Predictors of the chest CT score in COVID-19 patients: a cross-sectional study

Abstract Background Since the COVID-19 outbreak, pulmonary involvement was one of the most significant concerns in assessing patients. In the current study, we evaluated patient’s signs, symptoms, and laboratory data on the first visit to predict the severity of pulmonary involvement and their outcome regarding their initial findings. Methods All referred patients to the COVID-19 clinic of a tertiary referral university hospital were evaluated from April to August 2020. Four hundred seventy-eight COVID-19 patients with positive real-time reverse-transcriptase-polymerase chain reaction (RT-PCR) or highly suggestive symptoms with computed tomography (CT) imaging results with typical findings of COVID-19 were enrolled in the study. The clinical features, initial laboratory, CT findings, and short-term outcomes (ICU admission, mortality, length of hospitalization, and recovery time) were recorded. In addition, the severity of pulmonary involvement was assessed using a semi-quantitative scoring system (0–25). Results Among 478 participants in this study, 353 (73.6%) were admitted to the hospital, and 42 (8.7%) patients were admitted to the ICU. Myalgia (60.4%), fever (59.4%), and dyspnea (57.9%) were the most common symptoms of participants at the first visit. A review of chest CT scans showed that Ground Glass Opacity (GGO) (58.5%) and consolidation (20.7%) were the most patterns of lung lesions. Among initial clinical and laboratory findings, anosmia (P = 0.01), respiratory rate (RR) with a cut point of 25 (P = 0.001), C-reactive protein (CRP) with a cut point of 90 (P = 0.002), white Blood Cell (WBC) with a cut point of 10,000 (P = 0.009), and SpO2 with a cut point of 93 (P = 0.04) was associated with higher chest CT score. Lung involvement and consolidation lesions on chest CT scans were also associated with a more extended hospitalization and recovery period. Conclusions Initial assessment of COVID-19 patients, including symptoms, vital signs, and routine laboratory tests, can predict the severity of lung involvement and unfavorable outcomes.

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Predictors of The Chest CT Score in COVID-19 Patients: A Cross-Sectional Study

10.21203/rs.3.rs-777254/v1 ◽

2021 ◽

Author(s):

Niloofar Ayoobi Yazdi ◽

Abdolkarim Haji ghadery ◽

SeyedAhmad Seyedalinaghi ◽

Fatemeh Jafari ◽

Sirous Jafari ◽

...

Keyword(s):

Recovery Period ◽

Laboratory Data ◽

Pulmonary Involvement ◽

Chest Ct ◽

University Hospital ◽

Ct Scans ◽

Initial Assessment ◽

Lung Involvement ◽

Cut Point ◽

Imaging Results

Abstract Background: Since the COVID-19 outbreak, pulmonary involvement was one of the most significant concerns in assessing patients. In the current study, we evaluated patient’s signs, symptoms, and laboratory data on the first visit to predict the severity of pulmonary involvement and their outcome regarding their initial findings.Methods: All referred patients to the CODID-19 clinic of a tertiary referral university hospital were evaluated from April to August 2020. Four hundred seventy-eight COVID-19 patients with positive real-time reverse-transcriptase-polymerase chain reaction (RT-PCR) or highly suggestive symptoms with computed tomography(CT) imaging results with typical findings of COVID-19 were enrolled in the study. The clinical features, initial laboratory, CT findings, and short-term outcomes (ICU admission, mortality, length of hospitalization, and recovery time) were recorded. In addition, the severity of pulmonary involvement was assessed using a semi-quantitative scoring system (0-25). Results: Among 478 participants in this study, 353 (73.6%) were admitted to the hospital, and 57 (11.9%) patients were admitted to the ICU. Myalgia (60.3%), fever (59.3%), and dyspnea (57.8%) were the most common symptoms of participants at the first visit. A review of chest CT scans showed that Ground Glass Opacity (GGO) (58.5%) and consolidation (20.7%) were the most patterns of lung lesions. Among initial clinical and laboratory findings, anosmia (P = 0.01), respiratory rate (RR) with a cut point of 25 (P = 0.001), C-reactive protein (CRP) with a cut point of 90 (P = 0.002), white Blood Cell (WBC) with a cut point of 10,000 (P = 0.009), and SpO2 with a cut point of 93 (P = 0.04) was associated with higher chest CT score. Lung involvement and consolidation lesions on chest CT scans were also associated with a more extended hospitalization and recovery period.Conclusions: Initial assessment of COVID-19 patients, including symptoms, vital signs, and routine laboratory tests, can predict the severity of lung involvement and unfavorable outcomes.

