearing lung syndrome. Nine of them (7 men and 2 women aged 24 to 54 years) were treated at the institute during the acute period of the disease. Another 12 (8 men and 4 women aged 27 to 67 years) were referred to the institute from other medical institutions, where they were treated for community-acquired pneumonia of viral etiology (COVID-19) 3-4 months ago. RESULTS AND DISCUSSION. CT analysis of the chest in 21 patients with disappearing lung syndrome showed that 9 (42,9 %) of them were diagnosed with bullous-emphysematous changes in the acute period of the disease – from 1 to 2 months, and in 12 (57,1 %) – in the postpartum period, in the period from 3 to 4 months. At the same time, patients had difficulty breathing, coughing, no significant improvement in general condition after previous inpatient treatment. Three of 12 patients noted deterioration of the general condition. CONCLUSIONS. In severe patients with community-acquired pneumonia of viral etiology (COVID-19), a progressive pulmonary degradation syndrome with the formation of bullous-emphysematous changes can occur both in the acute period of the disease and develop or progress in the postpartum period (after 3-4 months after inpatient treatment). CT of the chest should be performed in all patients after inpatient treatment and elimination of acute respiratory distress syndrome, which will allow timely diagnosis of changes in lung architecture and complications of the disease.

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Diagnosis of disappearing lung syndrome as a complication of non-hospital pneumonia of viral etiology (COVID-19)

Feshchenko¹,

Lynnyk²,

Gumeniuk³

et al. 2021

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Differential diagnosis of the complicated course of COVID-19 pneumonias and infectious lung destruction

Yakovenko

Lynnyk²,

Liskina³

et al. 2022

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BACKGROUND. At present radiological criteria for diagnosis of viral pneumonia associated with SARS-CoV-2 have been defined. However, with the further course of the pandemic, physicians began to observe more and more often destructive processes developing in the lungs of patients with non-hospital pneumonia of viral etiology (COVID-19). Due to the development of surgical complications (pneumothorax, pneumomediastinum, vanishing lung syndrome) the question of their differential diagnostics with purulent-destructive lung diseases became actual. OBJECTIVE. To show the possibilities of differential diagnostics of infectious lung destruction (ILD) with cyst-like changes in the lungs at COVID-19 using clinical examples and data of computed tomography (CT) scan of the chest and pathomorphological study. MATERIALS AND METHODS. CT of the patients with ILD (lung abscess) and 90 patients with non-hospital pneumonia of viral etiology (COVID-19), who were treated in the National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky of the NAMS of Ukraine were analyzed. RESULTS AND DISCUSSION. There were analyzed 90 CT scans of the whole body of patients with non-hospital pneumonia of viral etiology (COVID-19); among them 27 cases (15 male and 12 female, aged from 23 to 78 years) with radiological signs of vanishing lung syndrome were revealed, which made 30 % of all patients with a complicated course of the disease. Chest CT findings and pathomorphologic findings in cyst-like changes in patients with COVID-19 were compared with those in patients treated for lung abscess. CONCLUSIONS. Clinical picture, pathogenesis and pathomorphological changes of pulmonary parenchyma at ILD differ greatly from non-hospital pneumonia of viral etiology (COVID-19) and form specific changes, which are revealed by chest CT. Necessary development of indications for surgical treatment in vanishing lung syndrome which occurs in patients with complicated course of COVID-19.

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Infectious complications of the respiratory tract and lungs in patients with post-COVID syndrome

Yakovenko

Lynnyk²,

Іgnatieva³

et al. 2022

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BACKGROUND. The mechanism of development of post-COVID syndrome is not fully understood. Long-term retention of complaints in patients is associated with long-term persistence of the virus, hyperinflammatory response of the body, as well as with the peculiarities of the patient’s cellular and humoral immunity. Secondary infectious complications in the post-COVID period are due not only to the ability of the SARS-CoV-2 virus to damage erythrocytes and attack the red bone marrow in the acute phase of the disease. It has been proven that the SARS-CoV-2 virus leads to the disappearance of white pulp cells in the spleen, the tissue where cells of the immune response, in particular T- and B-lymphocytes responsible for infectious immunity, mature. OBJECTIVE. To investigate the frequency of secondary infectious complications of the respiratory tract and lungs in patients with post-COVID syndrome who underwent inpatient treatment. MATERIALS AND METHODS. Clinical, laboratory and radiological data of 90 patients with post-COVID syndrome who were undergoing inpatient treatment in the clinical departments of the SI “National institute of phthisiology and pulmonology named after F.G. Yanovsky of the NAMS of Ukraine”. The diagnosis of coronavirus disease (COVID-19) was established in accordance with the current national protocol for the treatment. Computed tomography (CT) of the chest organs was performed on the Aquilion TSX-101A scanner (Toshiba, Japan). RESULTS AND DISCUSSION. Complications of COVID-19 were determined according to the clinical and functional, laboratory examination and CT scan of the chest. Some patients had two or more complications at the same time. Patients with post-COVID syndrome were most often hospitalized for progression or slight positive dynamics of the pathological process of the respiratory tract and lungs, disappearing lung syndrome, fibrotic changes in the lungs, exacerbation of bronchoobstructive lung diseases and infectious complications. The latter were observed most often – in 53,3 % of patients. Fungal and bacterial complications occurred secondarily, mainly in patients with disappearing lung syndrome, in places where cystlike cavities were formed. The most common concomitant diseases in patients with post-COVID syndrome were cardiovascular diseases and diabetes. CONCLUSIONS. The proportion of infectious complications of the respiratory tract and lungs in patients with post-COVID syndrome, who are indicated for inpatient treatment in the pulmonology department, is 53.3 %. The most frequent causes of infectious complications of the respiratory tract and lungs in patients with post-COVID syndrome are the reactivation of the Epstein – Barr virus infection – in 30.0 %, which in 2.2 % of patients is combined with the reactivation of the hepatitis C virus, and bacterial infections – in 15.6 %. Aspergillosis and mucormycosis occur in 1.1 and 3.3 % of patients respectively.

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Diagnostics of complicated course of community-acquired pneumonia of viral etiology (COVID-19) via using chest computed tomography

Cited by 5 publications

References 9 publications

Diagnosis of disappearing lung syndrome as a complication of non-hospital pneumonia of viral etiology (COVID-19)

Diagnosis of disappearing lung syndrome as a complication of non-hospital pneumonia of viral etiology (COVID-19)

Differential diagnosis of the complicated course of COVID-19 pneumonias and infectious lung destruction

Infectious complications of the respiratory tract and lungs in patients with post-COVID syndrome

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