Quantitative Evaluation of Lung Parenchyma Changes after Treatment in COVID-19 Pneumonia with Volumetric Study in Computed Tomography

Bahattin Özkul; Furkan Ertürk Urfalı; Kıyasettin Asil

doi:10.33808/clinexphealthsci.1136688

Research Article

Quantitative Evaluation of Lung Parenchyma Changes after Treatment in COVID-19 Pneumonia with Volumetric Study in Computed Tomography

Year 2022, Volume: 12 Issue: 2, 528 - 532, 30.06.2022

Bahattin Özkul Furkan Ertürk Urfalı Kıyasettin Asil

https://doi.org/10.33808/clinexphealthsci.1136688

Abstract

Objective
COVID-19 pandemic, causing approximately 3 million deaths over worldwide, still continues. Effect of COVID-19 pneumonia after treatment on the lungs still not know. Although widely using computed tomography (CT) for diagnosing COVID-19 pneumonia, there is not enough study to determine damage of lung after treatment in COVID-19 pneumonia. In this study, our aim was to evaluate lung parenchyma changes in COVID-19 pneumonia after treatment with volumetric study, quantitatively.
Methods
25 patients, who has CT at the time of diagnosis (CT1) and after 282 days (CT2), and positive polymerase chain reaction test, were included in this retrospective single center study. Total lung volüme (TLV) and emphysematous lung (ELV) volume of CT1 and CT2 were calculated automatically by using Myrian® XP-Lung and Percentage of emphysematous area (PEA) was calculated by dividing ELV by TLV. Differences between CT1 and CT2 in PEA and in TLV and ELV was determined by Wilcoxon and Paired sample t test, respectively.
Results
Although higher TLV was found in CT2 (4216,43 ± 1048,99 cm3) than CT1 (3943,22 ± 1177,16 cm3), there was no statistical significance difference (p=0.052) between CT1 and CT2. ELV was statistically (p=0.017) higher in CT2 (937,22 ± 486,89 cm3) than CT1 (716,26 ± 471,65 cm3). There was a strong indication that the medians were significantly different in PEA (p=0,009).
Conclusions
Our study showed that there were emphysematous changes in lung parenchyma after COVID-19 pneumonia with CT, quantitatively and in our knowledge, this is the first study that evaluating lung changes quantitative after COVID-19 pneumonia.
.

