Organizing pneumonia of COVID-19: Time-dependent evolution and outcome in CT findings
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Abstract
As a pandemic, a most-common pattern resembled organizing pneumonia (OP) has been identified by CT findings in novel coronavirus disease (COVID-19). We aimed to delineate the evolution of CT findings and outcome in OP of COVID-19.
Materials and methods
106 COVID-19 patients with OP based on CT findings were retrospectively included and categorized into non-severe (mild/common) and severe (severe/critical) groups. CT features including lobar distribution, presence of ground glass opacities (GGO), consolidation, linear opacities and total severity CT score were evaluated at three time intervals from symptom-onset to CT scan (day 0–7, day 8–14, day > 14). Discharge or adverse outcome (admission to ICU or death), and pulmonary sequelae (complete absorption or lesion residuals) on CT after discharge were analyzed based on the CT features at different time interval.
Results
79 (74.5%) patients were non-severe and 103 (97.2%) were discharged at median day 25 (range, day 8–50) after symptom-onset. Of 67 patients with revisit CT at 2–4 weeks after discharge, 20 (29.9%) had complete absorption of lesions at median day 38 (range, day 30–53) after symptom-onset. Significant differences between complete absorption and residuals groups were found in percentages of consolidation (1.5% vs. 13.8%, P = 0.010), number of involved lobe > 3 (40.0% vs. 72.5%, P = 0.030), CT score > 4 (20.0% vs. 65.0%, P = 0.010) at day 8–14.
Conclusion
Most OP cases had good prognosis. Approximately one-third of cases had complete absorption of lesions during 1–2 months after symptom-onset while those with increased frequency of consolidation, number of involved lobe > 3, and CT score > 4 at week 2 after symptom-onset may indicate lesion residuals on CT.
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SciScore for 10.1101/2020.05.22.20109934: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: Patients: This retrospective study was approved by the institutional review board and informed patients’ consent was waived with approval.
Consent: Patients: This retrospective study was approved by the institutional review board and informed patients’ consent was waived with approval.Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Software and Algorithms Sentences Resources All the statistical analyses were performed in the IBM SPSS Statistics Software (version 22; IBM, New York, USA). SPSSsuggested: (SPSS, RRID:SCR_002865)Results from OddPub: We did not detect open data. We …
SciScore for 10.1101/2020.05.22.20109934: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: Patients: This retrospective study was approved by the institutional review board and informed patients’ consent was waived with approval.
Consent: Patients: This retrospective study was approved by the institutional review board and informed patients’ consent was waived with approval.Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Software and Algorithms Sentences Resources All the statistical analyses were performed in the IBM SPSS Statistics Software (version 22; IBM, New York, USA). SPSSsuggested: (SPSS, RRID:SCR_002865)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:There were several limitations in this study. First was the relatively small sample and retrospective nature. A larger sample is required to further validate the findings regarding OP of COVID-19. Second, the follow-up period for patients is relatively short and many of residual lesions on CT may be reversible, a long-term follow-up in conjunction with lung function tests would help to further clarify the evolution of residual lesions and its relations with lung function. Third, although pathological evidence is scarce, highly resembled CT features of OP were used to define the OP pattern of COVID-19 in this study. Pathological studies are still needed to validate the OP of COVID-19. In conclusion, as a most common pattern of COVID-19, majority of OP cases were mild or common and had good prognosis. Approximately one-third of OP cases had complete absorption of lesions during 1-2 month after symptom onset while those with increased frequency of pure consolidation, number of involved lung lobe >3, and CT score >4 at week 2 after symptom onset were prone to have pulmonary residuals.
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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