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The role of chest CT in deciphering interstitial lung involvement: systemic sclerosis versus COVID-19.
Orlandi, Martina; Landini, Nicholas; Sambataro, Gianluca; Nardi, Cosimo; Tofani, Lorenzo; Bruni, Cosimo; Bellando-Randone, Silvia; Blagojevic, Jelena; Melchiorre, Daniela; Hughes, Michael; Denton, Christopher P; Luppi, Fabrizio; Ruaro, Barbara; Della Casa, Francesca; Rossi, Francesca W; De Luca, Giacomo; Campochiaro, Corrado; Spinicci, Michele; Zammarchi, Lorenzo; Tomassetti, Sara; Caminati, Antonella; Cavigli, Edoardo; Albanesi, Marco; Melchiorre, Fabio; Palmucci, Stefano; Vegni, Virginia; Guiducci, Serena; Moggi-Pignone, Alberto; Allanore, Yannick; Bartoloni, Alessandro; Confalonieri, Marco; Dagna, Lorenzo; DeCobelli, Francesco; dePaulis, Amato; Harari, Sergio; Khanna, Dinesh; Kuwana, Masataka; Taliani, Gloria; Lavorini, Federico; Miele, Vittorio; Morana, Giovanni; Pesci, Alberto; Vancheri, Carlo; Colagrande, Stefano; Matucci-Cerinic, Marco.
  • Orlandi M; Division of Rheumatology AOUC, Department of Clinical and Experimental Medicine, University of Florence, University of Florence.
  • Landini N; Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-AOUC, Florence.
  • Sambataro G; Department of Radiology, Ca' Foncello General Hospital, Treviso.
  • Nardi C; Regional Referral Centre for Rare Lung Diseases, A. O. U. 'Policlinico G. Rodolico-San Marco' Department of Clinical and Experimental Medicine, University of Catania.
  • Tofani L; Artroreuma SRL, Outpatient of Rheumatology Accredited with Italian National Health System, Mascalucia, Catania, Italy.
  • Bruni C; Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence-AOUC, Florence.
  • Bellando-Randone S; Division of Rheumatology AOUC, Department of Clinical and Experimental Medicine, University of Florence, University of Florence.
  • Blagojevic J; Division of Rheumatology AOUC, Department of Clinical and Experimental Medicine, University of Florence, University of Florence.
  • Melchiorre D; Division of Rheumatology AOUC, Department of Clinical and Experimental Medicine, University of Florence, University of Florence.
  • Hughes M; Division of Rheumatology AOUC, Department of Clinical and Experimental Medicine, University of Florence, University of Florence.
  • Denton CP; Division of Rheumatology AOUC, Department of Clinical and Experimental Medicine, University of Florence, University of Florence.
  • Luppi F; Department of Rheumatology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield.
  • Ruaro B; University College London Division of Medicine, Centre for Rheumatology and Connective Tissue Diseases, London, UK.
  • Della Casa F; Respiratory Unit, University of Milano-Bicocca, S. Gerardo Hospital, Monza.
  • Rossi FW; Department of Pulmonology, University Hospital of Cattinara, Trieste.
  • De Luca G; Division of Autoimmune & Allergic Diseases, Department of Translational Medical Sciences, University of Naples Federico II, Napoli.
  • Campochiaro C; Division of Autoimmune & Allergic Diseases, Department of Translational Medical Sciences, University of Naples Federico II, Napoli.
  • Spinicci M; Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milano.
  • Zammarchi L; Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milano.
  • Tomassetti S; Department of Experimental and Clinical Medicine, University of Florence, and Infectious and Tropical Diseases Unit, AOUC.
  • Caminati A; Department of Experimental and Clinical Medicine, University of Florence, and Infectious and Tropical Diseases Unit, AOUC.
  • Cavigli E; Department of Clinical and Experimental Medicine, University of Florence, Florence.
  • Albanesi M; U.O. di Pneumologia, Ospedale San Giuseppe MultiMedica, IRCCS, Milano.
  • Melchiorre F; Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Florence.
  • Palmucci S; Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Florence.
  • Vegni V; Department of Radiology, Sant'Andrea Hospital Vercelli, ASLVC.
  • Guiducci S; Radiodiagnostic and Radiotherapy Unit, Department of Medical Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania.
  • Moggi-Pignone A; Radiology Unit, Rugani Hospital, Siena.
  • Allanore Y; Division of Rheumatology AOUC, Department of Clinical and Experimental Medicine, University of Florence, University of Florence.
  • Bartoloni A; Department of Experimental and Clinical Medicine, AOU Careggi Hospital, University of Florence Medical School, Florence, Italy.
  • Confalonieri M; Department of Rheumatology A, Descartes University, APHP, Cochin Hospital, Paris, France.
  • Dagna L; Department of Experimental and Clinical Medicine, University of Florence, and Infectious and Tropical Diseases Unit, AOUC.
  • DeCobelli F; Department of Pulmonology, University Hospital of Cattinara, Trieste.
  • dePaulis A; Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milano.
  • Harari S; Department of Radiology IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University.
  • Khanna D; Division of Autoimmune & Allergic Diseases, Department of Translational Medical Sciences, University of Naples Federico II, Napoli.
  • Kuwana M; U.O. di Pneumologia, Ospedale San Giuseppe MultiMedica, IRCCS, Milano.
  • Taliani G; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
  • Lavorini F; Department of Medicine, University of Michigan, Ann Arbor, MI, USA.
  • Miele V; Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Tokyo, Japan.
  • Morana G; Department of Translational and Precision Medicine, Sapienza University, Rome, Italy.
  • Pesci A; Department of Clinical and Experimental Medicine, University of Florence, Florence.
  • Vancheri C; Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Florence.
  • Colagrande S; Department of Radiology, Ca' Foncello General Hospital, Treviso.
  • Matucci-Cerinic M; Respiratory Unit, University of Milano-Bicocca, S. Gerardo Hospital, Monza.
Rheumatology (Oxford) ; 61(4): 1600-1609, 2022 Apr 11.
Article in English | MEDLINE | ID: covidwho-1328934
ABSTRACT

