CT findings of COVID-19-associated pulmonary aspergillosis: a systematic review and individual patient data analysis
Common CT abnormalities of pulmonary aspergillosis represent a cavity with air-meniscus sign, nodule, mass, and consolidation having an angio-invasive pattern. This study aims to conduct a systematic review and an individual patient-level image analysis of CT findings of COVID-19-associated pulmonar...
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| Veröffentlicht in: | Clinical imaging 2022-10, Vol.90, p.11-18 |
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| creator | Hong, Wonju White, P. Lewis Backx, Matthijs Gangneux, Jean-Pierre Reizine, Florian Koehler, Philipp Bentvelsen, Robbert G. Cuestas, María Luján Fakhim, Hamed Jung, Jung Im Lee, Young Kyung Dalsania, Nishil R. Patti, Ravi Karan Yoon, Soon Ho |
| description | Common CT abnormalities of pulmonary aspergillosis represent a cavity with air-meniscus sign, nodule, mass, and consolidation having an angio-invasive pattern. This study aims to conduct a systematic review and an individual patient-level image analysis of CT findings of COVID-19-associated pulmonary aspergillosis (CAPA).
A systematic literature search was conducted to identify studies reporting CT findings of CAPA as of January 7, 2021. We summarized study-level clinical and CT findings of CAPA and collected individual patient CT images by inviting corresponding authors. The CT findings were categorized into four groups: group 1, typical appearance of COVID-19; group 2, indeterminate appearance of COVID-19; group 3, atypical for COVID-19 without cavities; and group 4, atypical for COVID-19 with cavities. In group 2, cases had only minor discrepant findings including solid nodules, isolated airspace consolidation with negligible ground-glass opacities, centrilobular micronodules, bronchial abnormalities, and cavities.
The literature search identified 89 patients from 25 studies, and we collected CT images from 35 CAPA patients (mean age 62.4 ± 14.6 years; 21 men): group 1, thirteen patients (37.1%); group 2, eight patients (22.9%); group 3, six patients (17.1%); and group 4, eight patients (22.9%). Eight of the 14 patients (57.1%) with an atypical appearance had bronchial abnormalities, whereas only one (7.1%) had an angio-invasive fungal pattern. In the study-level analysis, cavities were reported in 12 of 54 patients (22.2%).
CAPA can frequently manifest as COVID-19 pneumonia without common CT abnormalities of pulmonary aspergillosis. If abnormalities exist on CT images, CAPA may frequently accompany bronchial abnormalities.
•CAPA can manifest as typical to indeterminate COVID-19 pneumonia on CT without common features of pulmonary aspergillosis.•One-third of CAPA patients had an atypical appearance for COVID-19 pneumonia, and cavities were observed in one-fifth.•CAPA frequently accompanied bronchial abnormalities, whereas an angio-invasive pattern was rare. |
| doi_str_mv | 10.1016/j.clinimag.2022.07.003 |
| format | Article |
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A systematic literature search was conducted to identify studies reporting CT findings of CAPA as of January 7, 2021. We summarized study-level clinical and CT findings of CAPA and collected individual patient CT images by inviting corresponding authors. The CT findings were categorized into four groups: group 1, typical appearance of COVID-19; group 2, indeterminate appearance of COVID-19; group 3, atypical for COVID-19 without cavities; and group 4, atypical for COVID-19 with cavities. In group 2, cases had only minor discrepant findings including solid nodules, isolated airspace consolidation with negligible ground-glass opacities, centrilobular micronodules, bronchial abnormalities, and cavities.
The literature search identified 89 patients from 25 studies, and we collected CT images from 35 CAPA patients (mean age 62.4 ± 14.6 years; 21 men): group 1, thirteen patients (37.1%); group 2, eight patients (22.9%); group 3, six patients (17.1%); and group 4, eight patients (22.9%). Eight of the 14 patients (57.1%) with an atypical appearance had bronchial abnormalities, whereas only one (7.1%) had an angio-invasive fungal pattern. In the study-level analysis, cavities were reported in 12 of 54 patients (22.2%).
CAPA can frequently manifest as COVID-19 pneumonia without common CT abnormalities of pulmonary aspergillosis. If abnormalities exist on CT images, CAPA may frequently accompany bronchial abnormalities.
