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Denis A, Henket M, Ernst M, Maes N, Thys M, Regnier C, Malaise O, Frix AN, Gester F, Desir C, Meunier P, Louis R, Malaise M, Guiot J. Progressive fibrosing interstitial lung disease in rheumatoid arthritis: A retrospective study. Front Med (Lausanne) 2022; 9:1024298. [PMID: 36530900 PMCID: PMC9748274 DOI: 10.3389/fmed.2022.1024298] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 11/08/2022] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Rheumatoid arthritis associated-interstitial lung disease (RA-ILD) is the most common pulmonary manifestation of rheumatoid arthritis (RA) and an important cause of mortality. In patients suffering from interstitial lung diseases (ILD) from different etiologies (including RA-ILD), a significant proportion is exhibiting a fibrotic progression despite immunosuppressive therapies, defined as progressive fibrosing interstitial lung disease (PF-ILD). Here, we report the frequency of RA-ILD and PF-ILD in all RA patients' cohort at University Hospital of Liège and compare their characteristics and outcomes. METHODS Patients were retrospectively recruited from 2010 to 2020. PF-ILD was defined based on functional, clinical and/or iconographic progression criteria within 24 months despite specific anti-RA treatment. RESULTS Out of 1,500 RA patients, about one third had high-resolution computed tomography (HRCT) performed, 89 showed RA-ILD and 48 PF-ILD. RA-ILD patients were significantly older than other RA patients (71 old of median age vs. 65, p < 0.0001), with a greater proportion of men (46.1 vs. 27.7%, p < 0.0001) and of smoking history. Non-specific interstitial pneumonia pattern was more frequent than usual interstitial pneumonia among RA-ILD (60.7 vs. 27.0%) and PF-ILD groups (60.4 vs. 31.2%). The risk of death was 2 times higher in RA-ILD patients [hazard ratio 2.03 (95% confidence interval 1.15-3.57), p < 0.01] compared to RA. CONCLUSION We identified a prevalence of PF-ILD of 3% in a general RA population. The PF-ILD cohort did not seem to be different in terms of demographic characteristics and mortality compared to RA-ILD patients who did not exhibit the progressive phenotype yet.
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Affiliation(s)
- Anna Denis
- Department of Pneumology, CHU of Liège, Liège, Belgium
| | | | - Marie Ernst
- Department of Biostatistics and Medico-Economic, CHU of Liège, Liège, Belgium
| | - Nathalie Maes
- Department of Biostatistics and Medico-Economic, CHU of Liège, Liège, Belgium
| | - Marie Thys
- Department of Biostatistics and Medico-Economic, CHU of Liège, Liège, Belgium
| | - Céline Regnier
- Department of Rheumatology, CHU of Liège, Liège, Belgium
| | | | | | - Fanny Gester
- Department of Pneumology, CHU of Liège, Liège, Belgium
| | - Colin Desir
- Department of Radiology, CHU of Liège, Liège, Belgium
| | - Paul Meunier
- Department of Radiology, CHU of Liège, Liège, Belgium
| | - Renaud Louis
- Department of Pneumology, CHU of Liège, Liège, Belgium
| | - Michel Malaise
- Department of Rheumatology, CHU of Liège, Liège, Belgium
| | - Julien Guiot
- Department of Pneumology, CHU of Liège, Liège, Belgium
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Canivet P, Desir C, Thys M, Henket M, Frix AN, Ernst B, Walsh S, Occhipinti M, Vos W, Maes N, Canivet JL, Louis R, Meunier P, Guiot J. The Role of Imaging in the Detection of Non-COVID-19 Pathologies during the Massive Screening of the First Pandemic Wave. Diagnostics (Basel) 2022; 12:diagnostics12071567. [PMID: 35885473 PMCID: PMC9324631 DOI: 10.3390/diagnostics12071567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 06/25/2022] [Accepted: 06/26/2022] [Indexed: 11/24/2022] Open
Abstract
