Impact of Thymic Response in COVID-19 Pneumonia on Disease Severity and Mortality-As Assessed on CT-Chest
Objective: To determine the effect of thymic response to COVID-19 pneumonia on imaging and its impact on disease severity and outcome. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Radiology and Imaging (AFIRI), Rawalpindi Pakistan, from Mar to Ju...
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| Format: | Article |
| Language: | English |
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Army Medical College Rawalpindi
2023-05-01
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| Series: | Pakistan Armed Forces Medical Journal |
| Subjects: | |
| Online Access: | https://www.pafmj.org/index.php/PAFMJ/article/view/8125 |
| _version_ | 1797826699775180800 |
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| author | Saerah Iffat Zafar Hina Nasir Atiqur Rehman Slehria Nadeem Zafar Alina Shahiryar |
| author_facet | Saerah Iffat Zafar Hina Nasir Atiqur Rehman Slehria Nadeem Zafar Alina Shahiryar |
| author_sort | Saerah Iffat Zafar |
| collection | DOAJ |
| description |
Objective: To determine the effect of thymic response to COVID-19 pneumonia on imaging and its impact on disease severity and outcome.
Study Design: Cross-sectional study.
Place and Duration of Study: Armed Forces Institute of Radiology and Imaging (AFIRI), Rawalpindi Pakistan, from Mar to Jul 2020.
Methodology: A total of 1620 COVID-19 patients above the age of 18, of either gender, were included in the study. Their findings on High-Resolution CT (HRCT) chest were recorded and graded according to the CT severity score (CTSS) out of a total of 40; less than or equal to 19 was taken as mild while >20 scores were considered as severe disease. The thymic response was assessed by imaging appearance on CT and was graded from 0-3 as follows: fatty, predominantly fatty, mixed density (fat and soft density), and soft density. Fatty replacement implied thymic involution, while soft density depicted a reactivation of thymic tissue after a disease process depictive adequate thymic response.
Results: A significant difference in thymic response was observed in patients of different age groups (p<0.001), with the younger age group demonstrating thymic reactivation/ response in the majority (170/244, 69.7%). CT severity score and mortality were significantly higher in older patients demonstrating poor thymic response to COVID pneumonia.
Conclusion: Response of the thymus to acute viral infection by Sars COVID-19 is impaired as age progresses; this accounts for greater disease severity, morbidity and mortality in older patients.
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| first_indexed | 2024-04-09T12:36:31Z |
| format | Article |
| id | doaj.art-79958e18780b47828dd31a43e5afddc5 |
| institution | Directory Open Access Journal |
| issn | 0030-9648 2411-8842 |
| language | English |
| last_indexed | 2024-04-09T12:36:31Z |
| publishDate | 2023-05-01 |
| publisher | Army Medical College Rawalpindi |
| record_format | Article |
| series | Pakistan Armed Forces Medical Journal |
| spelling | doaj.art-79958e18780b47828dd31a43e5afddc52023-05-15T09:44:20ZengArmy Medical College RawalpindiPakistan Armed Forces Medical Journal0030-96482411-88422023-05-0173210.51253/pafmj.v73i2.8125Impact of Thymic Response in COVID-19 Pneumonia on Disease Severity and Mortality-As Assessed on CT-ChestSaerah Iffat Zafar0Hina Nasir1Atiqur Rehman Slehria2Nadeem Zafar3Alina Shahiryar4Armed Forces Institute of Radiology & Imaging/National University of Medical Sciences Rawalpindi PakistanArmed Forces Institute of Radiology & Imaging/National University of Medical Sciences Rawalpindi PakistanArmed Forces Institute of Radiology & Imaging/National University of Medical Sciences Rawalpindi PakistanArmed Forces Institute of Pathology/National University of Medical Sciences Rawalpindi PakistanIslamabad International Dental Hospital, Islamabad Pakistan Objective: To determine the effect of thymic response to COVID-19 pneumonia on imaging and its impact on disease severity and outcome. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Radiology and Imaging (AFIRI), Rawalpindi Pakistan, from Mar to Jul 2020. Methodology: A total of 1620 COVID-19 patients above the age of 18, of either gender, were included in the study. Their findings on High-Resolution CT (HRCT) chest were recorded and graded according to the CT severity score (CTSS) out of a total of 40; less than or equal to 19 was taken as mild while >20 scores were considered as severe disease. The thymic response was assessed by imaging appearance on CT and was graded from 0-3 as follows: fatty, predominantly fatty, mixed density (fat and soft density), and soft density. Fatty replacement implied thymic involution, while soft density depicted a reactivation of thymic tissue after a disease process depictive adequate thymic response. Results: A significant difference in thymic response was observed in patients of different age groups (p<0.001), with the younger age group demonstrating thymic reactivation/ response in the majority (170/244, 69.7%). CT severity score and mortality were significantly higher in older patients demonstrating poor thymic response to COVID pneumonia. Conclusion: Response of the thymus to acute viral infection by Sars COVID-19 is impaired as age progresses; this accounts for greater disease severity, morbidity and mortality in older patients. https://www.pafmj.org/index.php/PAFMJ/article/view/8125COVID pneumoniaThymusReactivationResponse |
| spellingShingle | Saerah Iffat Zafar Hina Nasir Atiqur Rehman Slehria Nadeem Zafar Alina Shahiryar Impact of Thymic Response in COVID-19 Pneumonia on Disease Severity and Mortality-As Assessed on CT-Chest Pakistan Armed Forces Medical Journal COVID pneumonia Thymus Reactivation Response |
| title | Impact of Thymic Response in COVID-19 Pneumonia on Disease Severity and Mortality-As Assessed on CT-Chest |
| title_full | Impact of Thymic Response in COVID-19 Pneumonia on Disease Severity and Mortality-As Assessed on CT-Chest |
| title_fullStr | Impact of Thymic Response in COVID-19 Pneumonia on Disease Severity and Mortality-As Assessed on CT-Chest |
| title_full_unstemmed | Impact of Thymic Response in COVID-19 Pneumonia on Disease Severity and Mortality-As Assessed on CT-Chest |
| title_short | Impact of Thymic Response in COVID-19 Pneumonia on Disease Severity and Mortality-As Assessed on CT-Chest |
| title_sort | impact of thymic response in covid 19 pneumonia on disease severity and mortality as assessed on ct chest |
| topic | COVID pneumonia Thymus Reactivation Response |
| url | https://www.pafmj.org/index.php/PAFMJ/article/view/8125 |
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