scholarly journals Respiratory symptoms and radiologic findings in post-acute COVID-19 syndrome

2021 ◽  
pp. 00479-2021
Author(s):  
Etienne-Marie Jutant ◽  
Olivier Meyrignac ◽  
Antoine Beurnier ◽  
Xavier Jaïs ◽  
Tai Pham ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Respiratory Symptoms ◽  
Total Lung Capacity ◽  
Pulmonary Function Tests ◽  
High Resolution Computed Tomography ◽  
Lung Capacity ◽  
Radiologic Findings ◽  
Care Visit ◽  
Respiratory Complaints ◽  
New Onset

RationaleThe characteristics of patients with respiratory complaints and/or lung radiologic abnormalities after hospitalisation for COVID-19 are unknown. The objectives were to determine their characteristics and the relationships between dyspnoea, radiologic abnormalities and functional impairment.MethodsIn the COMEBAC cohort study, 478 hospital survivors were evaluated by telephone 4 months after hospital discharge, and 177 who had been hospitalised in an intensive care unit (ICU) or presented relevant symptoms underwent an ambulatory evaluation. New-onset dyspnoea and cough were evaluated, and the results of pulmonary function tests, high-resolution computed tomography of the chest were collected.ResultsAmong the 478 patients, 78 (16.3%) reported new-onset dyspnoea, and 23 (4.8%) new-onset cough. The patients with new-onset dyspnoea were younger (56.1±12.3 versus 61.9±16.6 years), had more severe COVID-19 (ICU admission 56.4% versus 24.5%) and more frequent pulmonary embolism (18.0% versus 6.8%) (all p≤0.001) than patients without dyspnoea. Among the patients reassessed at the ambulatory care visit, the prevalence of fibrotic lung lesions was 19.3%, with extent <25% in 97% of the patients. The patients with fibrotic lesions were older (61±11 versus 56±14 years, p=0.03), more frequently managed in ICU (87.9 versus 47.4%, p<0.001), had lower total lung capacity (74.1±13.7 versus 84.9±14.8%pred, p<0.001) and diffusing lung capacity for carbon monoxide (DLCO) (73.3±17.9 versus 89.7±22.8%pred, p<0.001). The combination of new-onset dyspnoea, fibrotic lesions and DLCO <70%pred was observed in 8/478 patients.ConclusionsNew-onset dyspnoea and mild fibrotic lesions were frequent at 4 months, but the association of new-onset dyspnoea, fibrotic lesions and low DLCO was rare.

scholarly journals The airway response to deep inspirations decreases with COPD severity and is associated with airway distensibility assessed by computed tomography

2008 ◽  
Vol 105 (3) ◽  
pp. 832-838 ◽  
Author(s):  
Nicola Scichilone ◽  
Alba La Sala ◽  
Maria Bellia ◽  
Katherine Fallano ◽  
Alkis Togias ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Vital Capacity ◽  
Total Lung Capacity ◽  
Chronic Obstructive ◽  
High Resolution Computed Tomography ◽  
Lung Inflation ◽  
Lung Capacity ◽  
Gold Stage ◽  
Computed Tomography Scans

In patients with mild chronic obstructive pulmonary disease (COPD), the effect of deep inspirations (DIs) to reverse methacholine-induced bronchoconstriction is largely attenuated. In this study, we tested the hypothesis that the effectiveness of DI is reduced with increasing disease severity and that this is associated with a reduction in the ability of DI to distend the airways. Fifteen subjects [Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage I–II: n = 7; GOLD stage III–IV: n = 8] underwent methacholine bronchoprovocation in the absence of DI, followed by DI. The effectiveness of DI was assessed by their ability to improve inspiratory vital capacity and forced expiratory volume in 1 s (FEV1). To evaluate airway distensibility, two sets of high-resolution computed tomography scans [at residual volume (RV) and at total lung capacity] were obtained before the challenge. In addition, mean parenchymal density was calculated on the high-resolution computed tomography scans. We found a strong correlation between the response to DI and baseline FEV1 %predicted ( r2 = 0.70, P < 0.0001) or baseline FEV1/forced vital capacity ( r2 = 0.57, P = 0.001). RV %predicted and functional residual capacity %predicted correlated inversely ( r2 = 0.33, P = 0.02 and r2 = 0.32, P = 0.03, respectively), and parenchymal density at RV correlated directly ( r2 = 0.30, P = 0.03), with the response to DI. Finally, the effect of DI correlated to the change in large airway area from RV to total lung capacity ( r2 = 0.44, P = 0.01). We conclude that loss of the effects of DI is strongly associated with COPD severity and speculate that the reduction in the effectiveness of DI is due to the failure to expand the lungs because of the hyperinflated state and/or the parenchymal damage that prevents distension of the airways with lung inflation.

scholarly journals Computed tomography findings as determinants of pulmonary function tests in fibrotic interstitial lung diseases—Network-analyses and multivariate models