During the COVID-19 pandemic induced by the SARS-CoV-2, numerous chest scans were carried out in order to establish the diagnosis, quantify the extension of lesions but also identify the occurrence of potential pulmonary embolisms. In this perspective, the performed chest scans provided a varied database for a retrospective analysis of non-COVID-19 chest pathologies discovered de novo. The fortuitous discovery of de novo non-COVID-19 lesions was generally not detected by the automated systems for COVID-19 pneumonia developed in parallel during the pandemic and was thus identified on chest CT by the radiologist. The objective is to use the study of the occurrence of non-COVID-19-related chest abnormalities (known and unknown) in a large cohort of patients having suffered from confirmed COVID-19 infection and statistically correlate the clinical data and the occurrence of these abnormalities in order to assess the potential of increased early detection of lesions/alterations. This study was performed on a group of 362 COVID-19-positive patients who were prescribed a CT scan in order to diagnose and predict COVID-19-associated lung disease. Statistical analysis using mean, standard deviation (SD) or median and interquartile range (IQR), logistic regression models and linear regression models were used for data analysis. Results were considered significant at the 5% critical level (p < 0.05). These de novo non-COVID-19 thoracic lesions detected on chest CT showed a significant prevalence in cardiovascular pathologies, with calcifying atheromatous anomalies approaching nearly 35.4% in patients over 65 years of age. The detection of non-COVID-19 pathologies was mostly already known, except for suspicious nodule, thyroid goiter and the ascending thoracic aortic aneurysm. The presence of vertebral compression or signs of pulmonary fibrosis has shown a significant impact on inpatient length of stay. The characteristics of the patients in this sample, both from a demographic and a tomodensitometric point of view on non-COVID-19 pathologies, influenced the length of hospital stay as well as the risk of intra-hospital death. This retrospective study showed that the potential importance of the detection of these non-COVID-19 lesions by the radiologist was essential in the management and the intra-hospital course of the patients.
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Affiliation(s)
- Perrine Canivet
- Department of Radiology, University Hospital of Liège, 4000 Liège, Belgium; (C.D.); (P.M.)
- Correspondence:
| | - Colin Desir
- Department of Radiology, University Hospital of Liège, 4000 Liège, Belgium; (C.D.); (P.M.)
| | - Marie Thys
- Department of Medico-Economic Information, University Hospital of Liège, 4000 Liège, Belgium;
| | - Monique Henket
- Department of Pneumology, University Hospital of Liège, 4000 Liège, Belgium; (M.H.); (A.-N.F.); (B.E.); (R.L.); (J.G.)
| | - Anne-Noëlle Frix
- Department of Pneumology, University Hospital of Liège, 4000 Liège, Belgium; (M.H.); (A.-N.F.); (B.E.); (R.L.); (J.G.)
| | - Benoit Ernst
- Department of Pneumology, University Hospital of Liège, 4000 Liège, Belgium; (M.H.); (A.-N.F.); (B.E.); (R.L.); (J.G.)
| | - Sean Walsh
- Radiomics (Oncoradiomics SA), 4000 Liège, Belgium; (S.W.); (M.O.); (W.V.)
| | | | - Wim Vos
- Radiomics (Oncoradiomics SA), 4000 Liège, Belgium; (S.W.); (M.O.); (W.V.)
| | - Nathalie Maes
- Biostatistics and Medico-Economic Information Department, University Hospital of Liège, 4000 Liège, Belgium;
| | - Jean Luc Canivet
- Department of Intensive Unit Care, University Hospital of Liège, 4000 Liège, Belgium;
| | - Renaud Louis
- Department of Pneumology, University Hospital of Liège, 4000 Liège, Belgium; (M.H.); (A.-N.F.); (B.E.); (R.L.); (J.G.)
| | - Paul Meunier
- Department of Radiology, University Hospital of Liège, 4000 Liège, Belgium; (C.D.); (P.M.)
| | - Julien Guiot
- Department of Pneumology, University Hospital of Liège, 4000 Liège, Belgium; (M.H.); (A.-N.F.); (B.E.); (R.L.); (J.G.)
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Guiot J, Henket M, Frix AN, Gester F, Thys M, Giltay L, Desir C, Moermans C, Njock MS, Meunier P, Corhay JL, Louis R. Combined obstructive airflow limitation associated with interstitial lung diseases (O-ILD): the bad phenotype ? Respir Res 2022; 23:89. [PMID: 35410260 PMCID: PMC8996531 DOI: 10.1186/s12931-022-02006-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/24/2022] [Indexed: 12/17/2022] Open
Abstract
Abstract
Background
Patients suffering from combined obstructive and interstitial lung disease (O-ILD) represent a pathological entity which still has to be well clinically described. The aim of this descriptive and explorative study was to describe the phenotype and functional characteristics of a cohort of patients suffering from functional obstruction in a population of ILD patients in order to raise the need of dedicated prospective observational studies and the evaluation of the impact of anti-fibrotic therapies.
