P5-118: Clinical outcomes of diffuse alveolar damage and organising pneumonia in severe COVID-19 infection
Page Source : https://onlinelibrary.wiley.com/doi/10.1111/resp.14150_325
Ka Kiat Chin, Chee Kuan Wong, Wai Yee Chan, Chong Kin Liam, Yong Kek Pang, Mau Ern Poh, Jiunn Liang Tan, Chun Ian Soo, Thian Chee Loh, Vijayan Munusamy, Nur Husna Ibrahim
Department of Medicine, Faculty of Medicine, University of Malaya, Malaysia, Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Malaysia
Background and Aims: Diffuse alveolar damage (DAD) and organising pneumonia (OP) are lung organisation responses to injury from COVID-19 infection. We aim to evaluate the clinical characteristics and outcome of DAD and OP.
Methods: 22 patients with severe COVID-19 pneumonia were retrospectively reviewed. Chest CT patterns were categorised into DAD, OP or progressive OP. The degree of lobar involvement on CT were scored 0-4 (0=0%, 1≤25%, 2= 26-50%, 3= 51-75%, 4>75%) for each lobe.
Results: The median age of the patients was 64 (range, 33-79) years. All patients had chest CT at a median of 10 (range, 4-18) days from symptom onset, 10 (45.4%) had DAD and 12 had OP or progressive OP. All patients with DAD had a CT score of ≥10 and 9 received high flow nasal cannula or mechanical ventilatory support. The average PaO2/FiO2 ratio was lower in patients with DAD than those with OP or progressive OP (113 VS 179). All patients received systemic corticosteroids [median duration, 47.5 (range, 3-129) days] and 12 (54.5%) had pulse methylprednisolone therapy. The median length of hospital stay was 18.5 (range, 9-42) days. All patients were discharged home without the need for domiciliary oxygen therapy. All 19 patients with follow-up CXR showed radiological improvement after a median of 68 (range, 33-171) days from symptom onset.
Conclusions: Most cases of DAD and OP in severe COVID-19 pneumonia have a good outcome. A larger cohort study is needed to determine the prognosis of the different CT patterns of severe COVID-19 pneumonia.
