Cargando…

Follow-Up Study of the Chest CT Characteristics of COVID-19 Survivors Seven Months After Recovery

Background: It has remained a concern whether any long-term pulmonary sequelae exist for COVID-19 survivors. Methods: Forty-one patients (22 men and 19 women, 50 ± 14 years) confirmed with COVID-19 performed follow-up chest CT and cardiopulmonary exercise testing at 7 months after discharge. Patient...

Descripción completa

Detalles Bibliográficos
Autores principales: Liu, Mengqi, Lv, Fajin, Huang, Yang, Xiao, Kaihu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7956974/
https://www.ncbi.nlm.nih.gov/pubmed/33732719
http://dx.doi.org/10.3389/fmed.2021.636298
_version_ 1783664555731189760
author Liu, Mengqi
Lv, Fajin
Huang, Yang
Xiao, Kaihu
author_facet Liu, Mengqi
Lv, Fajin
Huang, Yang
Xiao, Kaihu
author_sort Liu, Mengqi
collection PubMed
description Background: It has remained a concern whether any long-term pulmonary sequelae exist for COVID-19 survivors. Methods: Forty-one patients (22 men and 19 women, 50 ± 14 years) confirmed with COVID-19 performed follow-up chest CT and cardiopulmonary exercise testing at 7 months after discharge. Patients were divided into fibrosis group and non-fibrosis group according to the evidence of fibrosis on follow-up CT. The clinical data and the CT findings were recorded and analyzed. Results: The predominant CT patterns of abnormalities observed at 7 months after discharge were parenchymal band (41%), interlobular septal thickening (32%), and traction bronchiectasis (29%). Sixty-one percent of the patients achieved complete radiological resolution, and 29% of patients developed pulmonary fibrosis. Compared with the patients in the non-fibrosis group, the patients in the fibrosis group were older, with a longer hospital stay, a higher rate of steroid and mechanical ventilation therapy, lower levels of lymphocyte and T cell count, higher levels of D-dimer and lactic dehydrogenase, and higher quantitative CT parameters (opacity score, volume of opacity, and percentage of opacity) at discharge. Besides, oxygen consumption and metabolic equations were decreased and ventilatory equivalent for carbon dioxide was increased in patients in the fibrosis group. Logistic regression analyses revealed that age, steroid therapy, presence of traction bronchiectasis on chest CT at discharge, and opacity score at discharge, were independent risk factors for developing pulmonary fibrosis at 7 months after discharge. Receiver operating characteristic analysis revealed that the combined clinical-radiological model was better than the clinical-only model in the prediction of pulmonary fibrosis. Conclusions: The chest CT lesions could be absorbed without any sequelae for most patients with COVID-19, whereas older patients with severe conditions are more prone to develop fibrosis, which may further lead to cardiopulmonary insufficiency. The combined clinical-radiological model may predict the formation of pulmonary fibrosis early.
format Online
Article
Text
id pubmed-7956974
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-79569742021-03-16 Follow-Up Study of the Chest CT Characteristics of COVID-19 Survivors Seven Months After Recovery Liu, Mengqi Lv, Fajin Huang, Yang Xiao, Kaihu Front Med (Lausanne) Medicine Background: It has remained a concern whether any long-term pulmonary sequelae exist for COVID-19 survivors. Methods: Forty-one patients (22 men and 19 women, 50 ± 14 years) confirmed with COVID-19 performed follow-up chest CT and cardiopulmonary exercise testing at 7 months after discharge. Patients were divided into fibrosis group and non-fibrosis group according to the evidence of fibrosis on follow-up CT. The clinical data and the CT findings were recorded and analyzed. Results: The predominant CT patterns of abnormalities observed at 7 months after discharge were parenchymal band (41%), interlobular septal thickening (32%), and traction bronchiectasis (29%). Sixty-one percent of the patients achieved complete radiological resolution, and 29% of patients developed pulmonary fibrosis. Compared with the patients in the non-fibrosis group, the patients in the fibrosis group were older, with a longer hospital stay, a higher rate of steroid and mechanical ventilation therapy, lower levels of lymphocyte and T cell count, higher levels of D-dimer and lactic dehydrogenase, and higher quantitative CT parameters (opacity score, volume of opacity, and percentage of opacity) at discharge. Besides, oxygen consumption and metabolic equations were decreased and ventilatory equivalent for carbon dioxide was increased in patients in the fibrosis group. Logistic regression analyses revealed that age, steroid therapy, presence of traction bronchiectasis on chest CT at discharge, and opacity score at discharge, were independent risk factors for developing pulmonary fibrosis at 7 months after discharge. Receiver operating characteristic analysis revealed that the combined clinical-radiological model was better than the clinical-only model in the prediction of pulmonary fibrosis. Conclusions: The chest CT lesions could be absorbed without any sequelae for most patients with COVID-19, whereas older patients with severe conditions are more prone to develop fibrosis, which may further lead to cardiopulmonary insufficiency. The combined clinical-radiological model may predict the formation of pulmonary fibrosis early. Frontiers Media S.A. 2021-03-01 /pmc/articles/PMC7956974/ /pubmed/33732719 http://dx.doi.org/10.3389/fmed.2021.636298 Text en Copyright © 2021 Liu, Lv, Huang and Xiao. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Liu, Mengqi
Lv, Fajin
Huang, Yang
Xiao, Kaihu
Follow-Up Study of the Chest CT Characteristics of COVID-19 Survivors Seven Months After Recovery
title Follow-Up Study of the Chest CT Characteristics of COVID-19 Survivors Seven Months After Recovery
title_full Follow-Up Study of the Chest CT Characteristics of COVID-19 Survivors Seven Months After Recovery
title_fullStr Follow-Up Study of the Chest CT Characteristics of COVID-19 Survivors Seven Months After Recovery
title_full_unstemmed Follow-Up Study of the Chest CT Characteristics of COVID-19 Survivors Seven Months After Recovery
title_short Follow-Up Study of the Chest CT Characteristics of COVID-19 Survivors Seven Months After Recovery
title_sort follow-up study of the chest ct characteristics of covid-19 survivors seven months after recovery
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7956974/
https://www.ncbi.nlm.nih.gov/pubmed/33732719
http://dx.doi.org/10.3389/fmed.2021.636298
work_keys_str_mv AT liumengqi followupstudyofthechestctcharacteristicsofcovid19survivorssevenmonthsafterrecovery
AT lvfajin followupstudyofthechestctcharacteristicsofcovid19survivorssevenmonthsafterrecovery
AT huangyang followupstudyofthechestctcharacteristicsofcovid19survivorssevenmonthsafterrecovery
AT xiaokaihu followupstudyofthechestctcharacteristicsofcovid19survivorssevenmonthsafterrecovery