Keywords

COVID-19, Emphysema, Pneumonia, Quantitative, Tomography

Supporting Institution

Project Number

Thanks

References

1. Zhou, S., Wang, Y., Zhu, T., & Xia, L. (2020). CT Features of Coronavirus Disease 2019 (COVID-19) Pneumonia in 62 Patients in Wuhan, China. AJR. American journal of roentgenology, 214(6), 1287–1294.
2. Li, K., Fang, Y., Li, W., Pan, C., Qin, P., Zhong, Y., Liu, X., Huang, M., Liao, Y., & Li, S. (2020). CT image visual quantitative evaluation and clinical classification of coronavirus disease (COVID-19). European radiology, 30(8), 4407–4416.
3. Application of Hayat Eve Sığar, (2021) Ministry of Health, Turkey.
4. Tercanlı Alkış H., Yeşiltepe S., Kurtuldu E.. Examination of the Knowledge Levels, Attitudes and Anxiety Sources Regarding Coronavirus Disease-2019 Infection in Dentistry Students in Clinical Practice. Meandros Med Dent J 2021;22:69-76
5. Wang, K., Kang, S., Tian, R., Zhang, X., Zhang, X., & Wang, Y. (2020). Imaging manifestations and diagnostic value of chest CT of coronavirus disease 2019 (COVID-19) in the Xiaogan area. Clinical radiology, 75(5), 341–347.
6. Zhao, X., Liu, B., Yu, Y., Wang, X., Du, Y., Gu, J., & Wu, X. (2020). The characteristics and clinical value of chest CT images of novel coronavirus pneumonia. Clinical radiology, 75(5), 335–340.
7. Ai, T., Yang, Z., Hou, H., Zhan, C., Chen, C., Lv, W., Tao, Q., Sun, Z., & Xia, L. (2020). Correlation of Chest CT and RT-PCR Testing for Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology, 296(2), E32–E40.
8. Fan, N., Fan, W., Li, Z., Shi, M., & Liang, Y. (2020). Imaging characteristics of initial chest computed tomography and clinical manifestations of patients with COVID-19 pneumonia. Japanese journal of radiology, 38(6), 533–538.
9. Zhao, W., Zhong, Z., Xie, X., Yu, Q., & Liu, J. (2020). Relation Between Chest CT Findings and Clinical Conditions of Coronavirus Disease (COVID-19) Pneumonia: A Multicenter Study. AJR. American journal of roentgenology, 214(5), 1072–1077.
10. Pan, F., Ye, T., Sun, P., Gui, S., Liang, B., Li, L., Zheng, D., Wang, J., Hesketh, R. L., Yang, L., & Zheng, C. (2020). Time Course of Lung Changes at Chest CT during Recovery from Coronavirus Disease 2019 (COVID-19). Radiology, 295(3), 715–721.
11. Iwasawa, T., Sato, M., Yamaya, T., Sato, Y., Uchida, Y., Kitamura, H., Hagiwara, E., Komatsu, S., Utsunomiya, D., & Ogura, T. (2020). Ultra-high-resolution computed tomography can demonstrate alveolar collapse in novel coronavirus (COVID-19) pneumonia. Japanese journal of radiology, 38(5), 394–398.
12. Hruban, R. H., Meziane, M. A., Zerhouni, E. A., Khouri, N. F., Fishman, E. K., Wheeler, P. S., Dumler, J. S., & Hutchins, G. M. (1987). High resolution computed tomography of inflation-fixed lungs. Pathologic-radiologic correlation of centrilobular emphysema. The American review of respiratory disease, 136(4), 935–940.
13. Bradley BT, Maioli H, Johnston R, Chaudhry I, Fink SL, Xu H, Najafian B, Deutsch G, Lacy JM, Williams T, Yarid N, Marshall DA. Histopathology and ultrastructural findings of fatal COVID-19 infections in Washington State: a case series. Lancet. 2020 Aug 1;396(10247):320-332. doi: 10.1016/S0140-6736(20)31305-2. Epub 2020 Jul 16. Erratum in: Lancet. 2020 Aug 1;396(10247):312. PMID: 32682491; PMCID: PMC7365650.
14. Kommoss FKF, Schwab C, Tavernar L, Schreck J, Wagner WL, Merle U, Jonigk D, Schirmacher P, Longerich T. The Pathology of Severe COVID-19-Related Lung Damage. Dtsch Arztebl Int. 2020 Jul 20;117(29-30):500-506. doi: 10.3238/arztebl.2020.0500. PMID: 32865490; PMCID: PMC7588618.
