Pulmonary fibrotic-like changes on follow-up chest CT exam in patients recovering from COVID-19 pneumonia

Tuberk Toraks. 2021 Dec;69(4):492-498. doi: 10.5578/tt.20219607.

Abstract

Introduction: To date, there is limited data on the long-term changes in the lungs of patients recovering from coronavirus (COVID-19) pneumonia. In order to evaluate pulmonary sequelae, it was planned to investigate fibrotic changes observed as sequelae in lung tissue in 3-6-month control thorax computerized tomography (CT) scans of moderate-to-severe COVID-19 pneumonia survivors.

Materials and methods: A total of 84 patients (mean age: 67.3 years ±15) with moderate-to-severe pneumonia on chest tomography at the time of diagnosis were included in the study, of which 51 (61%) were males and 33 (39%) were females. Initial and follow-up CT scans averaged 8.3 days ± 2.2 and 112.1 days ± 14.6 after symptom onset, respectively. Participants were recorded in two groups as those with and without fibrotic-like changes such as traction bronchiectasis, fibrotic - parenchymal bands, honeycomb appearance according to 3-6 months follow-up CT scans. Differences between the groups were evaluated with a two-sampled t-test. Logistic regression analyzes were performed to determine independent predictive factors of fibrotic-like sequelae changes.

Result: On follow-up CTs, fibrotic-like changes were observed in 29 (35%) of the 84 participants (Group 1), while the remaining 55 (65%) showed complete radiological recovery (Group 2). With logistic regression analysis, hospital stay of 22 days or longer (OR: 4.9; 95% CI: 20, 32; p< 0.05) and a CT score of 15 or more at diagnosis (OR: 2.2; 95% CI: 13.5, 18; p< 0.05) were found to be an independent predictor for sequelae fibrotic changes in lung tissue.

Conclusions: More than one-third of patients who survived COVID-19 pneumonia had fibrotic-like sequelae changes in the lung parenchyma. These changes were found to be associated with the presence of severe pneumonia at the time of diagnosis and longer hospital stay.

MeSH terms

  • Aged
  • COVID-19*
  • Female
  • Follow-Up Studies
  • Humans
  • Lung / diagnostic imaging
  • Male
  • Pneumonia* / diagnostic imaging
  • Retrospective Studies
  • SARS-CoV-2
  • Thorax
  • Tomography, X-Ray Computed