First report on clinical and radiological features of COVID-19 pneumonitis in a Caucasian population: Factors predicting fibrotic evolution
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 retrospe...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-10-01
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| Series: | International Journal of Infectious Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971220306834 |
| _version_ | 1828485851411120128 |
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| author | Maurizio Marvisi Francesco Ferrozzi Laura Balzarini Chiara Mancini Sara Ramponi Mario Uccelli |
| author_facet | Maurizio Marvisi Francesco Ferrozzi Laura Balzarini Chiara Mancini Sara Ramponi Mario Uccelli |
| author_sort | Maurizio Marvisi |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-11T09:22:36Z |
| format | Article |
| id | doaj.art-66a6a22041d046c39193902731ac6d5b |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-12-11T09:22:36Z |
| publishDate | 2020-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-66a6a22041d046c39193902731ac6d5b2022-12-22T01:13:14ZengElsevierInternational Journal of Infectious Diseases1201-97122020-10-0199485488First report on clinical and radiological features of COVID-19 pneumonitis in a Caucasian population: Factors predicting fibrotic evolutionMaurizio Marvisi0Francesco Ferrozzi1Laura Balzarini2Chiara Mancini3Sara Ramponi4Mario Uccelli5Dept. of Internal Medicine and Pneumology, Istituto Figlie di San Camillo, Cremona, Italy; Corresponding author.Dept. of Radiology, Istituto Figlie di San Camillo, Cremona, ItalyDept. of Internal Medicine and Pneumology, Istituto Figlie di San Camillo, Cremona, ItalyDept. of Internal Medicine and Pneumology, Istituto Figlie di San Camillo, Cremona, ItalyDept. of Internal Medicine and Pneumology, Istituto Figlie di San Camillo, Cremona, ItalyDept. of Radiology, Istituto Figlie di San Camillo, Cremona, ItalyBackground: 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.http://www.sciencedirect.com/science/article/pii/S1201971220306834Covid-19PneumonitisPulmonary fibrosisReversed halo sign |
| spellingShingle | Maurizio Marvisi Francesco Ferrozzi Laura Balzarini Chiara Mancini Sara Ramponi Mario Uccelli First report on clinical and radiological features of COVID-19 pneumonitis in a Caucasian population: Factors predicting fibrotic evolution International Journal of Infectious Diseases Covid-19 Pneumonitis Pulmonary fibrosis Reversed halo sign |
| title | First report on clinical and radiological features of COVID-19 pneumonitis in a Caucasian population: Factors predicting fibrotic evolution |
| title_full | First report on clinical and radiological features of COVID-19 pneumonitis in a Caucasian population: Factors predicting fibrotic evolution |
| title_fullStr | First report on clinical and radiological features of COVID-19 pneumonitis in a Caucasian population: Factors predicting fibrotic evolution |
| title_full_unstemmed | First report on clinical and radiological features of COVID-19 pneumonitis in a Caucasian population: Factors predicting fibrotic evolution |
| title_short | First report on clinical and radiological features of COVID-19 pneumonitis in a Caucasian population: Factors predicting fibrotic evolution |
| title_sort | first report on clinical and radiological features of covid 19 pneumonitis in a caucasian population factors predicting fibrotic evolution |
| topic | Covid-19 Pneumonitis Pulmonary fibrosis Reversed halo sign |
| url | http://www.sciencedirect.com/science/article/pii/S1201971220306834 |
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