Análise comparativa do padrão tomográfico pulmonar na infecção pelas variantes B.1.1.7 e P.1 do vírus SARS-COV-2

Abstract

Introduction: The SARS-CoV-2 virus quickly spread globally and acquired pandemic status in March 2020, posing a major threat to public health. Since then, it has suffered several genetic mutations, which culminated in multiple waves of disease transmission. Computed tomography (CT) of the chest may be a diagnostic alternative complementary to RT-PCR, to assess pulmonary involvement and assist in the therapeutic approach. Objective: To analyze lung tomographic patterns in the COVID-19 epidemic curves in 2020 and 2021 caused by the B.1.1.7 and P.1 variants of the SARS-CoV-2 virus. Methodology: A cross-sectional, descriptive, analytical and retrospective study was carried out through the evaluation of 360 CT scans of the chest, in a Reference Radiology Service, including patients with COVID-19 in two epidemic periods in an area of the Brazilian Amazon, characterized by lineages B.1.1.7 (Alpha) from April – September 2020 and P.1 (Gamma) from October 2020 – March 2021. Expert Consensus criteria of the Radiological Society of North America (RSNA) were used. In patients older than 18 years of age, of both sexes, the pattern and degree of pulmonary involvement, distribution of lesions, affected segments and other findings on tomography were evaluated. Results: The proportions of patients of different genders (p=0.289) or different age groups (p=0.314) did not vary significantly between periods. In the first period, 70.6% had pulmonary involvement between 10-25% and in the second period only 43.3%. All individuals had ground-glass lesions and the presence of thickening of the interlobular septa was significantly observed in the first epidemic curve (81.9%) (p=0.002). Conclusion: There was a prevalence of women and individuals aged between 45-60 years. 100% of the individuals presented ground-glass lesions and the typical pattern of involvement prevailed in both analyses. The Alpha variant, predominant in the first epidemic curve, presented a higher degree of pulmonary involvement in relation to the Gamma variant, predominant in the second epidemic curve.