Abstract
Background: The pulmonary sequelae of severe COVID-19 infection are yet to be fully defined. The authors undertook this study to find out the proportion of severe COVID-19 patients having fibrosis-like lung sequelae during a medium-term follow-up period.Materials and methods: This was a retrospective observational study from a dedicated COVID centre of Eastern India. Severe COVID-19 patients who had undergone chest computerized tomography (CT) during the acute phase of illness and at least one follow-up CT with a gap of minimum two months between the two scans were included in the study.Result: A total of 39 patients who had recovered from severe COVID-19 pneumonia and presented to the pulmonary medicine OPD in the months of July and August 2021 were included. Patients with pre-existing lung disease (n-4), mild to moderate (n-11), and due to unavailability of CT scan (n-2) were excluded. A total of 22 patients (thirteen males, nine females) were thus included for analysis. Follow-up scans were performed with a mean of 2.5 months after the onset of the disease. Out of 22 patients, only one patient’s follow-up scan was normal. Predominant fibrotic-like features were present in six (27.2%) patients, though some evidence of fibrosis-like changes were seen in 20 out of 22 (90.9%) patients. The remaining 15 (68.2%) patients with abnormal scans had predominant non-fibrotic changes like ground-glass opacities (GGOs), consolidation, cavity, or nodule. The most common presenting symptoms at the follow-up examination were dyspnoea (81.8%), cough (54.1%) followed by fatigue in 40.9% of patients.Conclusion: This study concluded that most of the severe COVID-19 patients have some residual radiological findings during medium-term follow-up. Fibrotic-like lesions are present in almost all patients but most of them get resolved with time. True fibrotic features like honeycombing are rarely seen as residual lung sequelae.
Highlights
Long COVID-19, known as post-acute sequelae of severe acute respiratory syndrome (SARS)-CoV-2 infection (PASC) or post COVID-19 condition, is defined as a post-viral syndrome affecting people who have recovered from COVID-19 infection
Post COVID-19 sequelae may vary from mild symptoms as fatigue and body ache to severe symptoms that may due to lung fibrosis, cardiac abnormalities, and stroke leading to significant impairment in quality of health [3]
Pulmonary sequelae can have fibrosis-like manifestations such as reticular opacities, honeycombing, traction bronchiectasis, parenchymal bands as well as non-fibrotic features such as groundglass opacities (GGOs), consolidation or nodules, etc
Summary
Long COVID-19, known as post-acute sequelae of SARS-CoV-2 infection (PASC) or post COVID-19 condition, is defined as a post-viral syndrome affecting people who have recovered from COVID-19 infection. It can manifest weeks or months after the apparent clinical resolution of the acute phase of the disease. Post COVID-19 sequelae may vary from mild symptoms as fatigue and body ache to severe symptoms that may due to lung fibrosis, cardiac abnormalities, and stroke leading to significant impairment in quality of health [3]. The authors undertook this study to find out the proportion of severe COVID-19 patients having fibrosis-like lung sequelae during a medium-term follow-up period
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