15. Lemmers DHL, Abu Hilal M, Bnà C, Prezioso C, Cavallo E, Nencini N, Crisci S, Fusina F, Natalini G. Pneumomediastinum and subcutaneous emphysema in COVID-19: barotrauma or lung frailty? ERJ Open Res. 2020 Nov 16;6(4):00385-2020. doi: 10.1183/23120541.00385-2020. PMID: 33257914; PMCID: PMC7537408.
16. Anzueto A, Frutos-Vivar F, Esteban A, Alía I, Brochard L, Stewart T, Benito S, Tobin MJ, Elizalde J, Palizas F, David CM, Pimentel J, González M, Soto L, D'Empaire G, Pelosi P. Incidence, risk factors and outcome of barotrauma in mechanically ventilated patients. Intensive Care Med. 2004 Apr;30(4):612-9. doi: 10.1007/s00134-004-2187-7. Epub 2004 Feb 28. PMID: 14991090.
17. Ioannidis G, Lazaridis G, Baka S, Mpoukovinas I, Karavasilis V, Lampaki S, Kioumis I, Pitsiou G, Papaiwannou A, Karavergou A, Katsikogiannis N, Sarika E, Tsakiridis K, Korantzis I, Zarogoulidis K, Zarogoulidis P. Barotrauma and pneumothorax. J Thorac Dis. 2015 Feb;7(Suppl 1):S38-43. doi: 10.3978/j.issn.2072-1439.2015.01.31. PMID: 25774306; PMCID: PMC4332090.
18. Murayama S, Gibo S. Spontaneous pneumomediastinum and Macklin effect: Overview and appearance on computed tomography. World J Radiol. 2014 Nov 28;6(11):850-4. doi: 10.4329/wjr.v6.i11.850. PMID: 25431639; PMCID: PMC4241491.
19. Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;8:420-2.
20. Wintermark M, Schnyder P. The Macklin effect: a frequent etiology for pneumomediastinum in severe blunt chest trauma. Chest. 2001 Aug;120(2):543-7. doi: 10.1378/chest.120.2.543. PMID: 11502656.
21. Lei J, Li J, Li X, Qi X. CT Imaging of the 2019 Novel Coronavirus (2019-nCoV) Pneumonia. Radiology. 2020 Apr;295(1):18. doi: 10.1148/radiol.2020200236. Epub 2020 Jan 31. PMID: 32003646; PMCID: PMC7194019.
22. Caruso D, Polici M, Zerunian M, Pucciarelli F, Polidori T, Guido G, Rucci C, Bracci B, Muscogiuri E, De Dominicis C, Laghi A. Quantitative Chest CT analysis in discriminating COVID-19 from non-COVID-19 patients. Radiol Med. 2021 Feb;126(2):243-249. doi: 10.1007/s11547-020-01291-y. Epub 2020 Oct 12. PMID: 33044733; PMCID: PMC7548413.
23. Crossley D, Renton M, Khan M, Low EV, Turner AM. CT densitometry in emphysema: a systematic review of its clinical utility. Int J Chron Obstruct Pulmon Dis. 2018 Feb 7;13:547-563. doi: 10.2147/COPD.S143066. PMID: 29445272; PMCID: PMC5808715.
24. Mascalchi M, Camiciottoli G, Diciotti S. Lung densitometry: why, how and when. J Thorac Dis. 2017 Sep;9(9):3319-3345. doi: 10.21037/jtd.2017.08.17. PMID: 29221318; PMCID: PMC5708390.
25. Yu N, Shen C, Yu Y, Dang M, Cai S, Guo Y. Lung involvement in patients with coronavirus disease-19 (COVID-19): a retrospective study based on quantitative CT findings. Chin J Acad Radiol. 2020 May 11:1-6. doi: 10.1007/s42058-020-00034-2. Epub ahead of print. PMID: 32395696; PMCID: PMC7211979.
26. Lanza E, Muglia R, Bolengo I, Santonocito OG, Lisi C, Angelotti G, Morandini P, Savevski V, Politi LS, Balzarini L. Quantitative chest CT analysis in COVID-19 to predict the need for oxygenation support and intubation. Eur Radiol. 2020 Dec;30(12):6770-6778. doi: 10.1007/s00330-020-07013-2. Epub 2020 Jun 26. PMID: 32591888; PMCID: PMC7317888.
27. Song F, Shi N, Shan F, Zhang Z, Shen J, Lu H, Ling Y, Jiang Y, Shi Y. Emerging 2019 Novel Coronavirus (2019-nCoV) Pneumonia. Radiology. 2020 Apr;295(1):210-217. doi: 10.1148/radiol.2020200274. Epub 2020 Feb 6. Erratum in: Radiology. 2020 Dec;297(3):E346. PMID: 32027573; PMCID: PMC7233366.

