Reply to “Segmental Pulmonary Vascular Changes in COVID-19 Pneumonia”
Sana Salehi, Ali Gholamrezanezhad
Abstract
Vascular Changes in COVID-19 Pneumonia"We thank Parry and Wani [1] for their interest in our article [2] and their comments.We agree with their remarks about the significance of vascular enlargement in coronavirus disease .However, as we stated in reply to another letter [3], at the time that our systematic review was concluded, available peer-reviewed publications were limited with regard to reporting the vascular changes on chest CT.Vascular enlargement seems to be used as an umbrella term suggesting "mural thickening or luminal dilation of pulmonary vessels in areas of lung opacity" [3]; however, a precise definition of this term was not included in some studies.This underlines the importance of using a common lexicon and standardized reporting scheme in research and practice [4][5][6].In our recent publication using the imaging data of 37 published COVID-19 studies (including 3647 patients), we reported that vascular enlargement was described in 60% (229/382) of patients and supposedly maintains a diagnostic and prognostic value [6].In the mentioned study, we classified the CT findings of COVID-19 into typical, fairly typical, and atypical categories and proposed the COVID-19 Imaging Reporting and Data System (COVID-RADS) grading framework.According to our study, vascular enlargement is regarded as a fairly typical finding in COVID-19.In the right clinical context and in the absence of atypical findings, intralesional vascular enlargement may indicate at least a moderate level of suspicion for COVID-19 pulmonary involvement.However, the sensitivity and specificity of individual CT findings for COVID-19 are yet to be determined and warrant additional studies.