Long-term pathological changes in lungs after COVID-19

Самсонова, М. В.; Конторщиков, А. С.; Черняев, А. Л.; Михайличенко, К. Ю.; Михалева, Л. М.; Od, Mishnev; Зайратьянц, О. В.

doi:10.18093/0869-0189-2021-31-5-571-579

Cited by 10 publications

(1 citation statement)

References 31 publications

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“…С учетом того, что количество учтенных переболевших COVID-19 в нашей стране приближается к 2 млн человек, это может стать огромной нагрузкой для системы здравоохранения. В настоящий момент информации о клинико-лучевых предикторах изменений в легких у пациентов, перенесших пневмонию, вызванную вирусом SARS-CoV-2, и об их долгосрочных последствиях, крайне мало [17].…”

Section: Introductionunclassified

Long-term effects of COVID-19 in patients according to the functional lung imaging in radiation therapy

Zolotnitskaya¹,

Speranskaya²,

Kuzubova³

et al. 2022

Russian Medical Inquiry

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Background: the majority of patients who experienced COVID-19, lung disorders persist for a long term. It remains unclear how reversible they are and what the clinical and radiation predictors of these changes are. Aim: to determine the consequences of pneumonia caused by the SARS-CoV-2 virus in patients who experienced COVID-19 during the period of 2020–2021; to evaluate possible clinical and radiation predictors of these changes and their reversibility. Patients and Methods: the article presents the analyzed results of radiation studies (computed tomography (CT), single-photon emission computed tomography (SPECT)), spirometry and diffusing capacity of the lungs for carbon monoxide (DLCO) performed in 68 patients who had COVID-19 during the period of 2020–2021 and complained of persistent shortness of breath, fatigue and disability. Results: 1–2 years after, there was a decrease in the bronchial patency to 39.2±4.5%pred in 63% of patients with mild COVID-19, which correlated (rs>0.92) with a decrease in microcirculation (MC) over 50% and mosaic attenuation (rs>0.77), air trapping (rs>0.89) and bronchiolectasis (rs>0.64). In mixed ventilatory defects (MEF75 to 46.8±3.6% of predicted, DLCO 62.4±3.1% of predicted), there were significant MC disorders over 70%, corresponding to zones of focal pneumosclerosis (rs>0.93). In the severe disease course, single areas of "frosted glass" were detected in 13% of patients, while mosaic attenuation and air trapping were detected in 34%, which was accompanied by a decrease in MEF75 to 37.4±3.7% of predicted. During a decrease in DLCO to 52.4±2.2% of predicted, there were a compaction of the interstitial by the type of usual interstitial pneumonia of small extent (65%), consolidation areas (34%), pneumosclerosis areas (54%), platelike atelectasis (31%), bronchiectasis (26%), signs of bronchiolitis obliterans (42%), and pulmonary hypertension development (38%). According to the single- photon emission computed tomography data, there were significant disorders of the MC. Irreversible changes were detected in lung areas with an inadequate perfusion of more than 50%, observed 6 months after the disease, and subsequently, after 1 year or more. Conclusions: a comprehensive functional lung imaging in radiation therapy increases the efficacy of clinical examination of patients in the postcovid period. The following type of patients need a comprehensive radiation monitoring: patients over 60 y.o., patients who had a severe COVID-19; patients who have respiratory complaints over 1 year, regardless of the COVID-19 severity. Microcirculation disorders over 50% detected 6 months after the disease are a predictor of changes in the lung parenchyma and may indicate long-term disease consequences. KEYWORDS: postcovid syndrome, microcirculation, computed tomography of the lungs, ventilation, artificial intelligence. FOR CITATION: Zolotnitskaya V.P., Speranskaya A.A., Kuzubova N.A. et al. Long-term effects of COVID-19 in patients according to the functional lung imaging in radiation therapy. Russian Medical Inquiry. 2022;6(7):360–366 (in Russ.). DOI: 10.32364/2587-6821- 2022-6-7-360-366.

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Section: Introductionunclassified

Long-term effects of COVID-19 in patients according to the functional lung imaging in radiation therapy

Zolotnitskaya¹,

Speranskaya²,

Kuzubova³

et al. 2022

Russian Medical Inquiry

View full text Add to dashboard Cite

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Lung pathology in children with a long-term novel coronavirus infection COVID-19

Nasyrov,

Galichina,

Timchenko

et al. 2024

Arkh. patol.

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Functional disorders of the respiratory system after a new coronavirus infection COVID-19

Савушкина¹,

Zaytsev

Kryukov³

et al. 2022

Russian Military Medical Academy Reports

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COVID-19 (Coronavirus disease 2019) is an infectious disease caused by the coronavirus SARS-CoV-2, characterized by a high level of morbidity and mortality. A new coronavirus infection affects all organs and systems and often occurs with lung damage and respiratory failure. In a significant part of patients after the acute period of COVID-19, the symptoms of the disease persist, but the most problematic symptoms are the ones regarding lung damage that persists for a long amount of time. This review summarizes the results of our research in 20202021. The purpose of the conducted studies was to estimate the functional parameters of the respiratory system in patients that have been infected by COVID-19. Along with conventional pulmonary function tests (spirometry, body plethysmography and diffusion test), impulse oscillometry, the multiple-breath nitrogen washout test, determination of the maximum inspiratory and expiratory pressures were performed in all patients. Thus, we evaluated the ventilation and gas exchange function of the bronchopulmonary system, the functional state of the peripheral parts of the lungs, including the small airways, the uniformity of pulmonary ventilation and the strength of the respiratory muscles in different periods of recovery after COVID-19, including the follow-up after medical rehabilitation. To sum up, comprehensive functional assessment of the respiratory system is an important clinical tool that allows the planning of pharmacotherapy and to create individual programs of medical rehabilitation of patients who had COVID-19.

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Long-term pathological changes in lungs after COVID-19

Cited by 10 publications

References 31 publications

Long-term effects of COVID-19 in patients according to the functional lung imaging in radiation therapy

Long-term effects of COVID-19 in patients according to the functional lung imaging in radiation therapy

Lung pathology in children with a long-term novel coronavirus infection COVID-19

Functional disorders of the respiratory system after a new coronavirus infection COVID-19

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