Analysis of thin-section CT in patients with coronavirus disease (COVID-19) after hospital discharge

Abstract

PURPOSE: To analyze clinical and thin-section computed tomographic (CT) data from the patients with coronavirus disease (COVID-19) to predict the development of pulmonary fibrosis after hospital discharge. MATERIALS AND METHODS: Fifty-nine patients (31 males and 28 females ranging from 25 to 70 years old) with confirmed COVID-19 infection performed follow-up thin-section thorax CT. After 31.5±7.9 days (range, 24 to 39 days) of hospital admission, the results of CT were analyzed for parenchymal abnormality (ground-glass opacification, interstitial thickening, and consolidation) and evidence of fibrosis (parenchymal band, traction bronchiectasis, and irregular interfaces). Patients were analyzed based on the evidence of fibrosis and divided into two groups namely, groups A and B (with and without CT evidence of fibrosis), respectively. Patient demographics, length of stay (LOS), rate of intensive care unit (ICU) admission, peak C-reactive protein level, and CT score were compared between the two groups. RESULTS: Among the 59 patients, 89.8% (53/59) had a typical transition from early phase to advanced phase and advanced phase to dissipating phase. Also, 39% (23/59) patients developed fibrosis (group A), whereas 61% (36/59) patients did not show definite fibrosis (group B). Patients in group A were older (mean age, 45.4±16.9 vs. 33.8±10.2 years) ( P = 0.001), with longer LOS (19.1±5.2 vs. 15.0±2.5 days) ( P = 0.001), higher rate of ICU admission (21.7% (5/23) vs. 5.6% (2/36)) ( P = 0.061), higher peak C-reactive protein level (30.7±26.4 vs. 18.1±17.9 mg/L) ( P = 0.041), and higher maximal CT score (5.2±4.3 vs. 4.0±2.2) ( P = 0.06) than those in group B. CONCLUSIONS: Pulmonary fibrosis may develop early in patients with COVID-19 after hospital discharge. Older patients with severe illness during treatment were more prone to develop fibrosis according to thin-section CT results.

Follow-up study of the pulmonary function and related physiological characteristics of COVID-19 survivors three months after recovery

“…To the best of our knowledge, few reports have described the sequelae of COVID-19 survivors [ 9 , 22 , 23 ], and this project was the first time to investigate the long term effects on changes in both pulmonary function and HRCT imaging. In our studies, we presented the results of lung function tests and HRCT of the chest in these patients with COVID-19 3 months after their hospital discharge.…”

Contribution of CT Features in the Diagnosis of COVID-19

“…Some studies have reported that fibrosis is a reliable indicator for good prognosis, which suggests the lesions are absorbed significantly and the patient is in a stable condition [ 31 , 35 , 94 ]. However, some researchers support the argument that fibrosis might be an indicator of a poor prognosis because it may result in interstitial lung disease [ 8 , 95 , 96 ].…”

Pulmonary Fibrosis Due to COVID-19 Pneumonia

“…In conclusion, although some fibrosis indicators such as irregular interfaces, parenchymal bands, and fibrotic changes during the follow-up of COVID-19 patients have been described in the literature, typical honeycomb appearances and typical pulmonary fibrosis have not been described before, to the best of our knowledge ( 1 3 ). Irregular interface and parenchymal bands, which were described as two early predictors of pulmonary fibrosis may not be seen on initial CT examination.…”