POST-COVID-19 LUNG FIBROSIS: STUDY OF 600 CASES IN TERTIARY CARE SETTING IN INDIA

Abstract

<b>Introduction:</b> Although Lung is the primary target organ involvement in corona virus disease-19 (COVID-19), post-covid lung pathology is still uncertain. <b>Methods:</b> multicentric observational study, included 600 COVID-19 cases with lung involvement documented and categorized on HRCT thorax at entry point and at six weeks post discharge from hospital. Age, gender, Comorbidity and use BIPAP/NIV in COVID-19 cases and outcome as with or withoutlung fibrosis as per CT severity were key observations. Statistical analysis is done by using Chi square test. <b>Observations and analysis:</b> We observed lung fibrosis in 13.66% post covid-19 pneumonia cases, and statistically significant association in males (70/82) versus females (12/82) [p&lt;0.00004]; similar observation in below 50 years (16/82) versus above 50 years (66/82) [p&lt;0.0003]. Diabetes Mellitus (DM) was present in 194/600 cases versus non-Diabetes (62/82) [p&lt;0.00001].Duration of illness has associated negative impact on lung fibrosis; &lt;7 days, 8-15 days and &gt;15 days of onset of symptoms documented post covid 19 fibrosis in (16/240) 6.66%, (22/190) 11.57% and (44/170) 25.88% cases respectively [p&lt;0.00001]. Use of BIPAP/NIV at entry point i.e &lt;1 day, 3-7 days and after 7 days of hospitalization were documented lung fibrosis in 7.77, 37.33 and 72.72 cases respectively [p&lt;0.00001]. <b>Conclusion:</b> Lung fibrosis in Post-covid 19 cases is documented and should be assessed cautiously to have successful treatment outcome. Age above 50 years, male gender, Diabetes, High CT severity, longer duration of illness, proper timing of initiation of BIPAP/NIV therapy, and its early use in comorbid class has documented significant impact on post covid lung fibrosis.