Journal article
Quantitative Chest CT Assessment of Small Airways Disease in Post-Acute SARS-CoV-2 Infection
Radiology, Vol.304(1), pp.185-192
03/15/2022
DOI: 10.1148/radiol.212170
PMCID: PMC9270680
PMID: 35289657
Abstract
Background The long-term effects of SARS-CoV-2 infection on pulmonary structure and function remain incompletely characterized. Purpose To test whether SARS-CoV-2 infection leads to small airways disease in patients with persistent symptoms. Materials and Methods In this single center study at a university teaching hospital, adults with confirmed COVID-19 who remained symptomatic >30 days following diagnosis were prospectively enrolled between June and December 2020 and compared to healthy participants (controls) prospectively enrolled between March and August 2018. Participants with post-acute sequelae of COVID-19 (PASC) were classified as ambulatory, hospitalized, or requiring the intensive care unit (ICU) based on the highest level of care received during acute infection. Symptoms, pulmonary function tests, and chest CT images were collected, and quantitative CT analysis was performed using supervised machine-learning to measure regional ground glass opacities (GGO) and inspiratory and expiratory image-matching to measure regional air trapping. Univariable analyses and multivariable linear regression were used to compare groups. Results 100 participants with PASC (median age, 48 years; 66 women) were evaluated and compared with 106 matched healthy controls. Sixty-seven percent (67/100) of the participants with PASC were classified as ambulatory, 17% (17/100) wer e hospitalized and 16% (16/100) required care in the ICU. Among the hospitalized and ICU groups, the mean percent of total lung classified as GGO was 13.2% and 28.7%, respectively, and was higher than in the ambulatory group (3.7%, p<.001 for both comparisons). The mean percentage of total lung affected by air trapping was 25.4%, 34.6%, and 27.3% in the ambulatory, hospitalized, and ICU groups and 7.2% in healthy controls (p<.001). Air trapping correlated with the residual volume to total lung capacity rati o (RV/TLC; r=0.6, p<.001). Conclusions In survivors of COVID-19, small airways disease occurred independently of initial infection severity. The long-term consequences are unknown. See also the editorial by Elicker.
Details
- Title: Subtitle
- Quantitative Chest CT Assessment of Small Airways Disease in Post-Acute SARS-CoV-2 Infection
- Creators
- Josalyn L Cho - Roy J. and Lucille A. Carver College of MedicineRaul Villacreses - Roy J. and Lucille A. Carver College of MedicinePrashant Nagpal - Roy J. and Lucille A. Carver College of MedicineJunfeng Guo - University of IowaAlejandro A Pezzulo - Roy J. and Lucille A. Carver College of MedicineAndrew L Thurman - University of IowaNabeel Y Hamzeh - University of IowaRobert J Blount - Roy J. and Lucille A. Carver College of MedicineSpyridon Fortis - United States Department of Veterans AffairsEric A Hoffman - Roy J. and Lucille A. Carver College of MedicineJoseph Zabner - Roy J. and Lucille A. Carver College of MedicineAlejandro P Comellas - Roy J. and Lucille A. Carver College of Medicine
- Resource Type
- Journal article
- Publication Details
- Radiology, Vol.304(1), pp.185-192
- DOI
- 10.1148/radiol.212170
- PMID
- 35289657
- PMCID
- PMC9270680
- NLM abbreviation
- Radiology
- ISSN
- 0033-8419
- eISSN
- 1527-1315
- Grant note
- DOI: 10.13039/100000002, name: National Institutes of Health, award: R01HL112986, S10OD018526, R01HL136813, P01HL152960, P01HL091842, P30DK054759, T32HL007638, R01HL148758
- Language
- English
- Date published
- 03/15/2022
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Pulmonary, Critical Care, and Occupational Medicine; Occupational and Environmental Health; ICTS; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Internal Medicine
- Record Identifier
- 9984318717702771
Metrics
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