CHEST COMPUTED TOMOGRAPHY IN THE CONTROL AND MONITORING OF THE

REHABILITATION TREATMENT EFFECTIVENESS OF COVID-ASSOCIATED PNEUMONIA IN PATIENTS IN AN INFECTIOUS DISEASES HOSPITAL

 

Malyutin D.S.¹, Serova N.S.², Koneva E.S.^1,2

 

1 - Medsi Clinical Hospital in Otradnoy. Krasnogorsk, Russia.

2 - Sechenov University. Moscow, Russia.

P

urpose. To assess the possibility of chest computed tomography in the control and monitoring of the rehabilitation treatment effectiveness in patients with COVID-19 in an infectious disease hospital.

Materials and methods. The study included 180 patients hospitalized between April 01, 2020 and until June 15, 2021 to the Clinical Hospital No. 1 of JSC Medsi Group of Companies with a diagnosis of COVID-associated pneumonia (ICD-10 codes U07.1 and U07.2). Chest computed tomography was performed using LightSpeed VCT (General Electric, USA), Brilliance iCT Elite (Philips, Nederland). The volume of lung injury was calculated using the IntelliSpace Portal V11 workstation (Philips, Nederland). The average values of the threshold density of unchanged lung tissue were -748.29±53.18 HU.

Following rehabilitation measures were conducted: monotherapy with respiratory gymnastics procedures (first comparison group, n=60), in the form of complex respiratory gymnastics procedures in combination with apparatus massage of the chest area in an electrostatic field (second comparison group, n=60). A control group of patients (n=60) was also identified, who did not receive rehabilitation treatment.

Results. According to the chest CT, the median values of the volume of lung parenchyma damage at the time of hospitalization in the first comparison group were 25.35% (interquartile range 15.66-36.0%); in the second comparison group – 25.2% (Q1-Q3 16.03-38.53%); in the control group this figure was 26.1% with an interquartile range of 15.28-40.0%. The volume of lung injury at discharge in the first group was 19.65% (Q1-Q3 12.525-28%); in the second group – 22.55% (Q1-Q3 14.925-32.20%); in the control group – 24.1% (Q1-Q3 15.8-33%).

The duration of hospitalization in the first comparison group was in average 14 days (Q1-Q3 11-15.25 days), in the second comparison group – 13 days (Q1-Q3 11-15 days) and in the control group – 15 days (Q1-Q3 12.75-18 days). At the same time, the duration of hospitalization in the two comparison groups was significantly lower than in the control group (p<0.05).

A significant decrease in the duration of staying in the infectious disease hospital in patients with CT-2 stage of viral pneumonia was established, when both therapeutic exercises and their complex in combination with chest massage in an electrostatic field were included in their therapy (p<0.05).

Discussion. For all groups of patients with CT-1 stage of viral pneumonia, there were no significant differences in the duration of treatment in the infectious disease hospital. At the same time a significant decrease in the duration of hospitalization in patients with CT-2 viral pneumonia was found when both therapeutic exercises and their complex in combination with chest massage in an electrostatic field were included in their therapy (p<0.05).

The data obtained also correlates with existing publications regarding the impact of breathing exercises on the quality of patient’s life. Patient stratification based on the CT stage of viral pneumonia is also noted as an assessment in some cases and with reservations from foreign authors.

In this publication the possibility of using data from multispiral computed tomography of the lungs as a prognostic factor for prescribing rehabilitation treatment in addition to standard COVID-19 therapy in an infectious diseases hospital was shown for the first time.

Conclusion. The usage of chest computed tomography, namely stratification of the viral pneumonia CT stage as a prognostic factor when patients are admitted to an infectious diseases hospital with a coronavirus infection, makes it possible to more effectively prescribe rehabilitation treatment.

 

Keywords: computed tomography, MSCT, COVID-19, rehabilitation.

 

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

 

For citation: Malyutin D.S., Serova N.S, Koneva E.S. Chest computed tomography in the control and monitoring of the rehabilitation treatment effectiveness of COVID-associated pneumonia in patients in an infectious diseases hospital. REJR 2023; 13(2):5-15. DOI: 10.21569/2222-7415-2023-13-2-5-15.

Received:        06.04.23                 Accepted: 12.06.23