TY - JOUR
T1 - Remarkable vessel enlargement within lung consolidation in COVID-19 compared to AH1N1 pneumonia
T2 - A retrospective study in Italy
AU - study investigators
AU - Bianco, Andrea
AU - Valente, Tullio
AU - Perrotta, Fabio
AU - Stellato, Elvira
AU - Brunese, Luca
AU - Wood, Brad J.
AU - Carrafiello, Gianpaolo
AU - Parrella, Roberto
AU - Aronne, Luigi
AU - Boccia, Matilde
AU - Lassandro, Francesco
AU - Lassandro, Giulia
AU - Rea, Gaetano
AU - Scialò, Filippo
N1 - Funding Information:
Work supported in part by the NIH Center for Interventional Oncology and the Intramural Research Program of the NIH.
Publisher Copyright:
© 2021
PY - 2021/5
Y1 - 2021/5
N2 - Purpose: To investigate the early CT findings in COVID-19 pneumonia as compared to influenza A virus H1N1 (AH1N1), with focus on vascular enlargement within consolidation or ground glass opacity (GGO) areas. Methods: 50 patients with COVID-19 pneumonia were retrospectively compared to 50 patients with AH1N1 pneumonia diagnosed during the 2009 pandemic. Two radiologists reviewed chest CT scans independently and blindly, with discordance resolved by consensus. Dilated or tortuous vessels within hyperdense lesions were recorded. Results: COVID-19 pneumonia presented with bilateral (96%), peripheral areas of GGO (22%), consolidation (4%) or combined GGO-consolidation (74%). The vascular enlargement sign in COVID-19 pneumonia was much more commonly present in COVID-19 (45/50, 90%) versus AH1N1 pneumonia (12/50, 24%) (p < 0.001). Vascular enlargement was more often present in lower lobes with a peripheral distribution. Conclusions: Vascular enlargement in consolidative/GGO areas may represent a reasonably common early CT marker in COVID-19 patients and is of uncertain etiology. Although speculative, theoretical mechanisms could potentially reflect acute inflammatory changes, pulmonary endothelial activation, or acute stasis. Further studies are necessary to verify specificity and to study if prognostic for clinical outcomes.
AB - Purpose: To investigate the early CT findings in COVID-19 pneumonia as compared to influenza A virus H1N1 (AH1N1), with focus on vascular enlargement within consolidation or ground glass opacity (GGO) areas. Methods: 50 patients with COVID-19 pneumonia were retrospectively compared to 50 patients with AH1N1 pneumonia diagnosed during the 2009 pandemic. Two radiologists reviewed chest CT scans independently and blindly, with discordance resolved by consensus. Dilated or tortuous vessels within hyperdense lesions were recorded. Results: COVID-19 pneumonia presented with bilateral (96%), peripheral areas of GGO (22%), consolidation (4%) or combined GGO-consolidation (74%). The vascular enlargement sign in COVID-19 pneumonia was much more commonly present in COVID-19 (45/50, 90%) versus AH1N1 pneumonia (12/50, 24%) (p < 0.001). Vascular enlargement was more often present in lower lobes with a peripheral distribution. Conclusions: Vascular enlargement in consolidative/GGO areas may represent a reasonably common early CT marker in COVID-19 patients and is of uncertain etiology. Although speculative, theoretical mechanisms could potentially reflect acute inflammatory changes, pulmonary endothelial activation, or acute stasis. Further studies are necessary to verify specificity and to study if prognostic for clinical outcomes.
KW - AH1N1 influenza
KW - Chest computed tomography
KW - COVID-19
KW - SARS-CoV-2
KW - Vascular enlargement
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U2 - 10.1016/j.heliyon.2021.e07112
DO - 10.1016/j.heliyon.2021.e07112
M3 - Article
AN - SCOPUS:85106945975
VL - 7
JO - Heliyon
JF - Heliyon
SN - 2405-8440
IS - 5
M1 - e07112
ER -