Year 2022, Volume: 12 Issue: 2, 528 - 532, 30.06.2022

Bahattin Özkul Furkan Ertürk Urfalı Kıyasettin Asil

https://doi.org/10.33808/clinexphealthsci.1136688

Abstract

Project Number

References

1. Zhou, S., Wang, Y., Zhu, T., & Xia, L. (2020). CT Features of Coronavirus Disease 2019 (COVID-19) Pneumonia in 62 Patients in Wuhan, China. AJR. American journal of roentgenology, 214(6), 1287–1294.
2. Li, K., Fang, Y., Li, W., Pan, C., Qin, P., Zhong, Y., Liu, X., Huang, M., Liao, Y., & Li, S. (2020). CT image visual quantitative evaluation and clinical classification of coronavirus disease (COVID-19). European radiology, 30(8), 4407–4416.
3. Application of Hayat Eve Sığar, (2021) Ministry of Health, Turkey.
4. Tercanlı Alkış H., Yeşiltepe S., Kurtuldu E.. Examination of the Knowledge Levels, Attitudes and Anxiety Sources Regarding Coronavirus Disease-2019 Infection in Dentistry Students in Clinical Practice. Meandros Med Dent J 2021;22:69-76
5. Wang, K., Kang, S., Tian, R., Zhang, X., Zhang, X., & Wang, Y. (2020). Imaging manifestations and diagnostic value of chest CT of coronavirus disease 2019 (COVID-19) in the Xiaogan area. Clinical radiology, 75(5), 341–347.
6. Zhao, X., Liu, B., Yu, Y., Wang, X., Du, Y., Gu, J., & Wu, X. (2020). The characteristics and clinical value of chest CT images of novel coronavirus pneumonia. Clinical radiology, 75(5), 335–340.
7. Ai, T., Yang, Z., Hou, H., Zhan, C., Chen, C., Lv, W., Tao, Q., Sun, Z., & Xia, L. (2020). Correlation of Chest CT and RT-PCR Testing for Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology, 296(2), E32–E40.
8. Fan, N., Fan, W., Li, Z., Shi, M., & Liang, Y. (2020). Imaging characteristics of initial chest computed tomography and clinical manifestations of patients with COVID-19 pneumonia. Japanese journal of radiology, 38(6), 533–538.
9. Zhao, W., Zhong, Z., Xie, X., Yu, Q., & Liu, J. (2020). Relation Between Chest CT Findings and Clinical Conditions of Coronavirus Disease (COVID-19) Pneumonia: A Multicenter Study. AJR. American journal of roentgenology, 214(5), 1072–1077.
10. Pan, F., Ye, T., Sun, P., Gui, S., Liang, B., Li, L., Zheng, D., Wang, J., Hesketh, R. L., Yang, L., & Zheng, C. (2020). Time Course of Lung Changes at Chest CT during Recovery from Coronavirus Disease 2019 (COVID-19). Radiology, 295(3), 715–721.
11. Iwasawa, T., Sato, M., Yamaya, T., Sato, Y., Uchida, Y., Kitamura, H., Hagiwara, E., Komatsu, S., Utsunomiya, D., & Ogura, T. (2020). Ultra-high-resolution computed tomography can demonstrate alveolar collapse in novel coronavirus (COVID-19) pneumonia. Japanese journal of radiology, 38(5), 394–398.
12. Hruban, R. H., Meziane, M. A., Zerhouni, E. A., Khouri, N. F., Fishman, E. K., Wheeler, P. S., Dumler, J. S., & Hutchins, G. M. (1987). High resolution computed tomography of inflation-fixed lungs. Pathologic-radiologic correlation of centrilobular emphysema. The American review of respiratory disease, 136(4), 935–940.
13. Bradley BT, Maioli H, Johnston R, Chaudhry I, Fink SL, Xu H, Najafian B, Deutsch G, Lacy JM, Williams T, Yarid N, Marshall DA. Histopathology and ultrastructural findings of fatal COVID-19 infections in Washington State: a case series. Lancet. 2020 Aug 1;396(10247):320-332. doi: 10.1016/S0140-6736(20)31305-2. Epub 2020 Jul 16. Erratum in: Lancet. 2020 Aug 1;396(10247):312. PMID: 32682491; PMCID: PMC7365650.
14. Kommoss FKF, Schwab C, Tavernar L, Schreck J, Wagner WL, Merle U, Jonigk D, Schirmacher P, Longerich T. The Pathology of Severe COVID-19-Related Lung Damage. Dtsch Arztebl Int. 2020 Jul 20;117(29-30):500-506. doi: 10.3238/arztebl.2020.0500. PMID: 32865490; PMCID: PMC7588618.
