Abstract
ObjectivesThe study reports our experience with paired inspiration/expiration thin-section computed tomographic (CT) scans in the follow-up of COVID-19 patients with persistent respiratory symptoms.MethodsFrom August 13, 2020, to May 31, 2021, 48 long-COVID patients with respiratory symptoms (27 men and 21 women; median age, 62.0 years; interquartile range: 54.0–69.0 years) underwent follow-up paired inspiration-expiration thin-section CT scans. Patient demographics, length of hospital stay, intensive care unit admission rate, and clinical and laboratory features of acute infection were also included. The scans were obtained on a median of 72.5 days after onset of symptoms (interquartile range: 58.5–86.5) and at least 30 days after hospital discharge. Thin-section CT findings included ground-glass opacity, mosaic attenuation pattern, consolidation, traction bronchiectasis, reticulation, parenchymal bands, bronchial wall thickening, and air trapping. We used a quantitative score to determine the degree of air trapping in the expiratory scans.ResultsParenchymal abnormality was found in 50% (24/48) of patients and included air trapping (37/48, 77%), ground-glass opacities (19/48, 40%), reticulation (18/48, 38%), parenchymal bands (15/48, 31%), traction bronchiectasis (9/48, 19%), mosaic attenuation pattern (9/48, 19%), bronchial wall thickening (6/48, 13%), and consolidation (2/48, 4%). The absence of air trapping was observed in 11/48 (23%), mild air trapping in 20/48 (42%), moderate in 13/48 (27%), and severe in 4/48 (8%). Independent predictors of air trapping were, in decreasing order of importance, gender (p = 0.0085), and age (p = 0.0182).ConclusionsOur results, in a limited number of patients, suggest that follow-up with paired inspiratory/expiratory CT in long-COVID patients with persistent respiratory symptoms commonly displays air trapping.Key Points• Our experience indicates that paired inspiratory/expiratory CT in long-COVID patients with persistent respiratory symptoms commonly displays air trapping.• Iterative reconstruction and dose-reduction options are recommended for demonstrating air trapping in long-COVID patients.
Highlights
The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) arose in late December 2019 in Wuhan, Hubei Province, China [1–3]
Iterative reconstruction and dose-reduction options are recommended for demonstrating air trapping in long-COVID patients
Parenchymal abnormality was found in 50% (24/48) of patients and included air trapping (37/48, 77%), ground-glass opacities (19/48, 40%), reticulation (18/48, 38%), parenchymal bands (15/ 48, 31%), traction bronchiectasis (9/48, 19%), mosaic attenuation pattern (9/48, 19%), bronchial wall thickening (6/48, 13%), and consolidation (2/48, 4%)
Summary
The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) arose in late December 2019 in Wuhan, Hubei Province, China [1–3]. SARS-CoV-2 has resulted in a pandemic with more than 180 million confirmed cases worldwide and a death toll of more than 3.9 million COVID-19 infection can range from asymptomatic or mild illness (e.g., fever with or without cough) to severe respiratory distress, multiorgan failure, and death. Typical and atypical imaging findings of COVID-19 infection have been extensively reported [6–8]. In patients without severe respiratory disease, the major pulmonary CT findings of COVID-19 are ground-glass opacities (GGOs) with a typical bilateral and multilobar distribution and middle-lower lung predominance, mainly with a subpleural distribution [10, 11]. In more severely affected patients, consolidation replaces GGO, and the abnormalities extend to the upper lobes or become bilateral or both [11]
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