Radiological pulmonary sequelae after COVID-19 and correlation with clinical and functional pulmonary evaluation: results of a prospective cohort.
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| Title: | Radiological pulmonary sequelae after COVID-19 and correlation with clinical and functional pulmonary evaluation: results of a prospective cohort. |
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| Authors: | Soliman, Samer1 (AUTHOR) samer.soliman@aphp.fr, Soliman, Heithem2 (AUTHOR), Crézé, Maud1 (AUTHOR), Brillet, Pierre-Yves3 (AUTHOR), Montani, David4 (AUTHOR), Savale, Laurent4 (AUTHOR), Jais, Xavier4 (AUTHOR), Bulifon, Sophie4 (AUTHOR), Jutant, Etienne-Marie4 (AUTHOR), Rius, Emily1 (AUTHOR), Devilder, Matthieu1 (AUTHOR), Beurnier, Antoine5 (AUTHOR), Colle, Romain6 (AUTHOR), Gasnier, Matthieu6 (AUTHOR), Pham, Tài7 (AUTHOR), Morin, Luc8 (AUTHOR), Noel, Nicolas9 (AUTHOR), Lecoq, Anne-Lise10 (AUTHOR), Becquemont, Laurent10 (AUTHOR), Figueiredo, Samy11 (AUTHOR) |
| Source: | European Radiology. Feb2024, Vol. 34 Issue 2, p1037-1052. 16p. |
| Subjects: | COVID-19, Pulmonary function tests, Disease complications, Intensive care units, Lung volume measurements, Pulmonary fibrosis |
| Abstract: | Objectives: Whether COVID-19 leads to long-term pulmonary sequelae or not remains unknown. The aim of this study was to assess the prevalence of persisting radiological pulmonary fibrotic lesions in patients hospitalized for COVID-19. Materials and methods: We conducted a prospective single-center study among patients hospitalized for COVID-19 between March and May 2020. Patients with residual symptoms or admitted into intensive care units were investigated 4 months after discharge by a chest CT (CCT) and pulmonary function tests (PFTs). The primary endpoint was the rate of persistent radiological fibrotic lesions after 4 months. Secondary endpoints included further CCT evaluation at 9 and 16 months, correlation of fibrotic lesions with clinical and PFT evaluation, and assessment of predictive factors. Results: Among the 1151 patients hospitalized for COVID-19, 169 patients performed a CCT at 4 months. CCTs showed pulmonary fibrotic lesions in 19% of the patients (32/169). These lesions were persistent at 9 months and 16 months in 97% (29/30) and 95% of patients (18/19) respectively. There was no significant clinical difference based on dyspnea scale in patients with pulmonary fibrosis. However, PFT evaluation showed significantly decreased diffusing lung capacity for carbon monoxide (p < 0.001) and total lung capacity (p < 0.001) in patients with radiological lesions. In multivariate analysis, the predictive factors of radiological pulmonary fibrotic lesions were pulmonary embolism (OR = 9.0), high-flow oxygen (OR = 6.37), and mechanical ventilation (OR = 3.49). Conclusion: At 4 months, 19% of patients investigated after hospitalization for COVID-19 had radiological pulmonary fibrotic lesions; they persisted up to 16 months. Clinical relevance statement: Whether COVID-19 leads to long-term pulmonary sequelae or not remains unknown. The aim of this study was to assess the prevalence of persisting radiological pulmonary fibrotic lesions in patients hospitalized for COVID-19. The prevalence of persisting lesions after COVID-19 remains unclear. We assessed this prevalence and predictive factors leading to fibrotic lesions in a large cohort. The respiratory clinical impact of these lesions was also assessed. Key Points: • Nineteen percent of patients hospitalized for COVID-19 had radiological fibrotic lesions at 4 months, remaining stable at 16 months. • COVID-19 fibrotic lesions did not match any infiltrative lung disease pattern. • COVID-19 fibrotic lesions were associated with pulmonary function test abnormalities but did not lead to clinical respiratory manifestation. [ABSTRACT FROM AUTHOR] |
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| Database: | Engineering Source |
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