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Lung volume and density assessment over time in hospitalized COVID-19 patients

Vincent Geudens, Jan Van Slambrouck, Gitte Aerts, Lynn Willems, Tinne Goos, Janne Kaes, Iwein Gyselinck, Celine Aelbrecht, Astrid Vermaut, Hanne Beeckmans, Marie Vermant, Charlotte De Fays, Annelore Sacreas, Lucia Aversa, Michaela Orlitova, Arno Vanstapel, John E. Mcdonough, Charles Pilette, Wim Janssens, Wim A. Wuyts, Dirk E. Van Raemdonck, Robin Vos, Ghislaine Gayan-Ramirez, Laurens J. Ceulemans, Bart M. Vanaudenaerde
ERJ Open Research 2022 8: 199; DOI: 10.1183/23120541.LSC-2022.199
Vincent Geudens
1Laboratory of Respiratory Diseases and Thoracic Surgery, BREATHE, Department of CHROMETA, KU Leuven, Leuven, Belgium, Leuven, Belgium
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  • For correspondence: vincent.geudens@kuleuven.be
Jan Van Slambrouck
1Laboratory of Respiratory Diseases and Thoracic Surgery, BREATHE, Department of CHROMETA, KU Leuven, Leuven, Belgium, Leuven, Belgium
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Gitte Aerts
1Laboratory of Respiratory Diseases and Thoracic Surgery, BREATHE, Department of CHROMETA, KU Leuven, Leuven, Belgium, Leuven, Belgium
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Lynn Willems
1Laboratory of Respiratory Diseases and Thoracic Surgery, BREATHE, Department of CHROMETA, KU Leuven, Leuven, Belgium, Leuven, Belgium
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Tinne Goos
1Laboratory of Respiratory Diseases and Thoracic Surgery, BREATHE, Department of CHROMETA, KU Leuven, Leuven, Belgium, Leuven, Belgium
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Janne Kaes
1Laboratory of Respiratory Diseases and Thoracic Surgery, BREATHE, Department of CHROMETA, KU Leuven, Leuven, Belgium, Leuven, Belgium
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Iwein Gyselinck
1Laboratory of Respiratory Diseases and Thoracic Surgery, BREATHE, Department of CHROMETA, KU Leuven, Leuven, Belgium, Leuven, Belgium
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Celine Aelbrecht
1Laboratory of Respiratory Diseases and Thoracic Surgery, BREATHE, Department of CHROMETA, KU Leuven, Leuven, Belgium, Leuven, Belgium
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Astrid Vermaut
1Laboratory of Respiratory Diseases and Thoracic Surgery, BREATHE, Department of CHROMETA, KU Leuven, Leuven, Belgium, Leuven, Belgium
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Hanne Beeckmans
1Laboratory of Respiratory Diseases and Thoracic Surgery, BREATHE, Department of CHROMETA, KU Leuven, Leuven, Belgium, Leuven, Belgium
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Marie Vermant
1Laboratory of Respiratory Diseases and Thoracic Surgery, BREATHE, Department of CHROMETA, KU Leuven, Leuven, Belgium, Leuven, Belgium
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Charlotte De Fays
2Departement of Pneumology, Cliniques universitaires Saint-Luc and Institute of Experimental and Clinical Research, Université catholique de Louvain, Brussels, Belgium., Brussels, Belgium
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Annelore Sacreas
1Laboratory of Respiratory Diseases and Thoracic Surgery, BREATHE, Department of CHROMETA, KU Leuven, Leuven, Belgium, Leuven, Belgium
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Lucia Aversa
1Laboratory of Respiratory Diseases and Thoracic Surgery, BREATHE, Department of CHROMETA, KU Leuven, Leuven, Belgium, Leuven, Belgium
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Michaela Orlitova
3Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium, Leuven, Belgium
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Arno Vanstapel
1Laboratory of Respiratory Diseases and Thoracic Surgery, BREATHE, Department of CHROMETA, KU Leuven, Leuven, Belgium, Leuven, Belgium
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John E. Mcdonough
4Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, CT, USA, Leuven, Belgium
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Charles Pilette
5Departement of Pneumology, Cliniques universitaires Saint-Luc and Institute of Experimental and Clinical Research, Université catholique de Louvain, Brussels, Belgium, Leuven, Belgium
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Wim Janssens
1Laboratory of Respiratory Diseases and Thoracic Surgery, BREATHE, Department of CHROMETA, KU Leuven, Leuven, Belgium, Leuven, Belgium
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Wim A. Wuyts
1Laboratory of Respiratory Diseases and Thoracic Surgery, BREATHE, Department of CHROMETA, KU Leuven, Leuven, Belgium, Leuven, Belgium
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Dirk E. Van Raemdonck
1Laboratory of Respiratory Diseases and Thoracic Surgery, BREATHE, Department of CHROMETA, KU Leuven, Leuven, Belgium, Leuven, Belgium
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Robin Vos
1Laboratory of Respiratory Diseases and Thoracic Surgery, BREATHE, Department of CHROMETA, KU Leuven, Leuven, Belgium, Leuven, Belgium
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Ghislaine Gayan-Ramirez
1Laboratory of Respiratory Diseases and Thoracic Surgery, BREATHE, Department of CHROMETA, KU Leuven, Leuven, Belgium, Leuven, Belgium
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Laurens J. Ceulemans
1Laboratory of Respiratory Diseases and Thoracic Surgery, BREATHE, Department of CHROMETA, KU Leuven, Leuven, Belgium, Leuven, Belgium
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Bart M. Vanaudenaerde
1Laboratory of Respiratory Diseases and Thoracic Surgery, BREATHE, Department of CHROMETA, KU Leuven, Leuven, Belgium, Leuven, Belgium
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Abstract

