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01-02-2021 | Ultrasound | Original

Ultrasound assessment of pulmonary fibroproliferative changes in severe COVID-19: a quantitative correlation study with histopathological findings

Authors: Renata Aparecida de Almeida Monteiro, Amaro Nunes Duarte-Neto, Luiz Fernando Ferraz da Silva, Ellen Pierre de Oliveira, Ellen Caroline Toledo do Nascimento, Thais Mauad, Paulo Hilário do Nascimento Saldiva, Marisa Dolhnikoff

Published in: Intensive Care Medicine | Issue 2/2021

Abstract

Purpose

This study was designed to evaluate the usefulness of lung ultrasound (LUS) imaging to characterize the progression and severity of lung damage in cases of COVID-19.

Methods

We employed a set of combined ultrasound parameters and histopathological images obtained simultaneously in 28 patients (15 women, 0.6–83 years) with fatal COVID-19 submitted to minimally invasive autopsies, with different times of disease evolution from initial symptoms to death (3–37 days, median 18 days). For each patient, we analysed eight post-mortem LUS parameters and the proportion of three histological patterns (normal lung, exudative diffuse alveolar damage [DAD] and fibroproliferative DAD) in eight different lung regions. The relationship between histopathological and post-mortem ultrasonographic findings was assessed using various statistical approaches.

Results

Statistically significant positive correlations were observed between fibroproliferative DAD and peripheral consolidation (coefficient 0.43, p = 0.02) and pulmonary consolidation (coefficient 0.51, p = 0.005). A model combining age, time of evolution, sex and ultrasound score predicted reasonably well (r = 0.66) the proportion of pulmonary parenchyma with fibroproliferative DAD.

Conclusion

The present study adds information to previous studies related to the use of LUS as a tool to assess the severity of acute pulmonary damage. We provide a histological background that supports the concept that LUS can be used to characterize the progression and severity of lung damage in severe COVID-19.

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Title: Ultrasound assessment of pulmonary fibroproliferative changes in severe COVID-19: a quantitative correlation study with histopathological findings
Authors: Renata Aparecida de Almeida Monteiro
Amaro Nunes Duarte-Neto
Luiz Fernando Ferraz da Silva
Ellen Pierre de Oliveira
Ellen Caroline Toledo do Nascimento
Thais Mauad
Paulo Hilário do Nascimento Saldiva
Marisa Dolhnikoff
Publication date: 01-02-2021
Publisher: Springer Berlin Heidelberg
Keywords: Ultrasound
Autopsy
Acute Respiratory Distress-Syndrome
COVID-19
Ultrasound
Lung Ultrasound
Published in: Intensive Care Medicine / Issue 2/2021
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-020-06328-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Ultrasound assessment of pulmonary fibroproliferative changes in severe COVID-19: a quantitative correlation study with histopathological findings

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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