OBJECTIVE:

The aim of this study was to identify the main CT features that may help in distinguishing a progression of interstitial lung disease (ILD) secondary to SSc from COVID-19 pneumonia.

METHODS:

This multicentric study included 22 international readers grouped into a radiologist group (RADs) and a non-radiologist group (nRADs). A total of 99 patients, 52 with COVID-19 and 47 with SSc-ILD, were included in the study.

RESULTS:

Fibrosis inside focal ground-glass opacities (GGOs) in the upper lobes; fibrosis in the lower lobe GGOs; reticulations in lower lobes (especially if bilateral and symmetrical or associated with signs of fibrosis) were the CT features most frequently associated with SSc-ILD. The CT features most frequently associated with COVID- 19 pneumonia were consolidation (CONS) in the lower lobes, CONS with peripheral (both central/peripheral or patchy distributions), anterior and posterior CONS and rounded-shaped GGOs in the lower lobes. After multivariate analysis, the presence of CONs in the lower lobes (P < 0.0001) and signs of fibrosis in GGOs in the lower lobes (P < 0.0001) remained independently associated with COVID-19 pneumonia and SSc-ILD, respectively. A predictive score was created that was positively associated with COVID-19 diagnosis (96.1% sensitivity and 83.3% specificity).

CONCLUSION:

CT diagnosis differentiating between COVID-19 pneumonia and SSc-ILD is possible through a combination of the proposed score and radiologic expertise. The presence of consolidation in the lower lobes may suggest COVID-19 pneumonia, while the presence of fibrosis inside GGOs may indicate SSc-ILD.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Scleroderma, Systemic / Lung Diseases, Interstitial / COVID-19 Type of study: Controlled clinical trial / Etiology study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Rheumatology (Oxford) Journal subject: Rheumatology Year: 2022 Document Type: Article Affiliation country: Rheumatology

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Scleroderma, Systemic / Lung Diseases, Interstitial / COVID-19 Type of study: Controlled clinical trial / Etiology study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Rheumatology (Oxford) Journal subject: Rheumatology Year: 2022 Document Type: Article Affiliation country: Rheumatology