Likhonosova S.E., Lukina O.V., Amosov V.I.


First Pavlov State Medical University of St. Petersburg. St. Petersburg, Russia.



Purpose. Determination of radiological patterns and complications of a new coronavirus infection in patients with different phenotypes of chronic obstructive pulmonary disease (COPD).

Materials and methods. In our work 99 patients with COPD infected a new coronavirus infection were examined: 24 women and 75 men (an average age of 69.1±10.8 years). Radiological studies were carried out on CT scanner OPTIMA 660 GE, followed by an assessment of changes in the lung tissue (the presence and prevalence of emphysematous rearrangement) and bronchi. The examined patients were divided into three groups according to the COPD phenotypes (emphysematous, bronchitic and mixed). Radiological patterns of a new coronavirus infections were also evaluated in all patients and the degree of lung tissue damage was determined.

Results. At admission in hospital 7.1% of patients had CT-0, 20.2% – CT-1, 41.4% – CT-2, 24.2% – CT-3, 7.1% – CT-4. The maximum degree of lung tissue damage (for the entire period of hospi-tal stay): 3.0% of patients - CT-0, 18.2% – CT-1, 24.2% – CT-2, 38.4% – CT-3, 16.2% – CT-4. 11.1% of patients developed pulmonary embolism, 2.0% – deep vein thrombosis. 28.3% of patients had second-ary infection, 24.2% – sepsis, 13.1% – ARDS, 16.2% – hydrothorax, 3.0% – pneumothorax. 41.4% of patients needed for a ventilator, 33.3% of patients had a fatal outcome. Typical radiological patterns of a new coronavirus infections were detected in 90.5% of cases. 18% of the examined patients had ir-regularly shaped areas of consolidation of lung tissue that did not correspond to lobes and segments, located around bullous cavities and areas of panlobular emphysema, which required differential diag-nosis with diseases characterized by manifestations of cavities in the lung tissue. Comparative analy-sis revealed a higher frequency of detection of consolidation sites by the type of organized pneumonia in patients with emphysematous and bronchitic COPD phenotype and a higher frequency of sepsis and ventilations need in patients with mixed and bronchitic COPD phenotype compared with patients with emphysematous phenotype. The risk of death in patients with bronchitis and mixed phenotype was statistically significantly higher compared to patients with emphysematous phenotype.

Discussion. COPD is characterized by the presence of systemic effects, the main of which is sys-temic inflammation. Systemic inflammation and colonization by pathogenic bacteria in the respiratory tract, in particular during remission, in patients with bronchitic and mixed phenotypes of COPD un-derlies the severe course and complications of a new coronavirus infection in this group of patients.

Conclusions. The combination of COPD and a new coronavirus infection, which are character-ized by the development of a systemic inflammatory reaction, leads to the formation of a pronounced immune response, the development of more severe complications and atypical radiological patterns. That is why a detailed study of CT-changes is required for fast detection, staging, risk stratification and prognosis in this group of patients, and research on this topic is extremely relevant.


Keywords: chronic obstructive pulmonary disease, the COPD phenotypes, new coronavirus infec-tion, ground-glass opacity, the emphysematous phenotype, the bronchitic phenotype, the mixed phe-notype.




Corresponding author: Likhonosova S.E., email: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript


For citation: Likhonosova S.E., Lukina O.V., Amosov V.I. Complications of a new coronavirus infection in patients with different phenotypes of chronic obstructive pulmonary disease. REJR 2023; 13(1):18-29. DOI: 10.21569/2222-7415-2023-13-1-18-29.


Received: 15.02.23

Accepted: 07.03.23