ABSTRACT
Background Coronavirus disease 2019 (COVID-19) pneumonia and anti-melanoma differentiation-associated gene 5 antibody-positive interstitial pneumonia (MDA5-IP) share many similarities; however, the treatment and management of the two diseases are different. In the early stages of developing a treatment plan, it is crucial to distinguish between the two diseases. This study was conducted to compare the radiological findings between COVID-19 pneumonia and MDA5-IP.Methods We recruited patients with COVID-19 pneumonia between January and June 2020. The control group comprised patients with MDA5-IP admitted between April 2013 and December 2019. Patients with thin-slice computed tomography (CT) images within 2 days of admission were enrolled. The CT images were analyzed using an artificial intelligence-based quantitative CT software program. Radiological findings were classified as faint ground-glass opacity (GGO), GGO, reticulation, consolidation, honeycombing, nodules, hyperlucency, or interlobular septum. The volumes of these radiological findings were compared between the two groups. A classification and regression tree algorithm was used to develop a prediction model to stratify the risk of COVID-19 pneumonia.Results We enrolled 72 and 15 patients in the COVID-19 pneumonia and MDA5-IP group, respectively. Faint GGO and consolidations were observed more extensively in patients with MDA5-IP. The prediction model was developed at cut-off values of faint GGO, < 30%; GGO, ≥ 10%, and consolidation < 1%. This prediction model contributed to changing post-test probability in 26% of cases.Conclusion The COVID-19 group showed fewer faint GGO and consolidation volumes than the MDA5-IP group. We developed a predictive model to stratify the risk of COVID-19 pneumonia.
Subject(s)
Lung Diseases, Interstitial , Pneumonia , Lung, Hyperlucent , COVID-19 , MelanomaABSTRACT
To elucidate the host genetic loci affecting severity of SARS-CoV-2 infection, or Coronavirus disease 2019 (COVID-19), is an emerging issue in the face of the current devastating pandemic. Here, we report a genome-wide association study (GWAS) of COVID-19 in a Japanese population led by the Japan COVID-19 Task Force, as one of the initial discovery GWAS studies performed on a non-European population. Enrolling a total of 2,393 cases and 3,289 controls, we not only replicated previously reported COVID-19 risk variants (e.g., LZTFL1, FOXP4, ABO, and IFNAR2), but also found a variant on 5p35 (rs60200309-A at DOCK2) that was significantly associated with severe COVID-19 in younger (<65 years of age) patients with a genome-wide significant p-value of 1.2 x 10-8 (odds ratio = 2.01, 95% confidence interval = 1.58-2.55). This risk allele was prevalent in East Asians, including Japanese (minor allele frequency [MAF] = 0.097), but rarely found in Europeans. Cross-population Mendelian randomization analysis made a causal inference of a number of complex human traits on COVID-19. In particular, obesity had a significant impact on severe COVID-19. The presence of the population-specific risk allele underscores the need of non-European studies of COVID-19 host genetics.