Pulmonary Sequelae in Patients After Recovery From Coronavirus Disease 2019: A Follow-Up Study With Chest CT.

Xuejiao Liao,Dan Shu,Zheng Zhang,Jing Cao,Lijun Yuan,Guangping Zheng,Qing He,Xiangyi Yang,Lina Zhang,Zhenghua Ma,Zhi Liu,Lei Liu,Dapeng Li,Jingke Dong,Guobao Li,Yirong Shi,Xiaowen Gu,Ling Huang

doi:10.3389/fmed.2021.686878

Abstract

Objective: The pulmonary sequelae of coronavirus disease 2019 (COVID-19) have not been comprehensively evaluated. We performed a follow-up study analyzing chest computed tomography (CT) findings of COVID-19 patients at 3 and 6 months after hospital discharge.Methods: Between February 2020 and May 2020, a total of 273 patients with COVID-19 at the Shenzhen Third People's Hospital were recruited and followed for 6 months after discharge. Chest CT scanning was performed with the patient in the supine position at end-inspiration. A total of 957 chest CT scans was obtained at different timepoints. A semi-quantitative score was used to assess the degree of lung involvement.Results: Most chest CT scans showed bilateral lung involvement with peripheral location at 3 and 6 months follow-up. The most common CT findings were ground-glass opacity and parenchymal band, which were found in 136 (55.3%) and 94 (38.2%) of the 246 patients at 3 months follow-up, and 82 (48.2%) and 76 (44.7%) of 170 patients at 6 months follow-up, respectively. The number of lobes involved and the total CT severity score declined over time. The total CT score gradually increased with the increasement of disease severity at both 3 months follow-up (trend test P < 0.001) and 6 months follow-up (trend test P < 0.001). Patients with different disease severity represented diverse CT patterns over time.Conclusions: The most common CT findings were ground-glass opacity and parenchymal bands at the 3 and 6 months follow-up. Patients with different disease severity represent diverse CT manifestations, indicating the necessary for long-term follow-up monitoring of patients with severe and critical conditions.

Highlights

The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has become global pandemic [1]
A total of 273 patients were recruited from February 3, 2020, to May 3, 2020 and underwent at least one Computed tomography (CT) scan at 3 and 6 months follow-up
In COVID19 patients, the evolution of lung abnormalities on chest CT scans is similar to the progression of other forms of acute lung injury caused by viral pneumonia, such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS)

Summary

Introduction

The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has become global pandemic [1]. Numbers of studies described many chest CT characteristics of COVID-19 patients during hospitalization, suggesting that the most common findings were ground-glass opacity (GGO) lesions [11, 12]. Some studies identified the different stages of the disease using pulmonary changes found on chest CT scans from initial diagnosis until hospital discharge [15,16,17]. Previous study reported persistent radiographic changes in a subgroup of patients with severe illness at 3, 6, 9, and 12 months following hospital discharge [18]. CT findings and lung function among patients with different disease severity over a longer follow-up period still need to be investigated. We assessed the chest CT characteristics of patients with COVID19 at 3 and 6 months after discharge, including changes from admission to follow-up and by disease severity

Methods

Results

Discussion

Conclusion