Imaging Severity COVID-19 Assessment in Vaccinated and Unvaccinated Patients: Comparison of the Different Variants in a High Volume Italian Reference Center
Purpose: To analyze the vaccine effect by comparing five groups: unvaccinated patients with Alpha variant, unvaccinated patients with Delta variant, vaccinated patients with Delta variant, unvaccinated patients with Omicron variant, and vaccinated patients with Omicron variant, assessing the “gravit...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-06-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/12/6/955 |
| _version_ | 1797485500008759296 |
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| author | Vincenza Granata Roberta Fusco Alberta Villanacci Simona Magliocchetti Fabrizio Urraro Nardi Tetaj Luisa Marchioni Fabrizio Albarello Paolo Campioni Massimo Cristofaro Federica Di Stefano Nicoletta Fusco Ada Petrone Vincenzo Schininà Francesca Grassi Enrico Girardi Stefania Ianniello |
| author_facet | Vincenza Granata Roberta Fusco Alberta Villanacci Simona Magliocchetti Fabrizio Urraro Nardi Tetaj Luisa Marchioni Fabrizio Albarello Paolo Campioni Massimo Cristofaro Federica Di Stefano Nicoletta Fusco Ada Petrone Vincenzo Schininà Francesca Grassi Enrico Girardi Stefania Ianniello |
| author_sort | Vincenza Granata |
| collection | DOAJ |
| description | Purpose: To analyze the vaccine effect by comparing five groups: unvaccinated patients with Alpha variant, unvaccinated patients with Delta variant, vaccinated patients with Delta variant, unvaccinated patients with Omicron variant, and vaccinated patients with Omicron variant, assessing the “gravity” of COVID-19 pulmonary involvement, based on CT findings in critically ill patients admitted to Intensive Care Unit (ICU). Methods: Patients were selected by ICU database considering the period from December 2021 to 23 March 2022, according to the following inclusion criteria: patients with proven Omicron variant COVID-19 infection with known COVID-19 vaccination with at least two doses and with chest Computed Tomography (CT) study during ICU hospitalization. Wee also evaluated the ICU database considering the period from March 2020 to December 2021, to select unvaccinated consecutive patients with Alpha variant, subjected to CT study, consecutive unvaccinated and vaccinated patients with Delta variant, subjected to CT study, and, consecutive unvaccinated patients with Omicron variant, subjected to CT study. CT images were evaluated qualitatively using a severity score scale of 5 levels (none involvement, mild: ≤25% of involvement, moderate: 26–50% of involvement, severe: 51–75% of involvement, and critical involvement: 76–100%) and quantitatively, using the Philips IntelliSpace Portal clinical application CT COPD computer tool. For each patient the lung volumetry was performed identifying the percentage value of aerated residual lung volume. Non-parametric tests for continuous and categorical variables were performed to assess statistically significant differences among groups. Results: The patient study group was composed of 13 vaccinated patients affected by the Omicron variant (Omicron V). As control groups we identified: 20 unvaccinated patients with Alpha variant (Alpha NV); 20 unvaccinated patients with Delta variant (Delta NV); 18 vaccinated patients with Delta variant (Delta V); and 20 unvaccinated patients affected by the Omicron variant (Omicron NV). No differences between the groups under examination were found (<i>p</i> value > 0.05 at Chi square test) in terms of risk factors (age, cardiovascular diseases, diabetes, immunosuppression, chronic kidney, cardiac, pulmonary, neurologic, and liver disease, etc.). A different median value of aerated residual lung volume was observed in the Delta variant groups: median value of aerated residual lung volume was 46.70% in unvaccinated patients compared to 67.10% in vaccinated patients. In addition, in patients with Delta variant every other extracted volume by automatic tool showed a statistically significant difference between vaccinated and unvaccinated group. Statistically significant differences were observed for each extracted volume by automatic tool between unvaccinated patients affected by Alpha variant and vaccinated patients affected by Delta variant of COVID-19. Good statistically significant correlations among volumes extracted by automatic tool for each lung lobe and overall radiological severity score were obtained (ICC range 0.71–0.86). GGO was the main sign of COVID-19 lesions on CT images found in 87 of the 91 (95.6%) patients. No statistically significant differences were observed in CT findings (ground glass opacities (GGO), consolidation or crazy paving sign) among patient groups. Conclusion: In our study, we showed that in critically ill patients no difference were observed in terms of severity of disease or exitus, between unvaccinated and vaccinated patients. The only statistically significant differences were observed, with regard to the severity of COVID-19 pulmonary parenchymal involvement, between unvaccinated patients affected by Alpha variant and vaccinated patients affected by Delta variant, and between unvaccinated patients with Delta variant and vaccinated patients with Delta variant. |
| first_indexed | 2024-03-09T23:20:40Z |
| format | Article |
| id | doaj.art-93fab691034848fb8a44412540c0c53b |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-09T23:20:40Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-93fab691034848fb8a44412540c0c53b2023-11-23T17:28:15ZengMDPI AGJournal of Personalized Medicine2075-44262022-06-0112695510.3390/jpm12060955Imaging Severity COVID-19 Assessment in Vaccinated and Unvaccinated Patients: Comparison of the Different Variants in a High Volume Italian Reference CenterVincenza Granata0Roberta Fusco1Alberta Villanacci2Simona Magliocchetti3Fabrizio Urraro4Nardi Tetaj5Luisa Marchioni6Fabrizio Albarello7Paolo Campioni8Massimo Cristofaro9Federica Di Stefano10Nicoletta Fusco11Ada Petrone12Vincenzo Schininà13Francesca Grassi14Enrico Girardi15Stefania Ianniello16Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, ItalyMedical Oncology Division, Igea SpA, 80013 Napoli, ItalyDiagnostic Imaging of Infectious Diseases, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, ItalyDivision of Radiology, Università degli Studi della Campania Luigi Vanvitelli, 80128 Naples, ItalyDivision of Radiology, Università degli Studi della Campania Luigi Vanvitelli, 80128 Naples, ItalyIntensive Care Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, ItalyIntensive Care Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, ItalyDiagnostic Imaging of Infectious Diseases, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, ItalyDiagnostic Imaging of Infectious Diseases, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, ItalyDiagnostic Imaging of Infectious Diseases, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, ItalyDiagnostic Imaging of Infectious Diseases, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, ItalyDiagnostic Imaging of Infectious Diseases, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, ItalyDiagnostic Imaging of Infectious Diseases, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, ItalyDiagnostic Imaging of Infectious Diseases, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, ItalyDivision of Radiology, Università degli Studi della Campania Luigi Vanvitelli, 80128 Naples, ItalyDepartment of Epidemiology and Research, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, ItalyDiagnostic Imaging of Infectious Diseases, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, ItalyPurpose: To analyze the vaccine effect by comparing five groups: unvaccinated patients with Alpha variant, unvaccinated patients with Delta variant, vaccinated patients with Delta variant, unvaccinated patients with Omicron variant, and vaccinated patients with Omicron variant, assessing the “gravity” of COVID-19 pulmonary involvement, based on CT findings in critically ill patients admitted to Intensive Care Unit (ICU). Methods: Patients were selected by ICU database considering the period from December 2021 to 23 March 2022, according to the following inclusion criteria: patients with proven Omicron variant COVID-19 infection with known COVID-19 vaccination with at least two doses and with chest Computed Tomography (CT) study during ICU hospitalization. Wee also evaluated the ICU database considering the period from March 2020 to December 2021, to select unvaccinated consecutive patients with Alpha variant, subjected to CT study, consecutive unvaccinated and vaccinated patients with Delta variant, subjected to CT study, and, consecutive unvaccinated patients with Omicron variant, subjected to CT study. CT images were evaluated qualitatively using a severity score scale of 5 levels (none involvement, mild: ≤25% of involvement, moderate: 26–50% of involvement, severe: 