4.7 Article

Thin-section computed tomography findings and longitudinal variations of the residual pulmonary sequelae after discharge in patients with COVID-19: a short-term follow-up study

Journal

EUROPEAN RADIOLOGY
Volume 31, Issue 9, Pages 7172-7183

Publisher

SPRINGER
DOI: 10.1007/s00330-021-07799-9

Keywords

Coronavirus; Pulmonary fibrosis; Lung injury; Multidetector computed tomography

Funding

  1. Sanming Project of Medicine in Shenzhen [SZSM201612053]

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This study analyzed and compared CT findings and longitudinal variations after discharge in severe and non-severe COVID-19 patients, showing significant differences in the characteristics and changing trends of pulmonary sequelae between the two groups. Patients with severe/critical disease had more serious pulmonary sequelae and slower recovery compared to those with moderate disease. Some fibrosis-like findings were completely absorbed in patients with moderate and severe/critical diseases after discharge.
Objectives This study analyzed and compared CT findings and longitudinal variations after discharge between severe and non-severe coronavirus disease (COVID-19) patients who had residual pulmonary sequelae at pre-discharge. Methods A total of 310 patients were included and stratified into severe and non-severe COVID-19 groups. Cross-sectional CT features across different time periods (T0: pre-discharge, T1: 1-4 weeks after discharge, T2: 5-8 weeks after discharge, T3: 9-12 weeks after discharge, T4: > 12 weeks after discharge) were compared, and the longitudinal variations of CT findings were analyzed and compared in both groups. Results The cumulative absorption rate of fibrosis-like findings in the severe and non-severe groups at T4 was 24.3% (17/70) and 52.0% (53/102), respectively. In both groups, ground-glass opacity (GGO) with consolidation showed a clear decreasing trend at T1, after which they maintained similar lower levels. The GGO in the severe group showed an increasing trend first at T1 and then decreasing at T4; however, the incidence decreased gradually in the non-severe group. Most fibrosis-like findings showed a tendency to decrease rapidly and then remained stable. Bronchial dilatation in the severe group persisted at an intermediate level. Conclusions After discharge, the characteristics and changing trends of pulmonary sequelae caused by COVID-19 were significantly different between the two groups. Pulmonary sequelae were more serious and recovery was slower in patients with severe/critical disease than in patients with moderate disease. A portion of the fibrosis-like findings were completely absorbed in patients with moderate and severe/critical diseases.

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