15. Lemmers DHL, Abu Hilal M, Bnà C, Prezioso C, Cavallo E, Nencini N, Crisci S, Fusina F, Natalini G. Pneumomediastinum and subcutaneous emphysema in COVID-19: barotrauma or lung frailty? ERJ Open Res. 2020 Nov 16;6(4):00385-2020. doi: 10.1183/23120541.00385-2020. PMID: 33257914; PMCID: PMC7537408.
16. Anzueto A, Frutos-Vivar F, Esteban A, Alía I, Brochard L, Stewart T, Benito S, Tobin MJ, Elizalde J, Palizas F, David CM, Pimentel J, González M, Soto L, D'Empaire G, Pelosi P. Incidence, risk factors and outcome of barotrauma in mechanically ventilated patients. Intensive Care Med. 2004 Apr;30(4):612-9. doi: 10.1007/s00134-004-2187-7. Epub 2004 Feb 28. PMID: 14991090.
17. Ioannidis G, Lazaridis G, Baka S, Mpoukovinas I, Karavasilis V, Lampaki S, Kioumis I, Pitsiou G, Papaiwannou A, Karavergou A, Katsikogiannis N, Sarika E, Tsakiridis K, Korantzis I, Zarogoulidis K, Zarogoulidis P. Barotrauma and pneumothorax. J Thorac Dis. 2015 Feb;7(Suppl 1):S38-43. doi: 10.3978/j.issn.2072-1439.2015.01.31. PMID: 25774306; PMCID: PMC4332090.
18. Murayama S, Gibo S. Spontaneous pneumomediastinum and Macklin effect: Overview and appearance on computed tomography. World J Radiol. 2014 Nov 28;6(11):850-4. doi: 10.4329/wjr.v6.i11.850. PMID: 25431639; PMCID: PMC4241491.
19. Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;8:420-2.
20. Wintermark M, Schnyder P. The Macklin effect: a frequent etiology for pneumomediastinum in severe blunt chest trauma. Chest. 2001 Aug;120(2):543-7. doi: 10.1378/chest.120.2.543. PMID: 11502656.
21. Lei J, Li J, Li X, Qi X. CT Imaging of the 2019 Novel Coronavirus (2019-nCoV) Pneumonia. Radiology. 2020 Apr;295(1):18. doi: 10.1148/radiol.2020200236. Epub 2020 Jan 31. PMID: 32003646; PMCID: PMC7194019.
22. Caruso D, Polici M, Zerunian M, Pucciarelli F, Polidori T, Guido G, Rucci C, Bracci B, Muscogiuri E, De Dominicis C, Laghi A. Quantitative Chest CT analysis in discriminating COVID-19 from non-COVID-19 patients. Radiol Med. 2021 Feb;126(2):243-249. doi: 10.1007/s11547-020-01291-y. Epub 2020 Oct 12. PMID: 33044733; PMCID: PMC7548413.
23. Crossley D, Renton M, Khan M, Low EV, Turner AM. CT densitometry in emphysema: a systematic review of its clinical utility. Int J Chron Obstruct Pulmon Dis. 2018 Feb 7;13:547-563. doi: 10.2147/COPD.S143066. PMID: 29445272; PMCID: PMC5808715.
24. Mascalchi M, Camiciottoli G, Diciotti S. Lung densitometry: why, how and when. J Thorac Dis. 2017 Sep;9(9):3319-3345. doi: 10.21037/jtd.2017.08.17. PMID: 29221318; PMCID: PMC5708390.
25. Yu N, Shen C, Yu Y, Dang M, Cai S, Guo Y. Lung involvement in patients with coronavirus disease-19 (COVID-19): a retrospective study based on quantitative CT findings. Chin J Acad Radiol. 2020 May 11:1-6. doi: 10.1007/s42058-020-00034-2. Epub ahead of print. PMID: 32395696; PMCID: PMC7211979.
26. Lanza E, Muglia R, Bolengo I, Santonocito OG, Lisi C, Angelotti G, Morandini P, Savevski V, Politi LS, Balzarini L. Quantitative chest CT analysis in COVID-19 to predict the need for oxygenation support and intubation. Eur Radiol. 2020 Dec;30(12):6770-6778. doi: 10.1007/s00330-020-07013-2. Epub 2020 Jun 26. PMID: 32591888; PMCID: PMC7317888.
27. Song F, Shi N, Shan F, Zhang Z, Shen J, Lu H, Ling Y, Jiang Y, Shi Y. Emerging 2019 Novel Coronavirus (2019-nCoV) Pneumonia. Radiology. 2020 Apr;295(1):210-217. doi: 10.1148/radiol.2020200274. Epub 2020 Feb 6. Erratum in: Radiology. 2020 Dec;297(3):E346. PMID: 32027573; PMCID: PMC7233366.

