Radiological pulmonary sequelae after COVID-19 and correlation with clinical and functional pulmonary evaluation: results of a prospective cohort

• Published in: European radiology 2024-02, Vol.34 (2), p.1037-1052
• Main Authors: Soliman, Samer, Soliman, Heithem, Crézé, Maud, Brillet, Pierre-Yves, Montani, David, Savale, Laurent, Jais, Xavier, Bulifon, Sophie, Jutant, Etienne-Marie, Rius, Emily, Devilder, Matthieu, Beurnier, Antoine, Colle, Romain, Gasnier, Matthieu, Pham, Tài, Morin, Luc, Noel, Nicolas, Lecoq, Anne-Lise, Becquemont, Laurent, Figueiredo, Samy, Harrois, Anatole, Bellin, Marie-France, Monnet, Xavier, Meyrignac, Olivier
• Format: Article
• Language: English
• Subjects: Abnormalities; Carbon monoxide; Chest; Complications; COVID-19; Diagnostic Radiology; Dyspnea; Embolism; Evaluation; Fibrosis; Hospitalization; Hospitals; Imaging; Intensive care units; Internal Medicine; Interventional Radiology; Lesions; Life Sciences; Lung diseases; Mechanical ventilation; Medicine; Medicine & Public Health; Multivariate analysis; Neuroradiology; Pulmonary functions; Radiology; Respiration; Respiratory function; Signs and symptoms; Ultrasound
• ISSN: 1432-1084; 0938-7994; 1432-1084
• DOI: 10.1007/s00330-023-10044-0

Objectives Whether COVID-19 leads to long-term pulmonary sequelae or not remains unknown. The aim of this study was to assess the prevalence of persisting radiological pulmonary fibrotic lesions in patients hospitalized for COVID-19. Materials and methods We conducted a prospective single-center study among patients hospitalized for COVID-19 between March and May 2020. Patients with residual symptoms or admitted into intensive care units were investigated 4 months after discharge by a chest CT (CCT) and pulmonary function tests (PFTs). The primary endpoint was the rate of persistent radiological fibrotic lesions after 4 months. Secondary endpoints included further CCT evaluation at 9 and 16 months, correlation of fibrotic lesions with clinical and PFT evaluation, and assessment of predictive factors. Results Among the 1151 patients hospitalized for COVID-19, 169 patients performed a CCT at 4 months. CCTs showed pulmonary fibrotic lesions in 19% of the patients (32/169). These lesions were persistent at 9 months and 16 months in 97% (29/30) and 95% of patients (18/19) respectively. There was no significant clinical difference based on dyspnea scale in patients with pulmonary fibrosis. However, PFT evaluation showed significantly decreased diffusing lung capacity for carbon monoxide ( p