scholarly journals Nintedanib in the management of pulmonary fibrosis after COVID-19: a case report

2021 ◽  
Vol 11 (2) ◽  
pp. 148-152
Author(s):  
Rajashish Chakrabortty ◽  
Samia Rahman ◽  
Rawnak Jahan ◽  
Abir Hasan Dip ◽  
Mohammed Mirazur Rahman

Pulmonary fibrosis is becoming a recognized complication of coronavirus disease 2019 (COVID-19). Patients with pulmonary fibrosis may present with dry cough, shortness of breath, nail clubbing, low oxygen saturation. We report a case of a 40-year-old male patient with pulmonary fibrosis due to COVID- 19. Clinical examination showed that the patient was dyspneic with low oxygen saturation and there was bilateral inspiratory crepitation in the lower part of his chest. High resolution computed tomography showed bilateral multifocal patchy ground-glass opacities, consolidation with peripheral and basal distribution, sub-pleural fibrotic bands and vascular thickening (almost 40-45% of parenchymal involvement). We prescribed him an antifibrotic drug, nintedanib and there was a significant clinical and radiological improvement after 15 days of treatment. Nintedanib may have novel therapeutic role in preventing COVID-19 associated fibrosis. Birdem Med J 2021; 11(2): 148-152

2020 ◽  
Vol 34 (10) ◽  
pp. 13979-13980
Author(s):  
Wenxi Yu ◽  
Hua Zhou ◽  
Jonathan G. Goldin ◽  
Grace Hyun J. Kim

Domain knowledge acquired from pilot studies is important for medical diagnosis. This paper leverages the population-level domain knowledge based on the D-optimal design criterion to judiciously select CT slices that are meaningful for the disease diagnosis task. As an illustrative example, the diagnosis of idiopathic pulmonary fibrosis (IPF) among interstitial lung disease (ILD) patients is used for this work. IPF diagnosis is complicated and is subject to inter-observer variability. We aim to construct a time/memory-efficient IPF diagnosis model using high resolution computed tomography (HRCT) with domain knowledge-assisted data dimension reduction methods. Four two-dimensional convolutional neural network (2D-CNN) architectures (MobileNet, VGG16, ResNet, and DenseNet) are implemented for an automatic diagnosis of IPF among ILD patients. Axial lung CT images are acquired from five multi-center clinical trials, which sum up to 330 IPF patients and 650 non-IPF ILD patients. Model performance is evaluated using five-fold cross-validation. Depending on the model setup, MobileNet achieved satisfactory results with overall sensitivity, specificity, and accuracy greater than 90%. Further evaluation of independent datasets is underway. Based on our knowledge, this is the first work that (1) uses population-level domain knowledge with optimal design criterion in selecting CT slices and (2) focuses on patient-level IPF diagnosis.


2020 ◽  
Vol 35 (2) ◽  
pp. 115-122 ◽  
Author(s):  
Stefano Palmucci ◽  
Sebastiano E. Torrisi ◽  
Daniele Falsaperla ◽  
Alessandro Stefano ◽  
Alfredo G. Torcitto ◽  
...  

2005 ◽  
Vol 172 (4) ◽  
pp. 488-493 ◽  
Author(s):  
David A. Lynch ◽  
J. David Godwin ◽  
Sharon Safrin ◽  
Karen M. Starko ◽  
Phil Hormel ◽  
...  

Author(s):  
Gaetano Rea ◽  
Marina De Martino ◽  
Annalisa Capaccio ◽  
Pasquale Dolce ◽  
Tullio Valente ◽  
...  

Abstract Background Volumetric high-resolution computed tomography (HRCT) of the chest has recently replaced incremental CT in the diagnostic workup of idiopathic pulmonary fibrosis (IPF). Concomitantly, visual and quantitative scores have been proposed for disease extent assessment to ameliorate disease management. Purpose To compare the performance of density histograms (mean lung attenuation, skewness, and kurtosis) and visual scores, along with lung function correlations, in IPF patients submitted to incremental or volumetric thorax HRCT. Material and methods Clinical data and CT scans of 89 newly diagnosed and therapy-naive IPF patients were retrospectively evaluated. Results Forty-six incremental and 43 volumetric CT scans were reviewed. No differences of density histograms and visual scores estimates were found by comparing two HRCT techniques, with an optimal inter-operator agreement (concordance correlation coefficient >0.90 in all instances). Single-breath diffusing lung capacity for carbon monoxide (DLCOsb) was inversely related with the Best score (r = −00.416; p = 0.014), the Kazerooni fibrosis extent (r = −0.481; p = 0.004) and the mean lung attenuation (r = −0.382; p = 0.026), while a positive correlation was observed with skewness (r = 0.583; p = 0.001) and kurtosis (r = 0.543; p = 0.001) in the incremental HRCT sub-group. Similarly, in the volumetric CT sub-cohort, DLCOsb was significantly associated with skewness (r = 0.581; p = 0.007) and kurtosis (r = 0.549; p = 0.018). Correlations with visual scores were not confirmed. Forced vital capacity significantly related to all density indices independently on HRCT technique. Conclusions Density histograms and visual scores similarly perform in incremental and volumetric HRCT. Density quantification displays an optimal reproducibility and proves to be superior to visual scoring as more strongly correlated with lung function.


2020 ◽  
Vol 13 (9) ◽  
pp. e237390
Author(s):  
Asadullah Nawazani ◽  
Mahmoud Ghanaim ◽  
Sadia Tariq

We are reporting a middle-aged male patient with polycythaemia vera comorbidity. The patient was exhibiting symptoms including fever, cough and shortness of breath and was found to have acute pulmonary embolism. He was diagnosed with SARS-CoV-2. This case suggests that a high index of suspicion should be taken into consideration for thromboembolic events, when treating patients with COVID-19 with breathing difficulty and low oxygen saturation levels, especially in those who have underlying predisposing conditions for coagulopathy.


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