COVID-19 lung alterations still evident at 60-day follow-up chest CT in asymptomatic patients despite negative rRT-PCR testing

Lanza, Ezio; Profili, Manuel; Bolengo, Isabella; Santonocito, Orazio Giuseppe; Muglia, Riccardo; Lisi, Costanza; Messana, Gaia; Balzarini, Luca

doi:10.21203/rs.3.rs-28202/v1

Cited by 2 publications

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References 4 publications

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“…5 Chest computed tomography (CT) shows higher sensitivity than RT-PCR from a swab sample 6 and can identify lung alterations even at 60 days of follow-up from disease onset. 7 However, CT may not be a feasible method for monitoring complete recovery from COVID-19 because of costs, radiation exposure, availability, and logistic issues (eg, difficulty in sanitizing). Lung ultrasound (LUS) findings in COVID-19 are strongly comparable to those obtained with chest CT. 8 Therefore, LUS could be a rapid, noninvasive, and low-cost reasonable alternative to CT 9 for COVID-19 follow-up.…”

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confidence: 99%

“…This may raise the question of whether patients should be considered fully recovered from COVID‐19 when they are discharged in the presence of negative results from 2 or more RT‐PCR tests 5 . Chest computed tomography (CT) shows higher sensitivity than RT‐PCR from a swab sample 6 and can identify lung alterations even at 60 days of follow‐up from disease onset 7 . However, CT may not be a feasible method for monitoring complete recovery from COVID‐19 because of costs, radiation exposure, availability, and logistic issues (eg, difficulty in sanitizing).…”

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confidence: 99%

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Lung Ultrasound in COVID‐19 A Role Beyond the Acute Phase?

Gaspardone

Meloni

Preda

et al. 2020

J of Ultrasound Medicine

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Objectives-Coronavirus disease 2019 (COVID-19) is a viral illness caused by severe acute respiratory syndrome coronavirus 2. With the increasing number of improved and discharged patients with COVID-19, the definition of an adequate follow-up strategy is needed. The purpose of this study was to assess whether lung ultrasound (LUS) is an effective indicator of subclinical residual lung damage in patients with COVID-19 who meet discharge criteria. Methods-We prospectively enrolled 70 consecutive patients with COVID-19 who had a prolonged hospitalization with inpatient rehabilitation between April 6 and May 22, 2020. All of the patients underwent an LUS evaluation at discharge. Data of patients with more severe disease during the acute phase (ie, required ventilatory support) were compared to those of patients with milder disease. Results-Among the 70 patients with COVID-19 (22 women and 48 men; mean age ± SD, 68 ± 13 years), the LUS score before discharge was still frankly pathologic and higher in patients who had more severe disease during the acute phase compared to patients with milder disease (median [interquartile range], 8.0 [5.5-13.5] versus 2.0 [1.0-7.0]; P < .001), even when both categories met internationally defined discharge criteria. Conclusions-Lung ultrasound can identify the persistence of subclinical residual lung damage in patients with severe COVID-19 even if they meet discharge criteria. Considering the low cost, easy application, and lack of radiation exposure, LUS seems the ideal tool to be adopted in outpatient and primary care settings for the follow-up of patients with COVID-19.

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confidence: 99%

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confidence: 99%

Lung Ultrasound in COVID‐19 A Role Beyond the Acute Phase?

Gaspardone

Meloni

Preda

et al. 2020

J of Ultrasound Medicine

View full text Add to dashboard Cite

show abstract

“…Other than physiological characteristics, many laboratory and instrumental tests are used as risk predictors of mortality during hospitalization and at discharge [11], however without clear evidence of long-term benefit. Chest computed tomography (CT) is a critical tool for the diagnosis and inpatient management, with higher sensitivity than a swab sample [12] capable to identify lung alterations even at 60 days of follow-up [13] in asymptomatic individuals [14]. Despite this, it may not be a feasible method for the routine follow-up of discharged COVID-19 patients because of radiation exposure, costs, availability, and logistic issues.…”

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confidence: 99%

Study on the utility and efficacy of clinical and instrumental tests in the follow-up of COVID-19 patients

Preda

Fiore

Gaspardone

et al. 2021

Medical Research Journal

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Introduction:The disease caused by the SARS-CoV-2 virus (COVID-19) frequently leads to serious complications and prolonged hospitalizations requiring effective care after discharge.Aim of the study: Aim of this study was to identify feasible and cost-effective predictors of outcome among clinical characteristics, functional status, laboratory, echocardiographic and lung ultrasound data of COVID-19 patients.Material and methods: Patients affected by COVID-19 who experienced a prolonged hospitalization due to a severe form of the disease and that have been discharged from the COVID-19 rehabilitation unit (RU) were prospectively enrolled between April 6 th and May 22 nd , 2020. All the patients underwent a 6-minute walk test (6MWT) at the 30-day follow-up. Baseline characteristics, laboratory, functional exercise tests, echocardiographic and lung ultrasound (LUS) data collected between hospitalization, admission to RU, discharge from RU and follow-up were compared. Correlations with the predicted distance covered at the 6MWT (6MWD) were made.Results: 40 patients met inclusion criteria and presented to follow-up (13 women [32.5%] and 27 men [67.5%]; mean age 66 ± 10 years). Among all variables analysed, only functional tests at discharge showed a remarkable correlation with the 6MWD. Significant improvement in lung ultrasound score (LUSS) was also observed however without correlation with 6MWD.Conclusions: functional tests at discharge from RU identified patients with different 30-day outcomes that could deserve a stricter long-term follow-up. This may help in planning a personalized follow-up. The costs and effort were minimal. The severity of the acute phase did not significantly influence functional recovery. LUS was useful to identify subclinical lung damage and its evolution over time, however without clear functional correlation.

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COVID-19 lung alterations still evident at 60-day follow-up chest CT in asymptomatic patients despite negative rRT-PCR testing

Abstract: Several patients who have recovered from COVID-19 pneumonia showed persistent infection at follow-up chest CT (31-63 days after disease onset) despite being asymptomatic and testing negative at rRT-PCR.

Cited by 2 publications

References 4 publications

Lung Ultrasound in COVID‐19 A Role Beyond the Acute Phase?

Lung Ultrasound in COVID‐19 A Role Beyond the Acute Phase?

Study on the utility and efficacy of clinical and instrumental tests in the follow-up of COVID-19 patients

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