•CAPA can manifest as typical to indeterminate COVID-19 pneumonia on CT without common features of pulmonary aspergillosis.•One-third of CAPA patients had an atypical appearance for COVID-19 pneumonia, and cavities were observed in one-fifth.•CAPA frequently accompanied bronchial abnormalities, whereas an angio-invasive pattern was rare.</description><identifier>ISSN: 0899-7071</identifier><identifier>EISSN: 1873-4499</identifier><identifier>DOI: 10.1016/j.clinimag.2022.07.003</identifier><identifier>PMID: 35908455</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Abnormalities ; Aged ; Aspergillosis ; Cardiothoracic Imaging ; Cavitation ; Cavities ; Computed tomography ; Consolidation ; Coronavirus 2019 ; Coronaviruses ; COVID-19 ; COVID-19 - complications ; Data Analysis ; Digital imaging ; Fungal infections ; Holes ; Human health and pathology ; Humans ; Image analysis ; Image processing ; Infectious diseases ; Influenza ; Intensive care ; Life Sciences ; Lung - diagnostic imaging ; Male ; Medical imaging ; Middle Aged ; Mortality ; Nodules ; Pandemics ; Patients ; Pattern analysis ; Pneumonia ; Pulmonary Aspergillosis - complications ; Pulmonary Aspergillosis - diagnostic imaging ; Radiology ; Review boards ; Severe acute respiratory syndrome coronavirus 2 ; Systematic review ; Tomography ; Tomography, X-Ray Computed - methods ; X-ray computed</subject><ispartof>Clinical imaging, 2022-10, Vol.90, p.11-18</ispartof><rights>2022</rights><rights>Copyright © 2022. Published by Elsevier Inc.</rights><rights>Copyright Elsevier Limited Oct 2022</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><rights>2022 Published by Elsevier Inc. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c533t-a06404301f7c00b758f3ebf00ed7d0e450ff1ed16c94140625aae907139347033</citedby><cites>FETCH-LOGICAL-c533t-a06404301f7c00b758f3ebf00ed7d0e450ff1ed16c94140625aae907139347033</cites><orcidid>0000-0002-9871-636X ; 0000-0002-7288-7769 ; 0000-0002-4974-5607 ; 0000-0002-7386-7495</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0899707122001814$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35908455$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-03789677$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Hong, Wonju</creatorcontrib><creatorcontrib>White, P. Lewis</creatorcontrib><creatorcontrib>Backx, Matthijs</creatorcontrib><creatorcontrib>Gangneux, Jean-Pierre</creatorcontrib><creatorcontrib>Reizine, Florian</creatorcontrib><creatorcontrib>Koehler, Philipp</creatorcontrib><creatorcontrib>Bentvelsen, Robbert G.</creatorcontrib><creatorcontrib>Cuestas, María Luján</creatorcontrib><creatorcontrib>Fakhim, Hamed</creatorcontrib><creatorcontrib>Jung, Jung Im</creatorcontrib><creatorcontrib>Lee, Young Kyung</creatorcontrib><creatorcontrib>Dalsania, Nishil R.</creatorcontrib><creatorcontrib>Patti, Ravi Karan</creatorcontrib><creatorcontrib>Yoon, Soon Ho</creatorcontrib><title>CT findings of COVID-19-associated pulmonary aspergillosis: a systematic review and individual patient data analysis</title><title>Clinical imaging</title><addtitle>Clin Imaging</addtitle><description>Common CT abnormalities of pulmonary aspergillosis represent a cavity with air-meniscus sign, nodule, mass, and consolidation having an angio-invasive pattern. This study aims to conduct a systematic review and an individual patient-level image analysis of CT findings of COVID-19-associated pulmonary aspergillosis (CAPA).
A systematic literature search was conducted to identify studies reporting CT findings of CAPA as of January 7, 2021. We summarized study-level clinical and CT findings of CAPA and collected individual patient CT images by inviting corresponding authors. The CT findings were categorized into four groups: group 1, typical appearance of COVID-19; group 2, indeterminate appearance of COVID-19; group 3, atypical for COVID-19 without cavities; and group 4, atypical for COVID-19 with cavities. In group 2, cases had only minor discrepant findings including solid nodules, isolated airspace consolidation with negligible ground-glass opacities, centrilobular micronodules, bronchial abnormalities, and cavities.
The literature search identified 89 patients from 25 studies, and we collected CT images from 35 CAPA patients (mean age 62.4 ± 14.6 years; 21 men): group 1, thirteen patients (37.1%); group 2, eight patients (22.9%); group 3, six patients (17.1%); and group 4, eight patients (22.9%). Eight of the 14 patients (57.1%) with an atypical appearance had bronchial abnormalities, whereas only one (7.1%) had an angio-invasive fungal pattern. In the study-level analysis, cavities were reported in 12 of 54 patients (22.2%).
CAPA can frequently manifest as COVID-19 pneumonia without common CT abnormalities of pulmonary aspergillosis. If abnormalities exist on CT images, CAPA may frequently accompany bronchial abnormalities.