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Laryngotracheobronchial papillomatosis: chest CT findings

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37562016000000351 ◽

2017 ◽

Vol 43 (4) ◽

pp. 259-263 ◽

Cited By ~ 6

Author(s):

Helena Ribeiro Fortes ◽

Felipe Mussi von Ranke ◽

Dante Luiz Escuissato ◽

Cesar Augusto Araujo Neto ◽

Gláucia Zanetti ◽

...

Keyword(s):

Respiratory Infections ◽

Lung Parenchyma ◽

Pulmonary Involvement ◽

Chest Ct ◽

Ct Scans ◽

Lung Nodules ◽

Inclusion Criteria ◽

Air Trapping ◽

Recurrent Respiratory Infections ◽

Ct Findings

ABSTRACT To evaluate the findings on chest CTs in 16 patients (8 men and 8 women) with laryngotracheobronchial papillomatosis. Methods: This was a retrospective study involving patients ranging from 2 to 72 years of age. The evaluation of the CT scans was independently performed by two observers, and discordant results were resolved by consensus. The inclusion criteria were presence of abnormalities on the CT scans, and the diagnosis was confirmed by anatomopathological examination of the papillomatous lesions. Results: The most common symptoms were hoarseness, cough, dyspnea, and recurrent respiratory infections. The major CT findings were nodular formations in the trachea, solid or cavitated nodules in the lung parenchyma, air trapping, masses, and consolidation. Nodular formations in the trachea were observed in 14 patients (87.5%). Only 2 patients had lesions in lung parenchyma without tracheal involvement. Only 1 patient had no pulmonary dissemination of the disease, showing airway involvement only. Solid and cavitated lung nodules were observed in 14 patients (87.5%) and 13 (81.2%), respectively. Masses were observed in 6 patients (37.5%); air trapping, in 3 (18.7%); consolidation in 3 (18.7%); and pleural effusion, in 1 (6.3%). Pulmonary involvement was bilateral in all cases. Conclusions: The most common tomography findings were nodular formations in the trachea, as well as solid or cavitated nodules and masses in the lung parenchyma. Malignant transformation of the lesions was observed in 5 cases.

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Protective reactive thymus hyperplasia in COVID-19 acute respiratory distress syndrome

Critical Care ◽

10.1186/s13054-020-03440-1 ◽

2021 ◽

Vol 25 (1) ◽

Author(s):

Pelagia Cuvelier ◽

Hélène Roux ◽

Anne Couëdel-Courteille ◽

Jacques Dutrieux ◽

Cécile Naudin ◽

...

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Cell Receptor ◽

Pulmonary Involvement ◽

Ct Scans ◽

Initial Assessment ◽

Lung Injury Score ◽

Control Group

Abstract Background Patients with COVID-19 (COVID) may develop acute respiratory distress syndrome with or without sepsis, coagulopathy and visceral damage. While chest CT scans are routinely performed in the initial assessment of patients with severe pulmonary forms, thymus involvement and reactivation have not been investigated so far. Methods In this observational study, we systematically scored the enlargement of the thymus and the lung involvement, using CT scans, in all adult patients admitted to the ICU for COVID or any other cause (control group) at one centre between March and April 2020. Initial biological investigations included nasal detection of SARS-CoV-2 ribonucleic acid by polymerase chain reaction (PCR). In a subgroup of 24 patients with different degrees of pulmonary involvement and thymus hypertrophy, plasma cytokine concentrations were measured and the export of mature T cells from the thymus was estimated simultaneously by PCR quantification of T cell receptor excision circles (TRECs). Results Eighty-seven patients were studied: 50 COVID patients and 37 controls. Non-atrophic or enlarged thymus was more commonly observed in COVID patients than in controls (66% vs. 24%, p < 0.0001). Thymus enlargement in COVID patients was associated with more extensive lung injury score on CT scans (4 [3–5] vs. 2 [1.5–4], p = 0.01), but a lower mortality rate (8.6% vs. 41.2%, p < 0.001). Other factors associated with mortality were age, lymphopaenia, high CRP and co-morbidities. COVID patients had higher concentrations of IL-7 (6.00 [3.72–9.25] vs. 2.17 [1.76–4.4] pg/mL; p = 0.04) and higher thymic production of new lymphocytes (sj/βTREC ratio = 2.88 [1.98–4.51] vs. 0.23 [0.15–0.60]; p = 0.004). Thymic production was also correlated with the CT scan thymic score (r = 0.38, p = 0.03) and inversely correlated with the number of lymphocytes (r = 0.56, p = 0.007). Conclusion In COVID patients, thymus enlargement was frequent and associated with increased T lymphocyte production, which appears to be a beneficial adaptation to virus-induced lymphopaenia. The lack of thymic activity/reactivation in older SARS-CoV-2 infected patients could contribute to a worse prognosis.