COVID-19 can have a devastating effect on the lungs, causing acute respiratory distress syndrome (ARDS) which, when not resolved, may progress to pulmonary fibrosis potentially leading to death or transplantation (LTx). We aim to describe the progression of COVID-19 ARDS and fibrosis on lung volume and density over time in vivo and ex vivo using high-resolution computed tomography (HRCT) and µCT.

Volume and density of in vivo HRCT scans of 3 COVID-19 patients (P) were assessed over time (P1: 4 scans; P2: 5 scans; P3: 3 scans). After LTx (n=2) or autopsy (n=1) (65.3±26.7 days), explanted right lungs were inflated to total lung capacity, frozen and scanned with whole lung µCT. Lung volumes and density were calculated using Mimics Innovation Suite (Materialise, Belgium). Three discarded donor lungs were used as controls.

In vivo lung volume decreased 4 days after symptom onset compared to 1 control and 1 COVID-19 patient before infection, with a steep decline in the first 20 days followed by a more gradual decline. Ex vivo volume of COVID-19 lungs decreased by 60% compared to ex vivo controls (4.2±0.3 vs 1.7±0.5 L; p<0.0058) (fig 1a,b). Volume reduction might be caused by fibroproliferative obliteration of alveolar ducts and spaces as reflected by the increase in density over time (fig 1c).

COVID-19 affects lung volume and density rapidly over time, indicating the potential to follow up these parameters to monitor severely ill patients.

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Footnotes

Cite this article as ERJ Open Research 2022; 8: Suppl. 8, 199.

This article was presented at the 2022 ERS Lung Science Conference, in session “Poster Session 2”.

This is an ERS Lung Science Conference abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

  • Copyright ©the authors 2022
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Lung volume and density assessment over time in hospitalized COVID-19 patients
Vincent Geudens, Jan Van Slambrouck, Gitte Aerts, Lynn Willems, Tinne Goos, Janne Kaes, Iwein Gyselinck, Celine Aelbrecht, Astrid Vermaut, Hanne Beeckmans, Marie Vermant, Charlotte De Fays, Annelore Sacreas, Lucia Aversa, Michaela Orlitova, Arno Vanstapel, John E. Mcdonough, Charles Pilette, Wim Janssens, Wim A. Wuyts, Dirk E. Van Raemdonck, Robin Vos, Ghislaine Gayan-Ramirez, Laurens J. Ceulemans, Bart M. Vanaudenaerde
ERJ Open Research Mar 2022, 8 (suppl 8) 199; DOI: 10.1183/23120541.LSC-2022.199

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Lung volume and density assessment over time in hospitalized COVID-19 patients
Vincent Geudens, Jan Van Slambrouck, Gitte Aerts, Lynn Willems, Tinne Goos, Janne Kaes, Iwein Gyselinck, Celine Aelbrecht, Astrid Vermaut, Hanne Beeckmans, Marie Vermant, Charlotte De Fays, Annelore Sacreas, Lucia Aversa, Michaela Orlitova, Arno Vanstapel, John E. Mcdonough, Charles Pilette, Wim Janssens, Wim A. Wuyts, Dirk E. Van Raemdonck, Robin Vos, Ghislaine Gayan-Ramirez, Laurens J. Ceulemans, Bart M. Vanaudenaerde
ERJ Open Research Mar 2022, 8 (suppl 8) 199; DOI: 10.1183/23120541.LSC-2022.199
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