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Brief communication
Published online: 2021-09-28
Submitted: 2021-01-20
Accepted: 2021-06-03
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Organizing pneumonia-like pattern in COVID-19

Masoomeh Raoufi1, Shahram Kahkooei2, Sara Haseli2, Farzaneh Robatjazi1, Jamileh Bahri1, Nastaran Khalili3
DOI: 10.5603/ARM.a2021.0081
·
Pubmed: 34612508
Affiliations
  1. Department of Radiology, School of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Tehran
  2. Department of Radiology, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  3. School of Medicine,Tehran University of Medical Sciences, Tehran, Iran, Tehran

open access

Ahead of Print
BRIEF REPORT
Published online: 2021-09-28
Submitted: 2021-01-20
Accepted: 2021-06-03

Abstract

Introduction: Organizing pneumonia (OP) is a radio-histologic pattern that forms in response to lung damage in patients with focal or diffuse lung injury. OP is frequently observed subsequent to viral-induced lung damage and is associated with a diverse range of clinical outcomes.
Material and methods: We included 210 patients (mean age: 55.8 ± 16.5 years old; 61% male) with mild Coronavirus disease 2019 (COVID-19) who underwent chest computed tomography (CT) from 25 February to 22 April, 2020. The patients were divided into two groups based on the presence (n = 103) or absence of typical OP-like pattern (n =107) on initial chest CT. The extent of lung involvement and final outcome was compared across the two groups. Serial changes in imaging were also evaluated in 36 patients in the OP-group with a second CT scan.
Results: Duration from symptom onset to presentation was significantly higher in the OP group (7.07 ± 3.71 versus 6.13 ± 4.96 days, p = 0.008). A higher COVID-19-related mortality rate was observed among patients with OP-like pattern (17.5% vs 3.7%, p = 0.001).There was no significant difference in the overall involvement of the lungs (p = 0.358), but lower lobes were significantly more affected in the OP group (p < 0.001). Of the 36 patients with follow-up imaging (mean duration of follow-up = 8.3 ± 2.1 days), progression of infiltration was seen in more than 61% of patients while lesions had resolved in only 22.2% of cases.
Conclusions: Our observation indicates that physicians should carefully monitor for the presence of OP-like pattern on initial CT as it is associated with a poor outcome. Furthermore, we recommend interval CT to evaluate the progression of infiltrations in these patients.

Abstract

Introduction: Organizing pneumonia (OP) is a radio-histologic pattern that forms in response to lung damage in patients with focal or diffuse lung injury. OP is frequently observed subsequent to viral-induced lung damage and is associated with a diverse range of clinical outcomes.
Material and methods: We included 210 patients (mean age: 55.8 ± 16.5 years old; 61% male) with mild Coronavirus disease 2019 (COVID-19) who underwent chest computed tomography (CT) from 25 February to 22 April, 2020. The patients were divided into two groups based on the presence (n = 103) or absence of typical OP-like pattern (n =107) on initial chest CT. The extent of lung involvement and final outcome was compared across the two groups. Serial changes in imaging were also evaluated in 36 patients in the OP-group with a second CT scan.
Results: Duration from symptom onset to presentation was significantly higher in the OP group (7.07 ± 3.71 versus 6.13 ± 4.96 days, p = 0.008). A higher COVID-19-related mortality rate was observed among patients with OP-like pattern (17.5% vs 3.7%, p = 0.001).There was no significant difference in the overall involvement of the lungs (p = 0.358), but lower lobes were significantly more affected in the OP group (p < 0.001). Of the 36 patients with follow-up imaging (mean duration of follow-up = 8.3 ± 2.1 days), progression of infiltration was seen in more than 61% of patients while lesions had resolved in only 22.2% of cases.
Conclusions: Our observation indicates that physicians should carefully monitor for the presence of OP-like pattern on initial CT as it is associated with a poor outcome. Furthermore, we recommend interval CT to evaluate the progression of infiltrations in these patients.

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Keywords

COVID-19, computed tomography, organizing pneumonia, respiratory, lung

About this article
Title

Organizing pneumonia-like pattern in COVID-19

Journal

Advances in Respiratory Medicine

Issue

Ahead of Print

Article type

Brief communication

Published online

2021-09-28

DOI

10.5603/ARM.a2021.0081

Pubmed

34612508

Keywords

COVID-19
computed tomography
organizing pneumonia
respiratory
lung

Authors

Masoomeh Raoufi
Shahram Kahkooei
Sara Haseli
Farzaneh Robatjazi
Jamileh Bahri
Nastaran Khalili

References (17)
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