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Extension of Collagen Deposition in COVID-19 Post Mortem Lung Samples and Computed Tomography Analysis Findings

Lung fibrosis has specific computed tomography (CT) findings and represents a common finding in advanced COVID-19 pneumonia whose reversibility has been poorly investigated. The aim of this study was to quantify the extension of collagen deposition and aeration in postmortem cryobiopsies of critical...

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Autores principales: Ball, Lorenzo, Barisione, Emanuela, Mastracci, Luca, Campora, Michela, Costa, Delfina, Robba, Chiara, Battaglini, Denise, Micali, Marco, Costantino, Federico, Cittadini, Giuseppe, Patroniti, Nicolò, Pelosi, Paolo, Fiocca, Roberto, Grillo, Federica
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8305333/
https://www.ncbi.nlm.nih.gov/pubmed/34299124
http://dx.doi.org/10.3390/ijms22147498
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author Ball, Lorenzo
Barisione, Emanuela
Mastracci, Luca
Campora, Michela
Costa, Delfina
Robba, Chiara
Battaglini, Denise
Micali, Marco
Costantino, Federico
Cittadini, Giuseppe
Patroniti, Nicolò
Pelosi, Paolo
Fiocca, Roberto
Grillo, Federica
author_facet Ball, Lorenzo
Barisione, Emanuela
Mastracci, Luca
Campora, Michela
Costa, Delfina
Robba, Chiara
Battaglini, Denise
Micali, Marco
Costantino, Federico
Cittadini, Giuseppe
Patroniti, Nicolò
Pelosi, Paolo
Fiocca, Roberto
Grillo, Federica
author_sort Ball, Lorenzo
collection PubMed
description Lung fibrosis has specific computed tomography (CT) findings and represents a common finding in advanced COVID-19 pneumonia whose reversibility has been poorly investigated. The aim of this study was to quantify the extension of collagen deposition and aeration in postmortem cryobiopsies of critically ill COVID-19 patients and to describe the correlations with qualitative and quantitative analyses of lung CT. Postmortem transbronchial cryobiopsy samples were obtained, formalin fixed, paraffin embedded and stained with Sirius red to quantify collagen deposition, defining fibrotic samples as those with collagen deposition above 10%. Lung CT images were analyzed qualitatively with a radiographic score and quantitatively with computer-based analysis at the lobe level. Thirty samples from 10 patients with COVID-19 pneumonia deceased during invasive mechanical ventilation were included in this study. The median [interquartile range] percent collagen extension was 6.8% (4.6–16.2%). In fibrotic compared to nonfibrotic samples, the qualitative score was higher (260 (250–290) vs. 190 (120–270), p = 0.036) while the gas fraction was lower (0.46 (0.32–0.47) vs. 0.59 (0.37–0.68), p = 0.047). A radiographic score above 230 had 100% sensitivity (95% confidence interval, CI: 66.4% to 100%) and 66.7% specificity (95% CI: 41.0% to 92.3%) to detect fibrotic samples, while a gas fraction below 0.57 had 100% sensitivity (95% CI: 66.4% to 100%) and 57.1% specificity (95% CI: 26.3% to 88.0%). In COVID-19 pneumonia, qualitative and quantitative analyses of lung CT images have high sensitivity but moderate to low specificity to detect histopathological fibrosis. Pseudofibrotic CT findings do not always correspond to increased collagen deposition.
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spelling pubmed-83053332021-07-25 Extension of Collagen Deposition in COVID-19 Post Mortem Lung Samples and Computed Tomography Analysis Findings Ball, Lorenzo Barisione, Emanuela Mastracci, Luca Campora, Michela Costa, Delfina Robba, Chiara Battaglini, Denise Micali, Marco Costantino, Federico Cittadini, Giuseppe Patroniti, Nicolò Pelosi, Paolo Fiocca, Roberto Grillo, Federica Int J Mol Sci Article Lung fibrosis has specific computed tomography (CT) findings and represents a common finding in advanced COVID-19 pneumonia whose reversibility has been poorly investigated. The aim of this study was to quantify the extension of collagen deposition and aeration in postmortem cryobiopsies of critically ill COVID-19 patients and to describe the correlations with qualitative and quantitative analyses of lung CT. Postmortem transbronchial cryobiopsy samples were obtained, formalin fixed, paraffin embedded and stained with Sirius red to quantify collagen deposition, defining fibrotic samples as those with collagen deposition above 10%. Lung CT images were analyzed qualitatively with a radiographic score and quantitatively with computer-based analysis at the lobe level. Thirty samples from 10 patients with COVID-19 pneumonia deceased during invasive mechanical ventilation were included in this study. The median [interquartile range] percent collagen extension was 6.8% (4.6–16.2%). In fibrotic compared to nonfibrotic samples, the qualitative score was higher (260 (250–290) vs. 190 (120–270), p = 0.036) while the gas fraction was lower (0.46 (0.32–0.47) vs. 0.59 (0.37–0.68), p = 0.047). A radiographic score above 230 had 100% sensitivity (95% confidence interval, CI: 66.4% to 100%) and 66.7% specificity (95% CI: 41.0% to 92.3%) to detect fibrotic samples, while a gas fraction below 0.57 had 100% sensitivity (95% CI: 66.4% to 100%) and 57.1% specificity (95% CI: 26.3% to 88.0%). In COVID-19 pneumonia, qualitative and quantitative analyses of lung CT images have high sensitivity but moderate to low specificity to detect histopathological fibrosis. Pseudofibrotic CT findings do not always correspond to increased collagen deposition. MDPI 2021-07-13 /pmc/articles/PMC8305333/ /pubmed/34299124 http://dx.doi.org/10.3390/ijms22147498 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ball, Lorenzo
Barisione, Emanuela
Mastracci, Luca
Campora, Michela
Costa, Delfina
Robba, Chiara
Battaglini, Denise
Micali, Marco
Costantino, Federico
Cittadini, Giuseppe
Patroniti, Nicolò
Pelosi, Paolo
Fiocca, Roberto
Grillo, Federica
Extension of Collagen Deposition in COVID-19 Post Mortem Lung Samples and Computed Tomography Analysis Findings
title Extension of Collagen Deposition in COVID-19 Post Mortem Lung Samples and Computed Tomography Analysis Findings
title_full Extension of Collagen Deposition in COVID-19 Post Mortem Lung Samples and Computed Tomography Analysis Findings
title_fullStr Extension of Collagen Deposition in COVID-19 Post Mortem Lung Samples and Computed Tomography Analysis Findings
title_full_unstemmed Extension of Collagen Deposition in COVID-19 Post Mortem Lung Samples and Computed Tomography Analysis Findings
title_short Extension of Collagen Deposition in COVID-19 Post Mortem Lung Samples and Computed Tomography Analysis Findings
title_sort extension of collagen deposition in covid-19 post mortem lung samples and computed tomography analysis findings
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8305333/
https://www.ncbi.nlm.nih.gov/pubmed/34299124
http://dx.doi.org/10.3390/ijms22147498
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