51–75% of involvement, and critical involvement: 76–100%) and quantitatively, using the Philips IntelliSpace Portal clinical application CT COPD computer tool. For each patient the lung volumetry was performed identifying the percentage value of aerated residual lung volume. Non-parametric tests for continuous and categorical variables were performed to assess statistically significant differences among groups. Results: The patient study group was composed of 13 vaccinated patients affected by the Omicron variant (Omicron V). As control groups we identified: 20 unvaccinated patients with Alpha variant (Alpha NV); 20 unvaccinated patients with Delta variant (Delta NV); 18 vaccinated patients with Delta variant (Delta V); and 20 unvaccinated patients affected by the Omicron variant (Omicron NV). No differences between the groups under examination were found (<i>p</i> value > 0.05 at Chi square test) in terms of risk factors (age, cardiovascular diseases, diabetes, immunosuppression, chronic kidney, cardiac, pulmonary, neurologic, and liver disease, etc.). A different median value of aerated residual lung volume was observed in the Delta variant groups: median value of aerated residual lung volume was 46.70% in unvaccinated patients compared to 67.10% in vaccinated patients. In addition, in patients with Delta variant every other extracted volume by automatic tool showed a statistically significant difference between vaccinated and unvaccinated group. Statistically significant differences were observed for each extracted volume by automatic tool between unvaccinated patients affected by Alpha variant and vaccinated patients affected by Delta variant of COVID-19. Good statistically significant correlations among volumes extracted by automatic tool for each lung lobe and overall radiological severity score were obtained (ICC range 0.71–0.86). GGO was the main sign of COVID-19 lesions on CT images found in 87 of the 91 (95.6%) patients. No statistically significant differences were observed in CT findings (ground glass opacities (GGO), consolidation or crazy paving sign) among patient groups. Conclusion: In our study, we showed that in critically ill patients no difference were observed in terms of severity of disease or exitus, between unvaccinated and vaccinated patients. The only statistically significant differences were observed, with regard to the severity of COVID-19 pulmonary parenchymal involvement, between unvaccinated patients affected by Alpha variant and vaccinated patients affected by Delta variant, and between unvaccinated patients with Delta variant and vaccinated patients with Delta variant.https://www.mdpi.com/2075-4426/12/6/955COVID-19vaccinationComputed Tomography |
| spellingShingle | Vincenza Granata Roberta Fusco Alberta Villanacci Simona Magliocchetti Fabrizio Urraro Nardi Tetaj Luisa Marchioni Fabrizio Albarello Paolo Campioni Massimo Cristofaro Federica Di Stefano Nicoletta Fusco Ada Petrone Vincenzo Schininà Francesca Grassi Enrico Girardi Stefania Ianniello Imaging Severity COVID-19 Assessment in Vaccinated and Unvaccinated Patients: Comparison of the Different Variants in a High Volume Italian Reference Center Journal of Personalized Medicine COVID-19 vaccination Computed Tomography |
| title | Imaging Severity COVID-19 Assessment in Vaccinated and Unvaccinated Patients: Comparison of the Different Variants in a High Volume Italian Reference Center |
| title_full | Imaging Severity COVID-19 Assessment in Vaccinated and Unvaccinated Patients: Comparison of the Different Variants in a High Volume Italian Reference Center |
| title_fullStr | Imaging Severity COVID-19 Assessment in Vaccinated and Unvaccinated Patients: Comparison of the Different Variants in a High Volume Italian Reference Center |
| title_full_unstemmed | Imaging Severity COVID-19 Assessment in Vaccinated and Unvaccinated Patients: Comparison of the Different Variants in a High Volume Italian Reference Center |
| title_short | Imaging Severity COVID-19 Assessment in Vaccinated and Unvaccinated Patients: Comparison of the Different Variants in a High Volume Italian Reference Center |
| title_sort | imaging severity covid 19 assessment in vaccinated and unvaccinated patients comparison of the different variants in a high volume italian reference center |
| topic | COVID-19 vaccination Computed Tomography |
| url | https://www.mdpi.com/2075-4426/12/6/955 |
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