TY - JOUR T1 - Increased monocyte level is a risk factor for radiological progression in patients with early fibrotic interstitial lung abnormality JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00226-2022 VL - 8 IS - 3 SP - 00226-2022 AU - Andrew Achaiah AU - Paul Lyon AU - Emily Fraser AU - Peter Saunders AU - Rachel Hoyles AU - Rachel Benamore AU - Ling-Pei Ho Y1 - 2022/07/01 UR - http://openres.ersjournals.com/content/8/3/00226-2022.abstract N2 - Background Interstitial lung abnormalities (ILA) are specific spatial patterns on computed tomography (CT) scan potentially compatible with early interstitial lung disease. A proportion will progress; management involves risk stratification and surveillance. Elevated blood monocyte levels have been shown to associate with progression of idiopathic pulmonary fibrosis. The aims of the present study were: 1) to estimate the proportion of “early fibrotic” (EF)-ILAs (reticular±ground-glass opacities, excluding traction bronchiectasis and honeycombing) on CT scans of patients attending all-indications thoracic CTs, and proportion demonstrating radiological progression; and 2) to explore association between peripheral blood leukocyte levels and ILA progression.Methods We analysed all thoracic CT reports in individuals aged 45–75 years performed between January 2015 and December 2020 in one large teaching hospital (Oxford, UK) to identify patient CT reports consistent with EF-ILA. CT-contemporaneous blood leukocyte counts were examined to explore contribution to progression and all-cause mortality, using multivariate Cox regression.Results 40 711 patients underwent thoracic CT imaging during this period. 1259 (3.1%) demonstrated the EF-ILA pattern (mean±sd age 65.4±7.32 years; 735 (47.8%) male). EF-ILA was significantly associated with all-cause mortality (hazard ratio 1.87, 95% CI 1.25–2.78; p=0.002). 362 cases underwent at least one follow-on CT. Radiological progression was observed in 157 (43.4%) cases: increase in reticulation n=51, new traction bronchiectasis n=84, honeycombing n=22. Monocyte count, neutrophil count, monocyte:lymphocyte ratio, neutrophil:lymphocyte ratio and “systemic inflammatory response index” were significantly associated with radiological progression.Conclusion 3.1% of subjects requiring thoracic CT during a 6-year period demonstrated EF-ILA. Monocyte levels and blood leukocyte-derived indexes were associated with radiological progression and could indicate which patients may require closer follow-up.Monocyte levels are associated with radiological progression of early fibrotic ILA to established interstitial lung disease and could indicate which patients might require closer follow-up https://bit.ly/3LlS2ff ER -