Tracheobronchitis signs observed on ventilation lung scintigraphy during the course of COVID-19 infection

Verger, Antoine; Bahloul, Achraf; Melki, S.; Karcher, Gilles; Imbert, Laëtitia; Marié, Pierre

doi:10.1007/s00259-020-04834-7

Cited by 10 publications

(13 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The parenchyma showed patchy areas of consolidation and congestion considering that ACE-2 receptors are also expressed in the upper respiratory tract. A recent study supports this hypothesis, documenting important inflammation with an intense scintigraphy uptake on the proximal bronchi in a COVID-19 nonsmoker patient [51].…”

Section: Pulmonary and Airway-associated Lesionsmentioning

confidence: 67%

Pulmonary pathology and COVID-19: lessons from autopsy. The experience of European Pulmonary Pathologists

et al. 2020

View full text Add to dashboard Cite

Since its initial recognition in December 2019, Coronavirus disease 19 (COVID-19) has quickly spread to a pandemic infectious disease. The causative agent has been recognized as a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), primarily affecting the respiratory tract. To date, no vaccines are available nor any specific treatment. To limit the number of infections, strict directives have been issued by governments that have been translated into equally rigorous guidelines notably for post-mortem examinations by international and national scientific societies. The recommendations for biosafety control required during specimen collection and handling have strongly limited the practice of autopsies of the COVID-19 patients to a few adequate laboratories. A full pathological examination has always been considered an important tool to better understand the pathophysiology of diseases, especially when the knowledge of an emerging disorder is limited and the impact on the healthcare system is significant. The first evidence of diffuse alveolar damage in the context of an acute respiratory distress syndrome has now been joined by the latest findings that report a more complex scenario in COVID-19, including a vascular involvement and a wide spectrum of associated pathologies. Ancillary tools such as electron microscopy and molecular biology used on autoptic tissue samples from autopsy are also significantly contributing to confirm and/or identify new aspects useful for a deeper knowledge of the pathogenetic mechanisms. This article will review and summarize the pathological findings described in COVID-19 until now, chiefly focusing on the respiratory tract, highlighting the importance of autopsy towards a better knowledge of this disease.

show abstract

Section: Pulmonary and Airway-associated Lesionsmentioning

confidence: 67%

Pulmonary pathology and COVID-19: lessons from autopsy. The experience of European Pulmonary Pathologists

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Thus, they more likely represent an intrinsic feature of the disease. Large airway findings have also been found by lung scintigraphy in a COVID-19 nonsmoker patient, with intense uptake on the proximal bronchi [ 37 ]. While in SARS and MERS this aspect was not emphasized, in H1N1 acute inflammatory cells and tracheobronchitis were a reported feature [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 pulmonary pathology: a multi-institutional autopsy cohort from Italy and New York City

et al. 2020

View full text Add to dashboard Cite

SARS-CoV-2, the etiologic agent of COVID-19, is a global pandemic with substantial mortality dominated by acute respiratory distress syndrome. We systematically evaluated lungs of 68 autopsies from 3 institutions in heavily hit areas (2 USA, 1 Italy). Detailed evaluation of several compartments (airways, alveolar walls, airspaces, and vasculature) was performed to determine the range of histologic features. The cohort consisted of 47 males and 21 females with a median age of 73 years (range 30-96). Co-morbidities were present in most patients with 60% reporting at least three conditions. Tracheobronchitis was frequently present, independent from intubation or superimposed pneumonia. Diffuse alveolar damage (DAD) was seen in 87% of cases. Later phases of DAD were less frequent and correlated with longer duration of disease. Large vessel thrombi were seen in 42% of cases but platelet (CD61 positive) and/or fibrin microthrombi were present at least focally in 84%. Ultrastructurally, small vessels showed basal membrane reduplication and significant endothelial swelling with cytoplasmic vacuolization. In a subset of cases, virus was detected using different tools (immunohistochemistry for SARS-CoV-2 viral spike protein, RNA in situ hybridization, lung viral culture, and electron microscopy). Virus was seen in airway epithelium and type 2 pneumocytes. IHC or in situ detection, as well as viable form (lung culture positive) was associated with the presence of hyaline membranes, usually within 2 weeks but up to 4 weeks after initial diagnosis. COVID-19 pneumonia is a heterogeneous disease (tracheobronchitis, DAD, and vascular injury), but with consistent features in three centers. The pulmonary vasculature, with capillary microthrombi and inflammation, as well as macrothrombi, is commonly involved. Viral infection in areas of ongoing active injury contributes to persistent and temporally heterogeneous lung damage.

show abstract

“…We report a series of 10 consecutive patients with COVID-19, experiencing shortness of breath and referred to lung scintigraphy for suspected pulmonary embolism during the period of the COVID-19 outbreak (March 25 to May 15, 2020). One patient has been the subject of a previous case report [4]. The diagnosis of COVID-19 was ascertained by positive reverse This article is part of the Topical Collection on Infection and inflammation transcriptase-polymerase chain reaction tests in 7 patients, and by serologic tests in 3 (Lateral Flow Immunoassay, BioSynex®, Illkirch-Graffenstaden, France).…”

Section: Methodsmentioning

confidence: 99%

“…A case report suggested that tracheobronchitis could be detected in the COVID patients through a tracheobronchial uptake of radioactive particles inhaled for lung scintigraphy [ 4 ]. These particles tend to deposit and create “hot spots” in the central airways when airway resistance is increased, especially during bronchitis and chronic pulmonary obstructive disease (COPD) [ 5 , 6 ].…”

mentioning

confidence: 99%

Signs of tracheobronchitis may constitute the principal finding on the lung SPECT/CT images of COVID-19 patients

Bahloul

Verger

Mandry

et al. 2021

Eur J Nucl Med Mol Imaging

Self Cite

View full text Add to dashboard Cite

Tracheobronchitis signs observed on ventilation lung scintigraphy during the course of COVID-19 infection

Cited by 10 publications

References 5 publications

Pulmonary pathology and COVID-19: lessons from autopsy. The experience of European Pulmonary Pathologists

Pulmonary pathology and COVID-19: lessons from autopsy. The experience of European Pulmonary Pathologists

COVID-19 pulmonary pathology: a multi-institutional autopsy cohort from Italy and New York City

Signs of tracheobronchitis may constitute the principal finding on the lung SPECT/CT images of COVID-19 patients

Contact Info

Product

Resources

About