2020 ◽  
Vol 17 ◽  
pp. 147997312096702
Author(s):  
David Lang ◽  
Kaveh Akbari ◽  
Stefan Walcherberger ◽  
Benedikt Hergan ◽  
Andreas Horner ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Function ◽  
Pulmonary Function Tests ◽  
Information Criterion ◽  
Forced Expiratory Volume ◽  
Interstitial Lung Diseases ◽  
High Resolution Computed Tomography ◽  
Diffusion Capacity ◽  
Network Analyses ◽  
The Impact

The aim was to evaluate the impact of multiple high-resolution computed tomography (HRCT) features on pulmonary function test (PFT) biomarkers in fibrotic interstitial lung disease (FILD) patients. HRCT of subsequently ILD-board-discussed FILD patients were semi-quantitatively evaluated in a standardized approach: 18 distinct lung regions were scored for noduli, reticulation, honeycombing, consolidations, ground glass opacities (GGO), traction bronchiectasis (BRK) and emphysema. Total lung capacity (TLC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC, diffusion capacity for carbon monoxide (DLCO) and transfer coefficient (KCO) were assessed. Interactions between each PFT biomarker and all HRCT scores were visualized by network analyses, modeled according to the Schwarz Bayesian Information Criterion and incorporated in uni- and multivariate stepwise regression analyses. Among 108 FILD patients (mean age 67 years, 77% male), BRK extent was a major significant uni- or multivariate determinant of all PFT analyzed. Besides that, diffusion-based variables DLCO and KCO showed a larger dependency on reticulation, emphysema and GGO, while forced expiratory volume-based measures FEV1, FVC and FEV1/FVC were more closely associated with consolidations. For TLC, the only significant multivariate determinant was reticulation. In conclusion, PFT biomarkers derived from spirometry, body plethysmography and diffusion capacity in FILD patients are differentially influenced by semi-quantified HRCT findings.

scholarly journals Uncommon radiologic computed tomography appearances of the chest in patients with lymphangioleiomyomatosis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yasuhito Sekimoto ◽  
Kazuhiro Suzuki ◽  
Makiko Okura ◽  
Takuo Hayashi ◽  
Hiroki Ebana ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Tuberous Sclerosis Complex ◽  
Diagnostic Algorithm ◽  
Large Cyst ◽  
High Resolution Computed Tomography ◽  
Radiologic Findings ◽  
Ground Glass Attenuation ◽  
Pulmonary Cysts ◽  
Thin Walled

AbstractLymphangioleiomyomatosis (LAM) is a rare destructive lung disease characterized by multiple thin-walled pulmonary cysts. The currently proposed diagnostic algorithm emphasizes the characteristic cystic appearance on high-resolution computed tomography (HRCT) so uncommon HRCT appearances present challenges to establishing the proper LAM diagnosis. The objective of this study is to accrue uncommon chest HRCT appearances, determine frequencies in both tuberous sclerosis complex (TSC)-associated LAM (TSC-LAM) and sporadic LAM (S-LAM) patients. 311 females referred to our hospital, including 272 S-LAM patients (mean age 39.2 years) and 39 TSC-LAM patients (mean age 38.3 years), were retrospectively evaluated. We found 2 types of radiologic findings likely to make HRCT cyst appearance atypical: characteristics of the cyst itself and uncommon findings in addition to cysts. We found that approximately 80% of LAM patients, whether TSC-associated or sporadic, showed typical HRCT appearance with mild to severe cystic destruction. The remaining 20% displayed unusual profiles in cyst appearance as well as additional findings aside from cyst: the former includes large cyst, thickened walls, and irregularly shaped whereas the latter includes ground glass attenuation and diffuse noncalcified nodules. It is important to be aware of various radiologic findings that make HRCT cystic appearance atypical of LAM.

scholarly journals Hypersensitivity Pneumonitis with Normal High Resolution Computed Tomography Scans

2001 ◽  
Vol 8 (2) ◽  
pp. 98-101 ◽  
Author(s):  
Farah J Nasser-Sharif ◽  
Meyer S Balter
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Lupus Erythematosus ◽  
Hypersensitivity Pneumonitis ◽  
Pulmonary Function Tests ◽  
Open Lung Biopsy ◽  
Ct Scans ◽  
High Resolution Computed Tomography ◽  
High Resolution Ct ◽  
History Of

A case of symptomatic hypersensitivity pneumonitis with normal high resolution computed tomography (CT) scans is presented. The patient, a 32-year-old man with systemic lupus erythematosus, had a chronic, progressive history of respiratory symptoms, abnormal findings on examination and abnormal pulmonary function tests but normal high resolution CT scans of the chest. Diagnosis was made through open lung biopsy. Clinical improvement was seen on removal of the offending antigen. The literature on the utility of high resolution CT scans in hypersensitivity pneumonitis is reviewed.

scholarly journals Comparison of Predicted Total Lung Capacity and Total Lung Capacity by Computed Tomography in Lung Transplantation Candidates

2016 ◽  
Vol 57 (4) ◽  
pp. 963 ◽  
Author(s):  
Sung Ho Hwang ◽  
Jin Gu Lee ◽  
Tae Hoon Kim ◽  
Hyo Chae Paik ◽  
Chul Hwan Park ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Transplantation ◽  
Total Lung Capacity ◽  
Lung Capacity
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