Usage of compromised lung volume in monitoring steroid therapy on severe COVID-19

Background Quantitative computed tomography (QCT) analysis may serve as a tool for assessing the severity of coronavirus disease 2019 (COVID-19) and for monitoring its progress. The present study aimed to assess the association between steroid therapy and quantitative CT parameters in a longitudinal cohort with COVID-19. Methods Between February 7 and February 17, 2020, 72 patients with severe COVID-19 were retrospectively enrolled. All 300 chest CT scans from these patients were collected and classified into five stages according to the interval between hospital admission and follow-up CT scans: Stage 1 (at admission); Stage 2 (3–7 days); Stage 3 (8–14 days); Stage 4 (15–21 days); and Stage 5 (22–31 days). QCT was performed using a threshold-based quantitative analysis to segment the lung according to different Hounsfield unit (HU) intervals. The primary outcomes were changes in percentage of compromised lung volume (%CL, − 500 to 100 HU) at different stages. Multivariate Generalized Estimating Equations were performed after adjusting for potential confounders. Results Of 72 patients, 31 patients (43.1%) received steroid therapy. Steroid therapy was associated with a decrease in %CL (− 3.27% [95% CI, − 5.86 to − 0.68, P = 0.01]) after adjusting for duration and baseline %CL. Associations between steroid therapy and changes in %CL varied between different stages or baseline %CL (all interactions, P < 0.01). Steroid therapy was associated with decrease in %CL after stage 3 (all P < 0.05), but not at stage 2. Similarly, steroid therapy was associated with a more significant decrease in %CL in the high CL group (P < 0.05), but not in the low CL group. Conclusions Steroid administration was independently associated with a decrease in %CL, with interaction by duration or disease severity in a longitudinal cohort. The quantitative CT parameters, particularly compromised lung volume, may provide a useful tool to monitor COVID-19 progression during the treatment process. Trial registration Clinicaltrials.gov, NCT04953247. Registered July 7, 2021, https://clinicaltrials.gov/ct2/show/NCT04953247.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:23

Enthalten in:

Respiratory research - 23(2022), 1 vom: 29. Apr.

Sprache:

Englisch

Beteiligte Personen:

Su, Ying [VerfasserIn]
Qiu, Ze-song [VerfasserIn]
Chen, Jun [VerfasserIn]
Ju, Min-jie [VerfasserIn]
Ma, Guo-guang [VerfasserIn]
He, Jin-wei [VerfasserIn]
Yu, Shen-ji [VerfasserIn]
Liu, Kai [VerfasserIn]
Lure, Fleming Y. M. [VerfasserIn]
Tu, Guo-wei [VerfasserIn]
Zhang, Yu-yao [VerfasserIn]
Luo, Zhe [VerfasserIn]

Links:

Volltext [kostenfrei]

Themen:

COVID-19
Compromised lung volume
Quantitative computed tomography
Steroid

Anmerkungen:

© The Author(s) 2022

doi:

10.1186/s12931-022-02025-6

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC2130322859

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