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What is the clinical course of patients hospitalised for COVID-19 treatment Ireland: a retrospective cohort study in Dublin’s North Inner City (the ‘Mater 100’)

HRB Open Research ◽

10.12688/hrbopenres.13138.1 ◽

2020 ◽

Vol 3 ◽

pp. 80

Author(s):

Brendan O’Kelly ◽

Colm Cronin ◽

Stephen Peter Connolly ◽

Walter Cullen ◽

Gordana Avramovic ◽

...

Keyword(s):

Intensive Care ◽

Clinical Characteristics ◽

Laboratory Data ◽

Supplemental Oxygen ◽

University Hospital ◽

Initial Assessment ◽

Hospital Treatment ◽

C Reactive Protein ◽

Reactive Protein ◽

D Dimer

Background: Ireland has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). While several cohorts from China have been described, there is little data describing the epidemiological and clinical characteristics of Irish patients with COVID-19. To improve our understanding of this infection we performed a retrospective review of patient data to examine the clinical characteristics of patients admitted for COVID-19 hospital treatment. Methods: Demographic, clinical and laboratory data on the first 100 patients admitted to Mater Misericordiae University Hospital for in-patient COVID-19 treatment after onset of the outbreak in March 2020 was extracted from patient records. Results: The median age was 45 years (interquartile range [IQR] =34-64 years), 58% were male, and 63% were Irish nationals. Patients had symptoms for a median of five days before diagnosis (IQR=2.5-7 days), most commonly cough (72%), fever (65%), dyspnoea (37%), fatigue (28%), myalgia (27%) and headache (24%). Of all cases, 54 had at least one pre-existing chronic illness (most commonly hypertension, diabetes mellitus or asthma). At initial assessment, the most common abnormal findings were: C-reactive protein >7.0mg/L (74%), ferritin >247μg/L (women) or >275μg/L (men) (62%), D-dimer >0.5μg/dL (62%), chest imaging (59%), NEWS Score (modified) of ≥3 (55%) and heart rate >90/min (51%). Supplemental oxygen was required by 27 patients, of which 17 were admitted to the intensive care unit - 14 requiring ventilation. Antiviral therapy was administered to 40 patients (most commonly hydroxychloroquine or lopinavir/ritonavir). Four died, 17 were admitted to intensive care, and 74 were discharged home, with nine days the median hospital stay (IQR=6-11). Conclusion: Our findings reinforce the consensus of COVID-19 as an acute life-threatening disease and highlights the importance of laboratory (ferritin, C-reactive protein, D-dimer) and radiological parameters, in addition to clinical parameters. Further cohort studies followed longitudinally are a priority.

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Association of Computer Tomography Features Of COVID-19 with Outcomes, Clinical and Laboratory Parameters

The Russian Archives of Internal Medicine ◽

10.20514/2226-6704-2021-11-6-447-456 ◽

2021 ◽

Vol 11 (6) ◽

pp. 447-456

Author(s):

A. V. Melekhov ◽

M. A. Sayfullin ◽

V. S. Petrovichev ◽

A. I. Agaeva ◽

K. Y. Golubykh ◽

...

