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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doaj-e11163a68492444bb454d092498fb5bb2021-07-23T13:46:09ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672021-07-01227498749810.3390/ijms22147498Extension of Collagen Deposition in COVID-19 Post Mortem Lung Samples and Computed Tomography Analysis FindingsLorenzo Ball0Emanuela Barisione1Luca Mastracci2Michela Campora3Delfina Costa4Chiara Robba5Denise Battaglini6Marco Micali7Federico Costantino8Giuseppe Cittadini9Nicolò Patroniti10Paolo Pelosi11Roberto Fiocca12Federica Grillo13Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16126 Genoa, ItalyInterventional Pulmonology Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, ItalyDepartment of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16126 Genoa, ItalySurgical Pathology Unit, Santa Chiara Hospital, Provincial Agency for Health Services, 38122 Trento, ItalyMolecular Oncology and Angiogenesis Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, ItalyDepartment of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16126 Genoa, ItalyAnesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, ItalyDepartment of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16126 Genoa, ItalyDepartment of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16126 Genoa, ItalyRadiology Department, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, ItalyDepartment of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16126 Genoa, ItalyDepartment of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16126 Genoa, ItalyDepartment of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16126 Genoa, ItalyDepartment of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16126 Genoa, ItalyLung 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), <i>p</i> = 0.036) while the gas fraction was lower (0.46 (0.32–0.47) vs. 0.59 (0.37–0.68), <i>p</i> = 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.https://www.mdpi.com/1422-0067/22/14/7498COVID-19fibrosiscollagencomputed tomography |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Lorenzo Ball Emanuela Barisione Luca Mastracci Michela Campora Delfina Costa Chiara Robba Denise Battaglini Marco Micali Federico Costantino Giuseppe Cittadini Nicolò Patroniti Paolo Pelosi Roberto Fiocca Federica Grillo |
spellingShingle |
Lorenzo Ball Emanuela Barisione Luca Mastracci Michela Campora Delfina Costa Chiara Robba Denise Battaglini Marco Micali Federico Costantino Giuseppe Cittadini Nicolò Patroniti Paolo Pelosi Roberto Fiocca Federica Grillo Extension of Collagen Deposition in COVID-19 Post Mortem Lung Samples and Computed Tomography Analysis Findings International Journal of Molecular Sciences COVID-19 fibrosis collagen computed tomography |
author_facet |
Lorenzo Ball Emanuela Barisione Luca Mastracci Michela Campora Delfina Costa Chiara Robba Denise Battaglini Marco Micali Federico Costantino Giuseppe Cittadini Nicolò Patroniti Paolo Pelosi Roberto Fiocca Federica Grillo |
author_sort |
Lorenzo Ball |
title |
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_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_sort |
extension of collagen deposition in covid-19 post mortem lung samples and computed tomography analysis findings |
publisher |
MDPI AG |
series |
International Journal of Molecular Sciences |
issn |
1661-6596 1422-0067 |
publishDate |
2021-07-01 |
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), <i>p</i> = 0.036) while the gas fraction was lower (0.46 (0.32–0.47) vs. 0.59 (0.37–0.68), <i>p</i> = 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. |
topic |
COVID-19 fibrosis collagen computed tomography |
url |
https://www.mdpi.com/1422-0067/22/14/7498 |
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