•CAPA can manifest as typical to indeterminate COVID-19 pneumonia on CT without common features of pulmonary aspergillosis.•One-third of CAPA patients had an atypical appearance for COVID-19 pneumonia, and cavities were observed in one-fifth.•CAPA frequently accompanied bronchial abnormalities, whereas an angio-invasive pattern was rare.</description><subject>Abnormalities</subject><subject>Aged</subject><subject>Aspergillosis</subject><subject>Cardiothoracic Imaging</subject><subject>Cavitation</subject><subject>Cavities</subject><subject>Computed tomography</subject><subject>Consolidation</subject><subject>Coronavirus 2019</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - complications</subject><subject>Data Analysis</subject><subject>Digital imaging</subject><subject>Fungal infections</subject><subject>Holes</subject><subject>Human health and pathology</subject><subject>Humans</subject><subject>Image analysis</subject><subject>Image processing</subject><subject>Infectious diseases</subject><subject>Influenza</subject><subject>Intensive care</subject><subject>Life Sciences</subject><subject>Lung - diagnostic imaging</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Nodules</subject><subject>Pandemics</subject><subject>Patients</subject><subject>Pattern analysis</subject><subject>Pneumonia</subject><subject>Pulmonary Aspergillosis - complications</subject><subject>Pulmonary Aspergillosis - diagnostic imaging</subject><subject>Radiology</subject><subject>Review boards</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Systematic review</subject><subject>Tomography</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>X-ray computed</subject><issn>0899-7071</issn><issn>1873-4499</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUk1v1DAQtRCIbgt_obLEBQ4J49iJYw6o1fLRSiv1UrhaXtvZeuXEi50s2n-P020r6IWTJc97b-bNG4TOCZQESPNxW2rvBterTVlBVZXASwD6Ai1Iy2nBmBAv0QJaIQoOnJyg05S2kImC8dfohNYCWlbXCzQub3HnBuOGTcKhw8ubn9dfCiIKlVLQTo3W4N3k-zCoeMAq7WzcOO9DcukTVjgd0mh7NTqNo907-xurweBZb-_MpDze5ZodRmzUqHJN-UNmvkGvOuWTffvwnqEf377eLq-K1c336-XlqtA1pWOhoGHAKJCOa4A1r9uO2nUHYA03YFkNXUesIY0WjDBoqlopK7JdKijjQOkZ-nzU3U3r3hqdB4nKy13Me4sHGZST_1YGdyc3YS8Fq2pgVRb4cBS4e0a7ulzJ-Q8ob0XD-Z5k7PuHZjH8mmwaZe-Stt6rwYYpyaoRHARhTZ2h755Bt2GKeTkZleNqG8ro3Lw5onQMKUXbPU1AQM5HILfy8QjkfAQSuIR72-d_236iPaaeARdHgM3Lz6lFmXROSVvjotWjNMH9r8cfMWvGfg</recordid><startdate>20221001</startdate><enddate>20221001</enddate><creator>Hong, Wonju</creator><creator>White, P. Lewis</creator><creator>Backx, Matthijs</creator><creator>Gangneux, Jean-Pierre</creator><creator>Reizine, Florian</creator><creator>Koehler, Philipp</creator><creator>Bentvelsen, Robbert G.</creator><creator>Cuestas, María Luján</creator><creator>Fakhim, Hamed</creator><creator>Jung, Jung Im</creator><creator>Lee, Young Kyung</creator><creator>Dalsania, Nishil R.</creator><creator>Patti, Ravi Karan</creator><creator>Yoon, Soon Ho</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><general>Elsevier</general><general>Published by Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>P64</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-9871-636X</orcidid><orcidid>https://orcid.org/0000-0002-7288-7769</orcidid><orcidid>https://orcid.org/0000-0002-4974-5607</orcidid><orcidid>https://orcid.org/0000-0002-7386-7495</orcidid></search><sort><creationdate>20221001</creationdate><title>CT findings of COVID-19-associated pulmonary aspergillosis: a systematic review and individual patient data analysis</title><author>Hong, Wonju ; White, P. Lewis ; Backx, Matthijs ; Gangneux, Jean-Pierre ; Reizine, Florian ; Koehler, Philipp ; Bentvelsen, Robbert G. ; Cuestas, María Luján ; Fakhim, Hamed ; Jung, Jung Im ; Lee, Young Kyung ; Dalsania, Nishil R. ; Patti, Ravi Karan ; Yoon, Soon Ho</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c533t-a06404301f7c00b758f3ebf00ed7d0e450ff1ed16c94140625aae907139347033</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Abnormalities</topic><topic>Aged</topic><topic>Aspergillosis</topic><topic>Cardiothoracic Imaging</topic><topic>Cavitation</topic><topic>Cavities</topic><topic>Computed tomography</topic><topic>Consolidation</topic><topic>Coronavirus 2019</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 - complications</topic><topic>Data Analysis</topic><topic>Digital imaging</topic><topic>Fungal infections</topic><topic>Holes</topic><topic>Human health and pathology</topic><topic>Humans</topic><topic>Image analysis</topic><topic>Image processing</topic><topic>Infectious diseases</topic><topic>Influenza</topic><topic>Intensive care</topic><topic>Life Sciences</topic><topic>Lung - diagnostic imaging</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Nodules</topic><topic>Pandemics</topic><topic>Patients</topic><topic>Pattern analysis</topic><topic>Pneumonia</topic><topic>Pulmonary Aspergillosis - complications</topic><topic>Pulmonary Aspergillosis - diagnostic imaging</topic><topic>Radiology</topic><topic>Review boards</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Systematic review</topic><topic>Tomography</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>X-ray computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hong, Wonju</creatorcontrib><creatorcontrib>White, P. 