organizing pneumonia of covid 19 time dependent evolution and outcome in ct findings CORD-Papers-2021-10-25 (Version 1)

Title: Organizing Pneumonia of COVID-19: Time-dependent Evolution and Outcome in CT Findings
Abstract: Objective: As a pandemic, a most-common pattern resembled organizing pneumonia (OP) has been identified by CT findings in novel coronavirus disease (COVID-19). We aimed to delineate the evolution of CT findings and outcome in OP of COVID-19. Materials and Methods: 106 COVID-19 patients with OP based on CT findings were retrospectively included and categorized into non-severe (mild/common) and severe (severe/critical) groups. CT features including lobar distribution, presence of ground glass opacities (GGO), consolidation, linear opacities and total severity CT score were evaluated at three time intervals from symptom-onset to CT scan (day 0-7, day 8-14, day>14). Discharge or adverse outcome (admission to ICU or death), and pulmonary sequelae (complete absorption or lesion residuals) on CT after discharge were analyzed based on the CT features at different time interval. Results: 79(74.5%) patients were non-severe and 103(97.2%) were discharged at median day 25 (range, day 8-50) after symptom-onset. Of 67 patients with revisit CT at 2-4 weeks after discharge, 20(29.9%) had complete absorption of lesions at median day 38 (range, day 30-53) after symptom-onset. Significant differences between complete absorption and residuals groups were found in percentages of consolidation (1.5% vs. 13.8%, P=0.010), number of involved lobe >3 (40.0% vs. 72.5%, P=0.030), CT score >4 (20.0% vs. 65.0%, P=0.010) at day 8-14. Conclusions: Most OP cases had good prognosis. Approximately one-third of cases had complete absorption of lesions during 1-2 months after symptom-onset while those with increased frequency of consolidation, number of involved lobe>3, and CT score >4 at week 2 after symptom-onset may indicate lesion residuals on CT.
Published: 5/26/2020
DOI: 10.1101/2020.05.22.20109934
DOI_URL: http://doi.org/10.1101/2020.05.22.20109934
Author Name: Wang, Y
Author link: https://covid19-data.nist.gov/pid/rest/local/author/wang_y
Author Name: Jin, C
Author link: https://covid19-data.nist.gov/pid/rest/local/author/jin_c
Author Name: Wu, C C
Author link: https://covid19-data.nist.gov/pid/rest/local/author/wu_c_c
Author Name: Zhao, H
Author link: https://covid19-data.nist.gov/pid/rest/local/author/zhao_h
Author Name: Liang, T
Author link: https://covid19-data.nist.gov/pid/rest/local/author/liang_t
Author Name: Liu, Z
Author link: https://covid19-data.nist.gov/pid/rest/local/author/liu_z
Author Name: Jian, Z
Author link: https://covid19-data.nist.gov/pid/rest/local/author/jian_z
Author Name: Li, R
Author link: https://covid19-data.nist.gov/pid/rest/local/author/li_r
Author Name: Wang, Z
Author link: https://covid19-data.nist.gov/pid/rest/local/author/wang_z
Author Name: Li, F
Author link: https://covid19-data.nist.gov/pid/rest/local/author/li_f
Author Name: Zhou, J
Author link: https://covid19-data.nist.gov/pid/rest/local/author/zhou_j
Author Name: Cai, S
Author link: https://covid19-data.nist.gov/pid/rest/local/author/cai_s
Author Name: Liu, Y
Author link: https://covid19-data.nist.gov/pid/rest/local/author/liu_y
Author Name: Li, H
Author link: https://covid19-data.nist.gov/pid/rest/local/author/li_h
Author Name: Li, Z
Author link: https://covid19-data.nist.gov/pid/rest/local/author/li_z
Author Name: Liang, Y
Author link: https://covid19-data.nist.gov/pid/rest/local/author/liang_y
Author Name: Zhou, H
Author link: https://covid19-data.nist.gov/pid/rest/local/author/zhou_h
Author Name: Wang, X
Author link: https://covid19-data.nist.gov/pid/rest/local/author/wang_x
Author Name: Ren, Z
Author link: https://covid19-data.nist.gov/pid/rest/local/author/ren_z
Author Name: Yang, J
Author link: https://covid19-data.nist.gov/pid/rest/local/author/yang_j
sha: ebc44c9e928f3e30d8de3a322ea32c44a84be4ef
license: medrxiv
source_x: MedRxiv; WHO
source_x_url: https://www.who.int/
url: http://medrxiv.org/cgi/content/short/2020.05.22.20109934v1?rss=1 https://doi.org/10.1101/2020.05.22.20109934
has_full_text: TRUE
Keywords Extracted from Text Content: COVID-19 symptom-onset CT lesions patients lobe >3 lobar day>14 lobe>3 coronavirus pulmonary coronavirus 2 pulmonary lesions left lobes>3 pulmonary medRxiv thoracic alveolar epithelium bronchovascular bundles lobe number>3 SARS-CoV-2 Xi'an lymphocyte fibrin alveolar lung lobes COVID-19 (9,10) Patients lobes COVID-19 nucleic acid medRxiv preprint lung lobes ≤2 interlobular septal https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-repo rts 4.7±2.5 GGO OP blood oxygen chest lesions patients C-reactive lung chest tightness neutrophil ≥ matrix coronavirus COVID-19 Hanzhong chest CT COVID-19 patients CT GGOs lungs arterial blood lung lobe peripheral bilateral lower lobes medRxiv preprint Coronavirus Disease 2019
