Abstract
BackgroundThe British Thoracic Society (BTS) recommends that all patients admitted with COVID-19 pneumonia should have a chest X-ray (CXR) and clinical follow-up at 6 or 12 weeks, depending on the disease severity. Little data is available on long-term CXR follow-up for moderate and severe COVID-19 pneumonia. This study aims to evaluate compliance with clinico-radiological follow-up of patients recovering from COVID-19 pneumonia at a local hospital in the UK, as per the BTS guidance, and to analyse radiological changes at clinical follow-up at 12 weeks, in order to risk-stratify and improve patient outcomes.MethodsThis is a single-centre retrospective audit of 255 consecutive COVID-19 positive patients admitted to a local hospital in the UK over 5 months between May and October 2020. All CXRs and clinic follow-up at 12 ± 8 weeks were checked on an electronic database.ResultsOver one in two (131/255) patients had CXR evidence of COVID-19 pneumonia during the initial hospital admission. Half of the patients (60/131) died before CXR or clinic follow-up. Fifty-eight percent (41/71) of the surviving patients had a follow-up CXR, and only two developed respiratory complications- one had residual lung fibrosis, another a pulmonary embolism. Eighty-eight percent (36/41) of the patients had either resolution or improved radiological changes at follow-up. Most patients who had abnormal follow-up CXR were symptomatic (6/8), and many asymptomatic patients at follow-up had a normal CXR (10/12).ConclusionsAlthough there were concerns about interstitial lung disease (ILD) incidence in patients with COVID-19 pneumonia, most of our patients with COVID-19 pneumonia had no pulmonary complications at follow-up with CXR. This emphasises that CXR, a cost-effective investigation, can be used to risk-stratify patients for long term pulmonary complications following their COVID-19 pneumonia. However, we acknowledge the limitations of a low CXR and clinic follow-up rate in our cohort.
Highlights
The British Thoracic Society (BTS) recommends that all patients admitted with COVID-19 pneumonia should have a chest X-ray (CXR) and clinical follow-up at 6 or 12 weeks, depending on the disease severity
As per the BTS guidance, we retrospectively evaluated CXR radiological and clinical follow-up of patients with COVID-19 pneumonia to assess our compliance with this guidance and understand the long-term sequelae following acute disease
The total number of patients admitted to the hospital with COVID-19 between the 1st of May and 10th of October 2020 was 255 (Fig. 1)
Summary
The British Thoracic Society (BTS) recommends that all patients admitted with COVID-19 pneumonia should have a chest X-ray (CXR) and clinical follow-up at 6 or 12 weeks, depending on the disease severity. The main consequence of Coronavirus, has led to a multi-fold increase in hospital admissions and mortality worldwide [2,3,4]. Pulmonary complications, such as viral pneumonia and pulmonary embolism (PE), are some of the leading causes of death in. Peripheral and lower lobe ground-glass lung opacities have been the most common presenting feature of SARS-CoV-2 infection in patients during hospital admission, often evident on chest imaging: CXR (chest X-ray) or CT scan (computed tomography) [1, 6]. Long-term data on chest imaging, CXR, is scarce at the moment, with studies focusing more on short-term complications of the disease [9, 10]
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