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Lewis</au><au>Backx, Matthijs</au><au>Gangneux, Jean-Pierre</au><au>Reizine, Florian</au><au>Koehler, Philipp</au><au>Bentvelsen, Robbert G.</au><au>Cuestas, María Luján</au><au>Fakhim, Hamed</au><au>Jung, Jung Im</au><au>Lee, Young Kyung</au><au>Dalsania, Nishil R.</au><au>Patti, Ravi Karan</au><au>Yoon, Soon Ho</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>CT findings of COVID-19-associated pulmonary aspergillosis: a systematic review and individual patient data analysis</atitle><jtitle>Clinical imaging</jtitle><addtitle>Clin Imaging</addtitle><date>2022-10-01</date><risdate>2022</risdate><volume>90</volume><spage>11</spage><epage>18</epage><pages>11-18</pages><issn>0899-7071</issn><eissn>1873-4499</eissn><abstract>Common CT abnormalities of pulmonary aspergillosis represent a cavity with air-meniscus sign, nodule, mass, and consolidation having an angio-invasive pattern. This study aims to conduct a systematic review and an individual patient-level image analysis of CT findings of COVID-19-associated pulmonary aspergillosis (CAPA).
A systematic literature search was conducted to identify studies reporting CT findings of CAPA as of January 7, 2021. We summarized study-level clinical and CT findings of CAPA and collected individual patient CT images by inviting corresponding authors. The CT findings were categorized into four groups: group 1, typical appearance of COVID-19; group 2, indeterminate appearance of COVID-19; group 3, atypical for COVID-19 without cavities; and group 4, atypical for COVID-19 with cavities. In group 2, cases had only minor discrepant findings including solid nodules, isolated airspace consolidation with negligible ground-glass opacities, centrilobular micronodules, bronchial abnormalities, and cavities.
The literature search identified 89 patients from 25 studies, and we collected CT images from 35 CAPA patients (mean age 62.4 ± 14.6 years; 21 men): group 1, thirteen patients (37.1%); group 2, eight patients (22.9%); group 3, six patients (17.1%); and group 4, eight patients (22.9%). Eight of the 14 patients (57.1%) with an atypical appearance had bronchial abnormalities, whereas only one (7.1%) had an angio-invasive fungal pattern. In the study-level analysis, cavities were reported in 12 of 54 patients (22.2%).
CAPA can frequently manifest as COVID-19 pneumonia without common CT abnormalities of pulmonary aspergillosis. If abnormalities exist on CT images, CAPA may frequently accompany bronchial abnormalities.
•CAPA can manifest as typical to indeterminate COVID-19 pneumonia on CT without common features of pulmonary aspergillosis.•One-third of CAPA patients had an atypical appearance for COVID-19 pneumonia, and cavities were observed in one-fifth.•CAPA frequently accompanied bronchial abnormalities, whereas an angio-invasive pattern was rare.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>35908455</pmid><doi>10.1016/j.clinimag.2022.07.003</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-9871-636X</orcidid><orcidid>https://orcid.org/0000-0002-7288-7769</orcidid><orcidid>https://orcid.org/0000-0002-4974-5607</orcidid><orcidid>https://orcid.org/0000-0002-7386-7495</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Clinical imaging, 2022-10, Vol.90, p.11-18 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Abnormalities Aged Aspergillosis Cardiothoracic Imaging Cavitation Cavities Computed tomography Consolidation Coronavirus 2019 Coronaviruses COVID-19 COVID-19 - complications Data Analysis Digital imaging Fungal infections Holes Human health and pathology Humans Image analysis Image processing Infectious diseases Influenza Intensive care Life Sciences Lung - diagnostic imaging Male Medical imaging Middle Aged Mortality Nodules Pandemics Patients Pattern analysis Pneumonia Pulmonary Aspergillosis - complications Pulmonary Aspergillosis - diagnostic imaging Radiology Review boards Severe acute respiratory syndrome coronavirus 2 Systematic review Tomography Tomography, X-Ray Computed - methods X-ray computed |
| title | CT findings of COVID-19-associated pulmonary aspergillosis: a systematic review and individual patient data analysis |
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