Please use this identifier to cite or link to this item:
http://hdl.handle.net/2445/194309
Title: | Radio-histological correlation of lung features in severe COVID19 |
Author: | Trias-Sabrià, Pere Dorca Duch, Eduard Molina Molina, María Aso, Samantha Díez-Ferrer, Marta Marin, Alfredo Bordas-Martínez, Jaume Sabater, Joan Luburich, Patricio Del Río, Belén Dorca i Sargatal, Jordi Santos Perez, Maria De La S. Suarez-Cuartin, Guillermo |
Keywords: | COVID-19 Biòpsia Patologia Radiologia COVID-19 Biopsy Pathology Radiology |
Issue Date: | Jan-2022 |
Publisher: | Frontiers Media |
Abstract: | Background: Patients with coronavirus disease 2019 (COVID-19) can develop severe bilateral pneumonia leading to respiratory failure. Lung histological samples were scarce due to the high risk of contamination during autopsies. We aimed to correlate histological COVID-19 features with radiological findings through lung ultrasound (LU)-guided postmortem core needle biopsies (CNBs) and computerized tomography (CT) scans. Methodology: We performed an observational prospective study, including 30 consecutive patients with severe COVID-19. The thorax was divided into 12 explorations regions to correlate LU and CT-scan features. Histological findings were also related to radiological features through CNBs. Results: Mean age was 62.56 ± 13.27 years old, with 96.7% male patients. Postmortem LU-guided CNBs were performed in 13 patients. Thirty patients were evaluated with both thoracic LU and chest CT scan, representing a total of 279 thoracic regions explored. The most frequent LU finding was B2-lines (49.1%). The most CT-scan finding was ground-glass opacity (GGO, 29%). Pathological CT-scan findings were commonly observed when B2-lines or C-lines were identified through LU (positive predictive value, PPV, 87.1%). Twenty-five postmortem echo-guided histological samples were obtained from 12 patients. Histological samples showed diffuse alveolar damage (DAD) (75%) and chronic interstitial inflammation (25%). The observed DAD was heterogeneous, showing multiple evolving patterns of damage, including exudative (33.3%), fibrotic (33.3%), and organizing (8.3%) phases. In those patients with acute or exudative pattern, two lesions were distinguished: classic hyaline membrane; fibrin "plug" in alveolar space (acute fibrinous organizing pneumonia, AFOP). C-profile was described in 33.3% and presented histological signs of DAD and lung fibrosis. The predominant findings were collagen deposition (50%) and AFOP (50%). B2-lines were identified in 66.7%; the presence of hyaline membrane was the predominant finding (37.5%), then organizing pneumonia (12.5%) and fibrosis (37.5%). No A-lines or B1-lines were observed in these patients. Conclusion: LU B2-lines and C-profile are predominantly identified in patients with severe COVID-19 with respiratory worsening, which correspond to different CT patterns and histological findings of DAD and lung fibrosis. |
Note: | Reproducció del document publicat a: https://doi.org/10.3389/fmed.2022.820661 |
It is part of: | Frontiers in Medicine, 2022, vol. 9 |
URI: | http://hdl.handle.net/2445/194309 |
Related resource: | https://doi.org/10.3389/fmed.2022.820661 |
ISSN: | 2296-858X |
Appears in Collections: | Articles publicats en revistes (Ciències Clíniques) Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
717350.pdf | 2.28 MB | Adobe PDF | View/Open |
This item is licensed under a Creative Commons License