Interstitial Lung Disease at High Resolution CT after SARS-CoV-2-Related Acute Respiratory Distress Syndrome According to Pulmonary Segmental Anatomy.
Elisa Baratella,Barbara Ruaro,Cristina Marrocchio,Natalia Starvaggi,Francesco Salton,Fabiola Giudici,Fabiola Giudici,Emilio Quaia,Marco Confalonieri,Maria Assunta Cova +9 more
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In this paper, the authors evaluated high resolution CT (HRCT) findings in SARS-CoV-2-related ARDS survivors treated with prolonged low-dose methylprednisolone after hospital discharge.Abstract:
Background: The purpose of this study was to evaluate High-Resolution CT (HRCT) findings in SARS-CoV-2-related ARDS survivors treated with prolonged low-dose methylprednisolone after hospital discharge. Methods: A total of 44 consecutive patients (M: 32, F: 12, average age: 64), hospitalised in our department from April to September 2020 for SARS-CoV-2-related ARDS, who had a postdischarge CT scan, were enrolled into this retrospective study. We reviewed the electronic medical charts to collect laboratory, clinical, and demographic data. The CT findings were evaluated and classified according to lung segmental distribution. The imaging findings were correlated with spirometry results and included ground glass opacities (GGOs), consolidations, reticulations, bronchiectasis/bronchiolectasis, linear bands, and loss of pulmonary volume. Results: Alterations in the pulmonary parenchyma were observed in 97.7% of patients at HRCT (median time lapse between ARDS diagnosis and HRCT: 2.8 months, range 0.9 to 6.7). The most common findings were linear bands (84%), followed by GGOs (75%), reticulations (34%), bronchiolectasis (32%), consolidations (30%), bronchiectasis (30%) and volume loss (25%). They had a symmetric distribution, and both lower lobes were the most affected areas. Conclusions: A reticular pattern with a posterior distribution was observed 3 months after discharge from severe COVID-19 pneumonia, and this differs from previously described postCOVID-19 fibrotic-like changes. We hypothesized that the systematic use of prolonged low-dose of corticosteroid could be the main reason of this different CT scan appearance.read more
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Different Methods to Improve the Monitoring of Noninvasive Respiratory Support of Patients with Severe Pneumonia/ARDS Due to COVID-19: An Update
Paolo Pelosi,M. Tonelli,Chiara Torregiani,Elisa Baratella,Marco Confalonieri,Denise Battaglini,Alessandro Marchioni,Paola Confalonieri,Enrico Clini,Francesco Salton,Barbara Ruaro +10 more
TL;DR: The needs and available tools for clinical–physiological monitoring that aims at optimizing the ventilatory management of patients affected by acute respiratory distress syndrome due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection are reviewed.
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An updated overview of recent advances, challenges, and clinical considerations of IL-6 signaling blockade in severe coronavirus disease 2019 (COVID-19)
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The pathogenesis, epidemiology and biomarkers of susceptibility of pulmonary fibrosis in COVID-19 survivors.
Andrea Vianello,Gabriella Guarnieri,Fausto Braccioni,Sara Lococo,Beatrice Molena,Antonella Cecchetto,Chiara Giraudo,Leonardo Bertagna De Marchi,Marco Caminati,Gianenrico Senna +9 more
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Characteristics and Prognostic Factors of Pulmonary Fibrosis After COVID-19 Pneumonia
Elisabetta Cocconcelli,Nicol Bernardinello,Chiara Giraudo,Gioele Castelli,A. Giorgino,Davide Leoni,Simone Petrarulo,Anna Maria Ferrari,Marina Saetta,Anna Maria Cattelan,Paolo Spagnolo,Elisabetta Balestro +11 more
TL;DR: In this population, only twenty percent of patients showed persistent lung abnormalities at 6 months after hospitalization for COVID-19 pneumonia, and the presence of reticulations and consolidation on HRCT at hospital admission predicts the persistence of radiological abnormalities during follow-up.
References
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Journal ArticleDOI
Pharmacological principles guiding prolonged glucocorticoid treatment in ARDS.
Gianfranco Umberto Meduri,Gianfranco Umberto Meduri,Dijillali Annane,Marco Confalonieri,George P. Chrousos,Bram Rochwerg,Amanda Busby,Barbara Ruaro,Bernd Meibohm +8 more
TL;DR: The role dosage, timing of initiation, mode of administration, duration, and tapering play in achieving optimal response to GC therapy in ARDS, and the role of the GR is addressed are addressed.
Journal ArticleDOI
COVID-19 and risk of pulmonary fibrosis: the importance of planning ahead.
Francesco Gentile,Alberto Aimo,Francesco Forfori,Giosuè Catapano,Alberto Clemente,Filippo Cademartiri,Michele Emdin,Alberto Giannoni +7 more
TL;DR: It is hypothesized that lung fibrosis may be also a possible long-term consequence of COVID-19 pneumonia, and the importance of setting up specific follow-up strategies in CO VID-19 patients showing pulmonary involvement to assess the possible progression toward lung Fibrosis is stressed.
Journal ArticleDOI
The role of chest ct in deciphering interstitial lung involvement: systemic sclerosis versus covid-19.
Martina Orlandi,Nicholas Landini,Gianluca Sambataro,Cosimo Nardi,Lorenzo Tofani,Cosimo Bruni,Silvia Bellando-Randone,Jelena Blagojevic,Daniela Melchiorre,Michael Hughes,Christopher P. Denton,Fabrizio Luppi,Barbara Ruaro,Francesca Della Casa,Francesca Wanda Rossi,Giacomo De Luca,C. Campochiaro,Michele Spinicci,Lorenzo Zammarchi,S. Tomassetti,Antonella Caminati,Edoardo Cavigli,Marco Albanesi,Fabio Melchiorre,Stefano Palmucci,Virginia Vegni,Serena Guiducci,Alberto Moggi-Pignone,Yannick Allanore,Alessandro Bartoloni,Marco Confalonieri,L. Dagna,Francesco De Cobelli,Amato de Paulis,Sergio Harari,Dinesh Khanna,Masataka Kuwana,Gloria Taliani,Federico Lavorini,Vittorio Miele,Giovanni Morana,Alberto Pesci,Carlo Vancheri,Stefano Colagrande,Marco Matucci-Cerinic,Marco Matucci-Cerinic +45 more
TL;DR: In this article, the CT features most frequently associated with COVID-19 pneumonia were: consolidation (CONS) in lower lobes, CONS with peripheral (both central/peripheral or patchy distributions), anterior and posterior CONS and rounded-shaped GGOs in the lower lobe.
Journal ArticleDOI
HRCT of fibrosing lung disease.
Joseph Jacob,David M. Hansell +1 more
TL;DR: Several diagnostic dilemmas are explored including challenges with the recent IPF diagnosis and management guidelines, as well as with the ‘difficult to characterize’ fibrosing diseases such as smoking‐related lung fibrosis, unclassifiable disease and acute exacerbations of fibrosed lung disease.
Journal ArticleDOI
Lung diffusing capacity for nitric oxide and carbon monoxide following mild-to-severe COVID-19.
Giovanni Barisione,Vito Brusasco +1 more
TL;DR: In this article, the authors investigated whether measurement of lung diffusing capacity for nitric oxide (DLNO) offers additional insights on the presence and mechanisms of gas transport abnormalities and found that DLNO was abnormal in 57% of subjects, independent of time of lung function testing and severity of COVID-19.