Methods
The current authors conducted a retrospective study including 557 ILD patients, with either obstructive (O-ILD, n = 82) or non-obstructive (non O-ILD, n = 475) pattern. Patients included were mainly males (54%) with a mean age of 62 years.
Results
Patients with O-ILD exhibited a characteristic functional profile with reduced percent predicted forced expired volume in 1 s (FEV1) [65% (53–77) vs 83% (71–96), p < 0.00001], small airway involvement assessed by maximum expiratory flow (MEF) 25/75 [29% (20–41) vs 81% (64–108), p < 0.00001], reduced sGaw [60% (42–75) vs 87% (59–119), p < 0.01] and sub-normal functional residual capacity (FRC) [113% (93–134) vs 92% (75–109), p < 0.00001] with no impaired of carbon monoxide diffusing capacity of the lung (DLCO) compared to those without obstruction. Total lung capacity (TLC) was increased in O-ILD patients [93% (82–107) vs 79% (69–91), p < 0.00001]. Of interest, DLCO sharply dropped in O-ILD patients over a 5-year follow-up. We did not identify a significant increase in mortality in patients with O-ILD. Interestingly, the global mortality was increased in the specific sub-group of patients with O-ILD and no progressive fibrosing ILD phenotype and in those with connective tissue disease associated ILD especially in case of rheumatoid arthritis.
Conclusions
The authors individualized a specific functional-based pattern of ILD patients with obstructive lung disease, who are at risk of increased mortality and rapid DLCO decline over time. As classically those patients are excluded from clinical trials, a dedicated prospective study would be of interest in order to define more precisely treatment response of those patients.
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Darcis G, Bouquegneau A, Maes N, Thys M, Henket M, Labye F, Rousseau AF, Canivet P, Desir C, Calmes D, Schils R, De Worm S, Léonard P, Meunier P, Moutschen M, Louis R, Guiot J. Long-term clinical follow-up of patients suffering from moderate-to-severe COVID-19 infection: a monocentric prospective observational cohort study. Int J Infect Dis 2021; 109:209-216. [PMID: 34273510 PMCID: PMC8278829 DOI: 10.1016/j.ijid.2021.07.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/06/2021] [Accepted: 07/06/2021] [Indexed: 12/12/2022] Open
Abstract
Objectives Various symptoms and considerable organ dysfunction persist following infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Uncertainty remains about the potential mid- and long-term health sequelae. This prospective study of patients hospitalized with coronavirus disease 2019 (COVID-19) in Liège University Hospital, Belgium aimed to determine the persistent consequences of COVID-19. Methods Patients admitted to the University Hospital of Liège with moderate-to-severe confirmed COVID-19, discharged between 2 March and 1 October 2020, were recruited prospectively. Follow-up at 3 and 6 months after hospital discharge included demographic and clinical data, biological data, pulmonary function tests (PFTs) and high-resolution computed tomography (CT) scans of the chest. Results In total, 199 individuals were included in the analysis. Most patients received oxygen supplementation (80.4%). Six months after discharge, 47% and 32% of patients still had exertional dyspnoea and fatigue. PFTs at 3-month follow-up revealed a reduced diffusion capacity of carbon monoxide (mean 71.6 ± 18.6%), and this increased significantly at 6-month follow-up (P<0.0001). Chest CT scans showed a high prevalence (68.9% of the cohort) of persistent abnormalities, mainly ground glass opacities. Duration of hospitalization, intensive care unit admission and mechanical ventilation were not associated with the persistence of symptoms 3 months after discharge. Conclusion The prevalence of persistent symptoms following hospitalization with COVID-19 is high and stable for up to 6 months after discharge. However, biological, functional and iconographic abnormalities improved significantly over time.
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Affiliation(s)
- Gilles Darcis
- Department of Infectious Diseases, University Hospital of Liège, Liège, Belgium.
