Abstract

We aimed to investigate changes in pulmonary function and computed tomography (CT) findings in patients with coronavirus disease 2019 (COVID-19) during the recovery period. COVID-19 patients underwent symptom assessment, pulmonary function tests, and high-resolution chest CT 6 months after discharge from the hospital. Of the 54 patients enrolled, 31 and 23 were in the moderate and severe group, respectively. The main symptoms 6 months after discharge were fatigue and exertional dyspnea, experienced by 24.1% and 18.5% of patients, respectively, followed by smell and taste dysfunction (9.3%) and cough (5.6%). One patient dropped out of the pulmonary function tests. Of the remaining 54 patients, 41.5% had pulmonary dysfunction. Specifically, 7.5% presented with restrictive ventilatory dysfunction (forced vital capacity <80% of the predicted value), 18.9% presented with small airway dysfunction, and 32.1% presented with pulmonary diffusion impairment (diffusing capacity for carbon monoxide <80% of the predicted value). Of the 54 patients enrolled, six patients dropped out of the chest CT tests. Eleven of the remaining 48 patients presented with abnormal lung CT findings 6 months after discharge. Patients with residual lung lesions were more common in the severe group (52.6%) than in the moderate group (3.4%); a higher proportion of patients had involvement of both lungs (42.1% vs. 3.4%) in the severe group. The residual lung lesions were mainly ground-glass opacities (20.8%) and linear opacities (14.6%). Semiquantitative visual scoring of the CT findings revealed significantly higher scores in the left, right, and both lungs in the severe group than in the moderate group. COVID-19 patients 6 months after discharge mostly presented with fatigue and exertional dyspnea, and their pulmonary dysfunction was mostly characterized by pulmonary diffusion impairment. As revealed by chest CT, the severe group had a higher prevalence of residual lesions than the moderate group, and the residual lesions mostly manifested as ground-glass opacities and linear opacities.

Highlights

  • Coronavirus disease 2019 (COVID-19) is an acute respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

  • Existing research mostly focuses on the treatment of COVID-19 [2], while much remains unknown about its prognosis, especially the pathophysiological outcome of COVID-19-induced pulmonary fibrosis

  • E average age of patients in the severe group was 54.4 ± 13.6 years, which was significantly higher than that of those in the moderate group (43.3 ± 15.0 years). e proportion of patients with diabetes was significantly higher in the severe group (26.1%) than in the moderate group (3.2%)

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Summary

Introduction

Coronavirus disease 2019 (COVID-19) is an acute respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As of 22 November, there have been over 57.8 million cases and 1.3 million deaths reported globally since the start of the pandemic [1]. Despite its current containment in China, the number of global cases is still on the rise. Existing research mostly focuses on the treatment of COVID-19 [2], while much remains unknown about its prognosis, especially the pathophysiological outcome of COVID-19-induced pulmonary fibrosis. Viral pneumonia tends to induce pulmonary interstitial changes. Many patients with COVID-19 experience varying degrees of dyspnea on exertion and present with postinflammatory pulmonary fibrosis as revealed by imaging examination, with

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