Impact of Thymic Response in COVID-19 Pneumonia on Disease Severity and Mortality-As Assessed on CT-Chest

Authors

  • Saerah Iffat Zafar Armed Forces Institute of Radiology & Imaging/National University of Medical Sciences Rawalpindi Pakistan
  • Hina Nasir Armed Forces Institute of Radiology & Imaging/National University of Medical Sciences Rawalpindi Pakistan
  • Atiqur Rehman Slehria Armed Forces Institute of Radiology & Imaging/National University of Medical Sciences Rawalpindi Pakistan
  • Nadeem Zafar Armed Forces Institute of Pathology/National University of Medical Sciences Rawalpindi Pakistan
  • Alina Shahiryar Islamabad International Dental Hospital, Islamabad Pakistan

DOI:

https://doi.org/10.51253/pafmj.v73i2.8125

Keywords:

COVID pneumonia, Thymus, Reactivation, Response

Abstract

Objective: To determine the effect of thymic response to COVID-19 pneumonia on imaging and its impact on disease severity and outcome.

Study Design: Cross-sectional study.

Place and Duration of Study: Armed Forces Institute of Radiology and Imaging (AFIRI), Rawalpindi Pakistan, from Mar to Jul 2020.

Methodology: A total of 1620 COVID-19 patients above the age of 18, of either gender, were included in the study. Their findings on High-Resolution CT (HRCT) chest were recorded and graded according to the CT severity score (CTSS) out of a total of 40; less than or equal to 19 was taken as mild while >20 scores were considered as severe disease. The thymic response was assessed by imaging appearance on CT and was graded from 0-3 as follows: fatty, predominantly fatty, mixed density (fat and soft density), and soft density. Fatty replacement implied thymic involution, while soft density depicted a reactivation of thymic tissue after a disease process depictive adequate thymic response.

Results: A significant difference in thymic response was observed in patients of different age groups (p<0.001), with the younger age group demonstrating thymic reactivation/ response in the majority (170/244, 69.7%). CT severity score and mortality were significantly higher in older patients demonstrating poor thymic response to COVID pneumonia.

Conclusion: Response of the thymus to acute viral infection by Sars COVID-19 is impaired as age progresses; this accounts for greater disease severity, morbidity and mortality in older patients.

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Published

03-05-2023

How to Cite

1.
Zafar SI, Nasir H, Slehria AR, Zafar N, Shahiryar A. Impact of Thymic Response in COVID-19 Pneumonia on Disease Severity and Mortality-As Assessed on CT-Chest. Pak Armed Forces Med J [Internet]. 2023 May 3 [cited 2024 May 24];73(2):527-30. Available from: https://pafmj.org/PAFMJ/article/view/8125

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