Extracted Text Content in Record: First 5000 Characters:Objective: As a pandemic, a most-common pattern resembled organizing pneumonia (OP) has been identified by CT findings in novel coronavirus disease . We aimed to delineate the evolution of CT findings and outcome in OP of COVID-19. Materials and Methods: 106 COVID-19 patients with OP based on CT findings were retrospectively included and categorized into non-severe (mild/common) and severe (severe/critical) groups. CT features including lobar distribution, presence of ground glass opacities (GGO), consolidation, linear opacities and total severity CT score were evaluated at three time intervals from symptom-onset to CT scan (day 0-7, day 8-14, day>14). Discharge or adverse outcome (admission to ICU or death), and pulmonary sequelae (complete absorption or lesion residuals) on CT after discharge were analyzed based on the CT features at different time interval. : 79(74.5%) patients were non-severe and 103(97.2%) were discharged at median day 25 (range, day 8-50) after symptom-onset. Of 67 patients with revisit CT at 2-4 weeks after discharge, 20(29.9%) had complete absorption of lesions at median day 38 (range, day 30-53) after symptom-onset. Significant differences between complete absorption and residuals groups were found in percentages of consolidation (1.5% vs. 13.8%, P=0.010), number of involved lobe >3 (40.0% vs. 72.5%, P=0.030), CT score >4 (20.0% vs. 65.0%, P=0.010) at day 8-14. Conclusions: Most OP cases had good prognosis. Approximately one-third of cases had complete absorption of lesions during 1-2 months after symptom-onset while those with increased frequency of consolidation, number of involved lobe>3, and CT score >4 at week 2 after symptom-onset may indicate lesion residuals on CT. Since late December 2019, the ongoing outbreak of Coronavirus Disease 2019 (COVID-19) related pneumonia, caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; previously known as 2019-nCoV), has rapidly expanded throughout worldwide (1) (2) (3) . By 29 April 2020, a total of 3.01 million patients with confirmed COVID-19 pneumonia and 207,973 deaths have been reported (4) . Clinical and radiological characteristics of COVID-19 pneumonia have been systematically described. It is noting that the most common findings on chest computed tomography (CT), i.e. peripheral ground glass opacity (GGO), consolidation or both predominantly in bilateral and multifocal distributions highly resembled to a CT pattern of organizing pneumonia (OP) (5,6). As a common lung injury, most cases of OP were demonstrated to have a good prognosis, while permanent damage and interstitial fibrosis were still observed in scare severe cases (7). Similar prognosis was observed in COVID-19, i.e. above 80% of cases had been discharged with recovery (8). Despite this, prognosis of OP pattern in including radiological outcome and disease course relating to resolution of pulmonary lesions remains currently unclear. A plenty of studies have explored the evolution of pulmonary lesions based on chest CT (9,10). As the disease progresses, increased number, extent and density of GGOs on CT have been observed (11). Among these, consolidation was considered as an indication of poor prognosis (12). However, evolutions of OP pattern in and the relations with radiological outcome have not been well described. This study therefore aimed to delineate the time-dependent evolution of CT findings and outcome in COVID-19 patients with OP pattern. . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 26, 2020. . https://doi.org/10.1101/2020.05.22.20109934 doi: medRxiv preprint This retrospective study was approved by the institutional review board and informed patients' consent was waived with approval. 158 laboratory-confirmed patients with COVID-19 pneumonia who underwent chest CT scans between 22 January 2020 and 16 March 2020 were collected from eight hospitals in China. Among the patients, 75 were from Xi'an region; 18 were from Ankang region; 17 were from Hanzhong region; 10 patients were from Baoji region, and 38 patients were from Wuhan region. A case of COVID-19 was confirmed by a positive result on next-generation sequencing or real-time RT-PCR. The pulmonary lesions were considered to belong to OP pattern based on baseline CT: (1) peripheral predominantly GGO, consolidation or both, with subpleural or bronchovascular bundles distribution ( Figure 4 ); (2) lobar involvement characterized by the total CT score less than or equal to 10 (Evaluation for total CT score detailed below). Unqualified CT images and CT characteristics unmatched with OP pattern were excluded. According to clinical classification from preliminary diagnosis and treatment protocols for novel coronavirus pneumonia (7th edition) of the National Health Commission, China (13) , all pat
PDF JSON Files: document_parses/pdf_json/ebc44c9e928f3e30d8de3a322ea32c44a84be4ef.json
G_ID: organizing_pneumonia_of_covid_19_time_dependent_evolution_and_outcome_in_ct_findings
S2 ID: 218887946