Post-Covid-19 Lung Fibrosis: Study of 600 Cases in Tertiary Care Setting in India

Abstract

Introduction: Although Lung is the primary target organ involvement in corona virus disease-19 (COVID-19), post-COVID lung pathology is still uncertain. Methods: multicentric observational study conducted during May-November 2020, in MIMSR Medical College and Venkatesh Hospital Latur India, 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 without lung fibrosis as per CT severity were key observations. Statistical analysis is done by using Chi square test. Observations and analysis: Lung fibrosis documented in 13.66% post COVID-19 pneumonia cases, and in males (70/82) versus females (12/82) [p 15 documented fibrosis in 2.22%, 8.57% and 18.37 % respectively of total 600 study cases [p 15 days of onset of symptoms documented post COVID 19 fibrosis in 6.66%, 11.57% and 25.88% cases respectively [p 90% observed in 36.36%, 18.23% and 3.43% respectively [p<0.00001]. Timing of BIPAP/NIV has significant association in preventing lung fibrosis;cases received BIPAP/NIV at entry point <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<0.00001]. BIPAP/NIV use has beneficial outcome in preventing lung fibrosis in comorbidity like DM cases [p,0.009];IHD cases [p<0.001] and COPD cases [p<0.013]. Conclusion: 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.