Keyword(s):

Computer Tomography ◽

Laboratory Data ◽

Chest Ct ◽

Ct Scans ◽

Chronic Obstructive ◽

Chain Reaction ◽

Obstructive Pulmonary Disease ◽

Cumulative Survival ◽

Coronavirus Infection ◽

Novel Coronavirus

Aim: to assess the results of chest computer tomography (CT) of patients with novel coronavirus infection in correspondence with their outcomes, clinical and laboratory data. Methods: retrospective analysis of 962 chest CT scans, outcomes, clinical and laboratory data of all 354 COVID-19 patients hospitalized from April to June 2020. Results: Sensitivity and specificity of CT with polimerase chain reaction (PCR) as a reference were: 98.0 % and 5.7 % respectively; for PCR with CT as a reference: 54.6 % and 70.7 % respectively. Patients with positive and negative PCR tests had no significant differences in mean CT score and CO-RADS score. Cumulative survival was better in patients with lower CT score (significant only for maximal, not baseline scores). CT score changed during hospitalization in survived patients clinically insignificant (from 2 (1-2) to 2 (1-2), p=0.001), and increased in dead (from 2 (1,5-3) to 4 (4-4), p <0.001). Lower CT score and better survival was in females, patient younger than 59 years, with NEWS score <3, without atrial fibrillation. Diabetes mellitus and obesity was associated with higher CT score, but not with survival. Chronic obstructive pulmonary disease, coronary heart disease and chronic heart failure was associated with lower survival, but not CT score. Conclusion: chest CT significantly increases diagnostic accuracy and assessment of the prognosis in COVID-19 patients.

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What is the clinical course of patients hospitalised for COVID-19 treatment Ireland: a retrospective cohort study in Dublin’s North Inner City (the ‘Mater 100’)

10.21203/rs.3.rs-34035/v1 ◽

2020 ◽

Author(s):

Brendan O’Kelly* ◽

Colm Cronin* ◽

Stephen Peter Connolly* ◽

Walter Cullen ◽

Gordana Avramovic ◽

...

Keyword(s):

Intensive Care ◽

Clinical Characteristics ◽

Antiviral Treatment ◽

Laboratory Data ◽

University Hospital ◽

Initial Assessment ◽

Hospital Treatment ◽

C Reactive Protein ◽

Reactive Protein ◽

D Dimer

Abstract Background: Since March 2020, Ireland has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To date, while several cohorts from China have been described, our understanding is limited, with no data describing the epidemiological and clinical characteristics of patients with COVID-19 in Ireland. To improve our understanding of the clinical characteristics of this emerging infection we carried out a retrospective review of patient data to examine the clinical characteristics of patients admitted for COVID-19 hospital treatment.Methods: Demographic, clinical and laboratory data on the first 100 adult patients admitted to Mater Misericordiae University Hospital (MMUH) for in-patient COVID-19 treatment after onset of the outbreak in March 2020 was extracted from clinical and administrative records. Missing data were excluded from the analysis.Results: Fifty-eight per cent were male, 63% were Irish nationals, 29% were GMS eligible, and median age was 45 years (interquartile range [IQR] =34-64 years). Patients had symptoms for a median of five days before diagnosis (IQR=2.5-7 days), most commonly cough (72%), fever (65%), dyspnoea (37%), fatigue (28%), myalgia (27%) and headache (24%). Of all cases, 54 had at least one pre-existing chronic illness (most commonly hypertension, diabetes mellitus or asthma). At initial assessment, the most common abnormal findings were: C-reactive protein >7.0mg/L (74%), ferritin >247μg/L (women) or >275μg/L (men) (62%), D-dimer >0.5μg/dL (62%), chest imaging (59%), NEWS Score (modified) of ≥3 (55%) and heart rate >90/min (51%). Twenty-seven required supplemental oxygen, of which 17 were admitted to the intensive care unit - 14 requiring ventilation. Forty received antiviral treatment (most commonly hydroxychloroquine or lopinavir/ritonavir). Four died, 17 were admitted to intensive care, and 74 were discharged home, with nine days the median hospital stay (IQR=6-11).Conclusion: Our findings reinforce the emerging consensus of COVID-19 as an acute life-threatening disease and highlights, the importance of laboratory (ferritin, C-reactive protein, D-dimer) and radiological parameters, in addition to clinical parameters. Further cohort studies involving larger samples followed longitudinally are a priority.

