Are there pulmonary sequelae in patients recovering from COVID-19?

Rogliani, Paola; Calzetta, Luigino; Coppola, Angelo; Puxeddu, Ermanno; Sergiacomi, Gianluigi; D'Amato, Dejanira; Orlacchio, Antonio

doi:10.1186/s12931-020-01550-6

Cited by 45 publications

(39 citation statements)

References 10 publications

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“…So this may raise an important question for doctors: are there any long-term pulmonary sequelae in patients recovering from COVID-19? Up to now, few reports have described the sequelae of COVID-19 survivors (5)(6)(7)(17)(18)(19)(20), and the long-term radiological changes have not been well-studied. In our study, we presented the results of 7-month follow-up chest CT in patients with COVID-19, and we compared clinical data and chest CT between patients with or without pulmonary fibrosis.…”

Section: Discussionmentioning

confidence: 99%

Follow-Up Study of the Chest CT Characteristics of COVID-19 Survivors Seven Months After Recovery

Liu

Huang

et al. 2021

Front. Med.

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Background: It has remained a concern whether any long-term pulmonary sequelae exist for COVID-19 survivors.Methods: Forty-one patients (22 men and 19 women, 50 ± 14 years) confirmed with COVID-19 performed follow-up chest CT and cardiopulmonary exercise testing at 7 months after discharge. Patients were divided into fibrosis group and non-fibrosis group according to the evidence of fibrosis on follow-up CT. The clinical data and the CT findings were recorded and analyzed.Results: The predominant CT patterns of abnormalities observed at 7 months after discharge were parenchymal band (41%), interlobular septal thickening (32%), and traction bronchiectasis (29%). Sixty-one percent of the patients achieved complete radiological resolution, and 29% of patients developed pulmonary fibrosis. Compared with the patients in the non-fibrosis group, the patients in the fibrosis group were older, with a longer hospital stay, a higher rate of steroid and mechanical ventilation therapy, lower levels of lymphocyte and T cell count, higher levels of D-dimer and lactic dehydrogenase, and higher quantitative CT parameters (opacity score, volume of opacity, and percentage of opacity) at discharge. Besides, oxygen consumption and metabolic equations were decreased and ventilatory equivalent for carbon dioxide was increased in patients in the fibrosis group. Logistic regression analyses revealed that age, steroid therapy, presence of traction bronchiectasis on chest CT at discharge, and opacity score at discharge, were independent risk factors for developing pulmonary fibrosis at 7 months after discharge. Receiver operating characteristic analysis revealed that the combined clinical-radiological model was better than the clinical-only model in the prediction of pulmonary fibrosis.Conclusions: The chest CT lesions could be absorbed without any sequelae for most patients with COVID-19, whereas older patients with severe conditions are more prone to develop fibrosis, which may further lead to cardiopulmonary insufficiency. The combined clinical-radiological model may predict the formation of pulmonary fibrosis early.

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Section: Discussionmentioning

confidence: 99%

Follow-Up Study of the Chest CT Characteristics of COVID-19 Survivors Seven Months After Recovery

Liu

Huang

et al. 2021

Front. Med.

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“…Pulmonary sequelae in survivors from COVID-19 pneumonia have been a matter of intense discussion [ 16 , 34 ]. In fact, all studies, but one [ 12 ], performed a single lung functional assessment [ 9 , 10 , 11 , 13 , 14 , 15 , 16 ], limiting any hypothesis on the potential evolution and determinants of lung function impairment in these patients.…”

Section: Discussionmentioning

confidence: 99%

“…The radiological evolution of COVID-19 pneumonia during the acute phase of the disease has been extensively studied [ 7 , 8 ], but the pathophysiological and clinical impact of potential pulmonary sequelae is still under investigation. Some line of evidence suggested that thirty days from discharge the CT abnormalities resolve almost completely in mild to moderate COVID-19 forms [ 9 ]. Other Authors, however, reported that in patients with moderate, severe and critical disease, both ground glass opacities and septal thickening tend to persist up to three months post-discharge [ 8 , 10 , 11 , 12 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Trends over Time of Lung Function and Radiological Abnormalities in COVID-19 Pneumonia: A Prospective, Observational, Cohort Study

Santus

Flor

Saad

et al. 2021

JCM

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Radiological and functional sequelae of Coronavirus Disease 2019 (COVID-19) pneumonia are still poorly understood. This was a prospective, observational, physiological, cohort study on consecutive adult patients with COVID-19 pneumonia admitted in April–May 2020 in the high dependency respiratory unit of L. Sacco University Hospital in Milan (Italy). During hospitalization, patients underwent chest computed tomography (CT), blood gas analysis, spirometry, and lung diffusion capacity for carbon monoxide (DLco), which were repeated 6 weeks post-discharge. Chest CTs were individually read by two expert radiologists, that calculated the total severity score (TSS). Twenty patients completed the study (mean age 58.2 years, 70% males). During the acute phase, mean DLco, alveolar volume (VA), and vital capacity (VC) were 56.0 (16.3), 64.8 (14.0), and 71.7 (16.9) % predicted, respectively, and were inversely associated with PaO2/FiO2 ratio. Fifty percent of patients had a restrictive ventilatory pattern; mean TSS was 7.9 (4.0). At follow up, gas exchange parameters were normalized; consolidations persisted in 10% of cases, while DLco was <80% predicted in 65% of patients and was independently predicted by Log10D-dimer at admission (β −18.675; 95%CI, −28.373–−9.076; p = 0.001). In conclusion, functional abnormalities in COVID-19 pneumonia survivors can persist during follow up and are associated with the severity of the disease.

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“…Those who recover might survive with lung fibrosis as sequelae and are more prone to re-infection and subsequent respiratory compromise. 1,2 Although clinically diverse, and as previous researches have opined, these infections are propagated through the atmospheric conditions of the ambient environment. 3,4 One such condition is air pollution that may alter the respiratory tract through inflammation resulting in diseases like COPD and Bronchial Asthma.…”

Section: Introductionmentioning

confidence: 99%

Atmospheric conditions affecting the transmission of COVID-19 virus

Shoor¹,

Kaur²,

Chauhan³

2021

Int J Community Med Public Health

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The physical environment plays an important role in the transmission of respiratory infections like COVID-19. Atmospheric conditions associated to diseases like influenza, adenovirus infections, parainfluenza, common cold viruses and so on. But we are still lacking in evidence to support the influence of meteorological conditions in spreading COVID-19. We have discussed air pollution, smoking, low air temperature, and proximity to equator, low humidity and air velocity as contributing factors in the spread of SARS-CoV-2 through this narrative synthesis. Bio-aerosol or ultra-fine particulate matter seems to be the most promising mode of transmission of COVID-19. Other methods are direct contact and droplet infection. Air pollution control can prevent priming of respiratory system which shall further protect from pulmonary infections. Air sanitization and humidifiers can be considered to modify the indoor air and prevent contracting infection at workplaces, schools and other gatherings.

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Are there pulmonary sequelae in patients recovering from COVID-19?

Cited by 45 publications

References 10 publications

Follow-Up Study of the Chest CT Characteristics of COVID-19 Survivors Seven Months After Recovery

Follow-Up Study of the Chest CT Characteristics of COVID-19 Survivors Seven Months After Recovery

Trends over Time of Lung Function and Radiological Abnormalities in COVID-19 Pneumonia: A Prospective, Observational, Cohort Study

Atmospheric conditions affecting the transmission of COVID-19 virus

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