| | - Antoine Bouquegneau
- Department of Nephrology-Dialysis-Transplantation, University Hospital of Liège, Liège, Belgium
| | - Nathalie Maes
- Department of Biostatistics and Medico-Economic Information, University Hospital of Liège, Liège, Belgium
| | - Marie Thys
- Department of Biostatistics and Medico-Economic Information, University Hospital of Liège, Liège, Belgium
| | - Monique Henket
- Department of Pneumology, University Hospital of Liège, Liège, Belgium
| | - Florence Labye
- Department of Internal Medicine, University Hospital of Liège, Liège, Belgium
| | | | - Perrine Canivet
- Department of Radiology, University Hospital of Liège, Liège, Belgium
| | - Colin Desir
- Department of Radiology, University Hospital of Liège, Liège, Belgium
| | - Doriane Calmes
- Department of Pneumology, University Hospital of Liège, Liège, Belgium
| | - Raphael Schils
- Department of Infectious Diseases, University Hospital of Liège, Liège, Belgium
| | - Sophie De Worm
- Department of Infectious Diseases, University Hospital of Liège, Liège, Belgium
| | - Philippe Léonard
- Department of Infectious Diseases, University Hospital of Liège, Liège, Belgium
| | - Paul Meunier
- Department of Radiology, University Hospital of Liège, Liège, Belgium
| | - Michel Moutschen
- Department of Infectious Diseases, University Hospital of Liège, Liège, Belgium
| | - Renaud Louis
- Department of Pneumology, University Hospital of Liège, Liège, Belgium
| | - Julien Guiot
- Department of Pneumology, University Hospital of Liège, Liège, Belgium
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Cousin F, Desir C, Ben Mustapha S, Mievis C, Coucke P, Hustinx R. Incidence, risk factors, and CT characteristics of radiation recall pneumonitis induced by immune checkpoint inhibitor in lung cancer. Radiother Oncol 2021; 157:47-55. [DOI: 10.1016/j.radonc.2021.01.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/30/2020] [Accepted: 01/02/2021] [Indexed: 11/29/2022]
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Desir C, Coimbra C, Decker M, Reenaers C, Van Kemseke C, Latour P, Louis E, Meunier P. [How I explore … Crohn's disease by various imaging modalities]. Rev Med Liege 2017; 72:51-56. [PMID: 28387079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Crohn's disease is a chronic inflammatory condition characterized by recurrent and/or chronic lesions, leading to cumulative structural bowel damage. It is established that the correlation between symptoms and intestinal lesions is weak. Therefore, monitoring by frequent cross-sectional imaging is proposed to assess the disease activity. There is no consensus about the preferred imaging option. Priority is given to non-radiating modalities, such as ultrasonography and MRI. Tomodensitometry will be reserved for emergency cases. Ultrasonography can be useful, in emergency as well as for the monitoring of lesions of known topography. Entero-MRI is henceforth considered the standard imaging technique for the diagnosis and follow-up of Crohn's disease. Its high contrast resolution allows an accurate assessment of disease activity, therapeutic efficacy, cumulative structural bowel damage and complications.
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Affiliation(s)
- C Desir
- Service de Radiologie, CHU de Liège, Site Sart Tilman, Liège, Belgique
| | - C Coimbra
- Service de Chirurgie Abdominale, CHU de Liège, Site Sart Tilman, Liège, Belgique
| | - M Decker
- Service de Chirurgie Abdominale, CHU de Liège, Site Sart Tilman, Liège, Belgique
| | - C Reenaers
- Service de Gastro-entérologie, CHU de Liège, Site Sart Tilman, Liège, Belgique
| | - C Van Kemseke
- Service de Gastro-entérologie, CHU de Liège, Site Sart Tilman, Liège, Belgique
| | - P Latour
- Service de Gastro-entérologie, CHU de Liège, Site Sart Tilman, Liège, Belgique
| | - E Louis
- Service de Gastro-entérologie, CHU de Liège, Site Sart Tilman,Liège, Belgique
| | - P Meunier
- Service de Radiodiagnostic, CHU de Liège, Site du Sart Tilman, Liège, Belgique
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Gerbelot R, Koenig A, Goyer C, Willemin J, Desir C, Porcherot J, Kane HS, Guillemaud R, Borel JC, Jallon P. A wireless patch for sleep respiratory disorders applications. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2015:2279-82. [PMID: 26736747 DOI: 10.1109/embc.2015.7318847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This paper presents a conformable wireless patch and its mobile application for physical activity, spO2 and pCO2 recording associated to digital biomarkers that aim at providing the clinicians with a reliable computer-aided diagnosis tool for rapid and continuous monitoring of sleep respiratory disorders. Each part of the system is described and results are presented and discussed. The reflectance sp02 sensor has been tested in vivo on several body sites and several subjects then compared to a reference device. The electrochemical tcpO2 sensor has been validated in vitro. Based on these physiological parameters, the proposed algorithms to automatically identifying sleep respiratory events are compared to a reference index.
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