There are 27 citations in total.

Details

Primary Language	English
Subjects	Health Care Administration
Journal Section	Articles
Authors	Bahattin Özkul 0000-0003-3339-8329 Furkan Ertürk Urfalı 0000-0002-4875-7761 Kıyasettin Asil 0000-0001-9927-6282
Project Number	-
Publication Date	June 30, 2022
Submission Date	June 27, 2022
Published in Issue	Year 2022 Volume: 12 Issue: 2

Cite

APA	Özkul, B., Urfalı, F. E., & Asil, K. (2022). Quantitative Evaluation of Lung Parenchyma Changes after Treatment in COVID-19 Pneumonia with Volumetric Study in Computed Tomography. Clinical and Experimental Health Sciences, 12(2), 528-532. https://doi.org/10.33808/clinexphealthsci.1136688
AMA	Özkul B, Urfalı FE, Asil K. Quantitative Evaluation of Lung Parenchyma Changes after Treatment in COVID-19 Pneumonia with Volumetric Study in Computed Tomography. Clinical and Experimental Health Sciences. June 2022;12(2):528-532. doi:10.33808/clinexphealthsci.1136688
Chicago	Özkul, Bahattin, Furkan Ertürk Urfalı, and Kıyasettin Asil. “Quantitative Evaluation of Lung Parenchyma Changes After Treatment in COVID-19 Pneumonia With Volumetric Study in Computed Tomography”. Clinical and Experimental Health Sciences 12, no. 2 (June 2022): 528-32. https://doi.org/10.33808/clinexphealthsci.1136688.
EndNote	Özkul B, Urfalı FE, Asil K (June 1, 2022) Quantitative Evaluation of Lung Parenchyma Changes after Treatment in COVID-19 Pneumonia with Volumetric Study in Computed Tomography. Clinical and Experimental Health Sciences 12 2 528–532.
IEEE	B. Özkul, F. E. Urfalı, and K. Asil, “Quantitative Evaluation of Lung Parenchyma Changes after Treatment in COVID-19 Pneumonia with Volumetric Study in Computed Tomography”, Clinical and Experimental Health Sciences, vol. 12, no. 2, pp. 528–532, 2022, doi: 10.33808/clinexphealthsci.1136688.
ISNAD	Özkul, Bahattin et al. “Quantitative Evaluation of Lung Parenchyma Changes After Treatment in COVID-19 Pneumonia With Volumetric Study in Computed Tomography”. Clinical and Experimental Health Sciences 12/2 (June 2022), 528-532. https://doi.org/10.33808/clinexphealthsci.1136688.
JAMA	Özkul B, Urfalı FE, Asil K. Quantitative Evaluation of Lung Parenchyma Changes after Treatment in COVID-19 Pneumonia with Volumetric Study in Computed Tomography. Clinical and Experimental Health Sciences. 2022;12:528–532.
MLA	Özkul, Bahattin et al. “Quantitative Evaluation of Lung Parenchyma Changes After Treatment in COVID-19 Pneumonia With Volumetric Study in Computed Tomography”. Clinical and Experimental Health Sciences, vol. 12, no. 2, 2022, pp. 528-32, doi:10.33808/clinexphealthsci.1136688.
Vancouver	Özkul B, Urfalı FE, Asil K. Quantitative Evaluation of Lung Parenchyma Changes after Treatment in COVID-19 Pneumonia with Volumetric Study in Computed Tomography. Clinical and Experimental Health Sciences. 2022;12(2):528-32.

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