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Article

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

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Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16126 Genoa, Italy
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Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
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Interventional Pulmonology Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
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Anatomic Pathology Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
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Surgical Pathology Unit, Santa Chiara Hospital, Provincial Agency for Health Services, 38122 Trento, Italy
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Molecular Oncology and Angiogenesis Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
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Radiology Department, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Alexander Schramm
Int. J. Mol. Sci. 2021, 22(14), 7498; https://doi.org/10.3390/ijms22147498
Received: 3 June 2021 / Revised: 30 June 2021 / Accepted: 9 July 2021 / Published: 13 July 2021
(This article belongs to the Special Issue Molecular Research on Fibrotic Interstitial Lung Diseases)
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. View Full-Text
Keywords: COVID-19; fibrosis; collagen; computed tomography COVID-19; fibrosis; collagen; computed tomography
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MDPI and ACS Style

Ball, L.; Barisione, E.; Mastracci, L.; Campora, M.; Costa, D.; Robba, C.; Battaglini, D.; Micali, M.; Costantino, F.; Cittadini, G.; Patroniti, N.; Pelosi, P.; Fiocca, R.; Grillo, F. Extension of Collagen Deposition in COVID-19 Post Mortem Lung Samples and Computed Tomography Analysis Findings. Int. J. Mol. Sci. 2021, 22, 7498. https://doi.org/10.3390/ijms22147498

AMA Style

Ball L, Barisione E, Mastracci L, Campora M, Costa D, Robba C, Battaglini D, Micali M, Costantino F, Cittadini G, Patroniti N, Pelosi P, Fiocca R, Grillo F. Extension of Collagen Deposition in COVID-19 Post Mortem Lung Samples and Computed Tomography Analysis Findings. International Journal of Molecular Sciences. 2021; 22(14):7498. https://doi.org/10.3390/ijms22147498

Chicago/Turabian Style

Ball, Lorenzo, Emanuela Barisione, Luca Mastracci, Michela Campora, Delfina Costa, Chiara Robba, Denise Battaglini, Marco Micali, Federico Costantino, Giuseppe Cittadini, Nicolò Patroniti, Paolo Pelosi, Roberto Fiocca, and Federica Grillo. 2021. "Extension of Collagen Deposition in COVID-19 Post Mortem Lung Samples and Computed Tomography Analysis Findings" International Journal of Molecular Sciences 22, no. 14: 7498. https://doi.org/10.3390/ijms22147498

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