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

Frontiers in Medicine

article

Mengqi Liu¹  Fajin Lv¹  Yang Huang¹  Kaihu Xiao² 

[1] Department of Radiology, The First Affiliated Hospital of Chongqing Medical University;Department of Cardiology, Chongqing University Three Gorges Hospital

关键词: coronavirus disease 2019;    computed tomography;    follow-up;    pulmonary fibrosis;    cardiopulmonary exercise testing;   

DOI  :  10.3389/fmed.2021.636298

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

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.

【 授权许可】

CC BY