Paranasal and thoracic computed tomography (CT) were useful to detect clinically important factors associated with poor asthma control in patients with severe asthma, according to study results published in Respiratory Medicine.

Researchers conducted a retrospective review of the medical records of adults with confirmed severe asthma from a single hospital in Spain who had had paranasal and/or chest CT (n=161). Findings from paranasal and/or chest CT conducted within the 5 years preceding the study were collected and reviewed. The investigators searched for a set of terms in the clinical record, including nasal polyps, thickening, bronchiectasis, infiltrates, atelectasis, emphysema, and air trapping.

A total of 103 and 57 patients underwent a paranasal and chest CT, respectively. Of the patients who underwent paranasal CT, 73% had ≥1 sinus occupied, 70.5% had mucous thickening associated with peripheral eosinophils, and 46.7% had chronic rhinosinusitis with nasal polyps.


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Of the patients who underwent chest CT, 28% had atelectasis, 17.7% had affectation of the small airway, 16.5% had air trapping, 11.6% presented pulmonary infiltrates, and 10.4% had emphysema. In this cohort, 60.5% of patients had bronchiectasis, which was more common in those who were older and had poorer lung function.

Limitations of this study included its retrospective nature, the inclusion of patient data from a single center, and the relatively small sample size.

“We should consider accomplishing paranasal and chest CT scan in every patient diagnosed with severe asthma in an era of personalized medicine with constant development of new therapeutics for severe asthma,” the study authors noted.

Disclosure: This clinical trial was supported by GlaxoSmithKline. Please see the original reference for a full list of authors’ disclosures.

Reference

Zamarron E, Romero D, Fernández-Lahera J, et al. Should we consider paranasal and chest computed tomography in severe asthma patients? Respir Med. 2020;169:106013.