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A novel deep learning-based quantification of serial chest computed tomography in Coronavirus Disease 2019 (COVID-19)

10.21203/rs.3.rs-38083/v1 ◽

2020 ◽

Cited By ~ 2

Author(s):

Feng Pan ◽

Lin Li ◽

Bo Liu ◽

Tianhe Ye ◽

Lingli Li ◽

...

Keyword(s):

Computed Tomography ◽

Deep Learning ◽

Quantitative Computed Tomography ◽

Pulmonary Involvement ◽

Chest Ct ◽

Estimation Methods ◽

Ct Scans ◽

Severe Group ◽

Conventional Ct ◽

Spearman’S Correlation

Abstract Objectives: This study aims to explore and compare a novel deep learning-based quantification with the conventional semi-quantitative computed tomography (CT) scoring for the serial chest CT scans of COVID-19. Materials and Methods: 95 patients with confirmed COVID-19 and a total of 465 serial chest CT scans were involved, including 61 moderate patients (moderate group, 319 chest CT scans) and 34 severe patients (severe group, 146 chest CT scans). Conventional CT scoring and deep learning-based quantification were performed for all chest CT scans for two study goals: 1. Correlation between these two estimations; 2. Exploring the dynamic patterns using these two estimations between moderate and severe groups.Results: The Spearman’s correlation coefficient between these two estimation methods was 0.920 (p<0.001). predicted pulmonary involvement (CT score and percent of pulmonary lesions calculated using deep learning-based quantification) increased more rapidly and reached a higher peak on 23rd days from symptom onset in severe group, which reached a peak on 18th days in moderate group with faster absorption of the lesions. Conclusions: The deep learning-based quantification for COVID-19 showed a good correlation with the conventional CT scoring and demonstrated a potential benefit in the estimation of disease severities of COVID-19.

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Pulmonary Sequelae in Patients After Recovery From Coronavirus Disease 2019: A Follow-Up Study With Chest CT

Frontiers in Medicine ◽

10.3389/fmed.2021.686878 ◽

2022 ◽

Vol 8 ◽

Author(s):

Xuejiao Liao ◽

Dapeng Li ◽

Zhi Liu ◽

Zhenghua Ma ◽

Lina Zhang ◽

...

Keyword(s):

Disease Severity ◽

Ground Glass Opacity ◽

Chest Ct ◽

Ct Scans ◽

Trend Test ◽

Lung Involvement ◽

Follow Up Study ◽

Ct Findings ◽

Over Time

Objective: The pulmonary sequelae of coronavirus disease 2019 (COVID-19) have not been comprehensively evaluated. We performed a follow-up study analyzing chest computed tomography (CT) findings of COVID-19 patients at 3 and 6 months after hospital discharge.Methods: Between February 2020 and May 2020, a total of 273 patients with COVID-19 at the Shenzhen Third People's Hospital were recruited and followed for 6 months after discharge. Chest CT scanning was performed with the patient in the supine position at end-inspiration. A total of 957 chest CT scans was obtained at different timepoints. A semi-quantitative score was used to assess the degree of lung involvement.Results: Most chest CT scans showed bilateral lung involvement with peripheral location at 3 and 6 months follow-up. The most common CT findings were ground-glass opacity and parenchymal band, which were found in 136 (55.3%) and 94 (38.2%) of the 246 patients at 3 months follow-up, and 82 (48.2%) and 76 (44.7%) of 170 patients at 6 months follow-up, respectively. The number of lobes involved and the total CT severity score declined over time. The total CT score gradually increased with the increasement of disease severity at both 3 months follow-up (trend test P < 0.001) and 6 months follow-up (trend test P < 0.001). Patients with different disease severity represented diverse CT patterns over time.Conclusions: The most common CT findings were ground-glass opacity and parenchymal bands at the 3 and 6 months follow-up. Patients with different disease severity represent diverse CT manifestations, indicating the necessary for long-term follow-up monitoring of patients with severe and critical conditions.

