Impact of COVID-19 pneumonia on interstitial lung disease: semi-quantitative evaluation with computed tomography

OBJECTIVES

To evaluate the CT scores and fibrotic pattern changes in interstitial lung disease (ILD) patients, with and without previous COVID-19 pneumonia.

METHODS

Patients with ILD (idiopathic pulmonary fibrosis (IPF) and connective tissue disease-associated ILD (CTD-ILD)) were retrospectively enrolled in the study which consisted of patients who had COVID-19 pneumonia while the control group had not. All patients had two CT scans, initial and follow-up, which were evaluated semi-quantitatively for severity, extent, and total CT scores, fibrosis patterns, and traction bronchiectasis.

RESULTS

A total of 102 patients (pneumonia group n = 48; control group n = 54) were enrolled in the study. For both groups, baseline characteristics were similar and CT scores were increased. While there was a 4.5 ± 4.6 point change in the total CT score of the COVID-19 group, there was a 1.2 ± 2.7 point change in the control group (p < 0.001). In the IPF subgroup, the change in total CT score was 7.0 points (95% CI: 4.1 to 9.9) in the COVID-19 group and 2.1 points (95% CI: 0.8 to 3.4) in the control group. Seven patients (14.6%) in the COVID-19 group progressed to a higher fibrosis pattern, but none in the control group.

CONCLUSIONS

Semi-quantitative chest CT scores in ILD patients demonstrated a significant increase after having COVID-19 pneumonia compared to ILD patients who had not had COVID-19 pneumonia. The increase in CT scores was more prominent in the IPF subgroup. There was also a worsening in the fibrosis pattern in the COVID-19 group.

KEY POINTS

• The impact of COVID-19 pneumonia on existing interstitial lung diseases and fibrosis is unclear. • COVID-19 pneumonia may worsen existing interstitial lung involvement with direct lung damage and indirect inflammatory effect. • COVID-19 pneumonia may affect existing lung fibrosis by triggering inflammatory pathways.

Leaching of metals from soil contaminated by mining activities

Stabilization/solidification (s/s) is one of the most effective methods of dealing with heavy metal contaminated sites. The ability of lime and cement stabilization to immobilize Pb, Cu and Fe contained in a contaminated soil originating from an old mining and smelting area located along the Mediterranean Sea shore in northern Cyprus was investigated. The stabilization was evaluated by applying leaching tests. A series of tests were conducted to optimize the additive soil ratio for the best immobilization process. Additive/soil=1/15 (m/m) ratio was found to be the optimum for both lime and cement. Application of the US EPA toxicity characteristic leaching procedure (TCLP) on the soil samples treated with lime at additive/soil=1/15 (m/m) mixing ratios showed that Cu and Fe solubility was reduced at 94 and 90%, respectively. The results of cement treatment using the same ratio, reduced the solubility 48 and 71% for Cu and Fe, respectively. The Pb solubility was found to be below the regulatory limit of 5mg/l so no additive treatment was needed. The optimum additive/soil amount (1/15) was selected for more detailed column studies, that were carried out in the acidic pH range. According to the results of column leaching tests, it was found that, the degree of heavy metal leaching is highly dependent on pH.