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Pulmonary manifestations in children with systemic lupus erythematosus

10.21203/rs.3.rs-16536/v1 ◽

2020 ◽

Author(s):

Wujun Jiang ◽

Ge Dai ◽

Ting Wang ◽

Jie Ma ◽

Canhong Zhu ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Clinical Characteristics ◽

Laboratory Data ◽

Ground Glass Opacity ◽

Pulmonary Involvement ◽

Lung Involvement ◽

Systemic Lupus ◽

Pulmonary Manifestations ◽

Interlobular Septal Thickening

Abstract Background Symptomatic pulmonary involvement in systemic lupus erythematosus (SLE) is commonly reported in children. However, few studies have assessed risk factors that predict pulmonary involvement in SLE.Methods This was a seven-year retrospective study involving 111 SLE patients. The demographic, clinical and laboratory data of the patients were collected. Logistic regression analysis was performed to identify different clinical characteristics and laboratory parameters associated with presence of high resolution computerized tomography(HRCT) chest abnormalities.Results Of the 111 patients with SLE, we identified 18 patients (16.2%) with pulmonary involvement. The most common HRCT findings were ground glass opacity, interlobular septal thickening, bilateral diffuse infiltrates and pleurisy/pleural effusion (55.6%, 50%, 50%, and 44.4%, respectively). The variables independently associated with pulmonary involvement were anti- ribonucleoprotein (RNP) antibody (OR:7.9; 95% CI: 1.1–54.6) and anti-neutrophil cytoplasmic antibodies (ANCA, OR: 73.6; 95% CI: 2.9-1894.7).Conclusions Lung involvement was frequent in SLE patients from Southeast China. Anti-RNP antibody and ANCA were significantly associated with abnormal HRCT findings.

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Protective reactive thymus hyperplasia in COVID-19 acute respiratory distress syndrome

10.21203/rs.3.rs-59411/v2 ◽

2020 ◽

Author(s):

Pelagia Cuvelier ◽

Hélène Roux ◽

Anne Couëdel-Courteille ◽

Jacques Dutrieux ◽

Cécile Naudin ◽

...

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Cell Receptor ◽

Pulmonary Involvement ◽

Ct Scans ◽

Initial Assessment ◽

Lung Injury Score ◽

Control Group

Abstract Background. Patients with COVID-19 (COVID) may develop acute respiratory distress syndrome with or without sepsis, coagulopathy and visceral damage. While chest CT-scans are routinely performed in the initial assessment of patients with severe pulmonary forms, thymus involvement and reactivation have not been investigated so far.Methods. In this observational study, we systematically scored the enlargement of the thymus and the lung involvement, using CT-scans, in all adult patients admitted to the ICU for COVID or any other cause (control group) at one centre between March and April 2020. Initial biological investigations included nasal detection of SARS-CoV-2 ribonucleic acid by polymerase chain reaction (PCR). In a subgroup of 24 patients with different degrees of pulmonary involvement and thymus hypertrophy, plasma cytokine concentrations were measured and the export of mature T-cells from the thymus was estimated simultaneously by PCR quantification of T-cell receptor excision circles (TRECs).Results. Eighty-seven patients were studied: 50 COVID patients and 37 controls. Non-atrophic or enlarged thymus was more commonly observed in COVID patients than in controls (66% vs. 24%, p<0.0001). Thymus enlargement in COVID patients was associated with more extensive lung injury score on CT-scans (4 [3-5] vs. 2 [1.5-4], p=0.01), but a lower mortality rate (8.6% vs. 41.2%, p<0.001). Other factors associated with mortality were age, lymphopaenia, high CRP and co-morbidities. COVID patients had higher concentrations of IL-7 (6.00 [3.72-9.25] vs. 2.17 [1.76-4.4] pg/mL; p=0.04), and higher thymic production of new lymphocytes (sj/bTREC ratio = 2.88 [1.98-4.51] vs. 0.23 [0.15-0.60]; p=0.004). Thymic production was also correlated with the CT-scan thymic score (r = 0.38, p=0.03) and inversely correlated with the number of lymphocytes (r=0.56, p=0.007).Conclusions. In COVID patients, thymus enlargement was frequent and associated with increased T-lymphocyte production, which appears to be a beneficial adaptation to virus-induced lymphopaenia. The lack of thymic activity/reactivation in older SARS-CoV-2 infected patients could contribute to a worse prognosis. Trial registration: N/A

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