Lung function and radiological findings 1 year after COVID-19: a prospective follow-up

Abstract

Background The coronavirus disease (COVID-19) pandemic has already affected more than 400 million people, with increasing numbers of survivors. These data indicate that a myriad of people may be affected by pulmonary sequelae of the infection. The aim of this study was to evaluate pulmonary sequelae in patients with bilateral COVID-19 pneumonia according to severity 1 year after hospital discharge. Methods COVID-FIBROTIC is a multicenter prospective observational cohort study for admitted patients with bilateral COVID-19 pneumonia. Pulmonary functional outcomes and chest computed tomography sequelae were analyzed 12 months after hospital discharge and we classified patients into three groups according to severity. A post hoc analysis model was designed to establish how functional test changed between groups and over time. A multivariable logistic regression model was created to study prognostic factors for lung diffusion impairment and radiological fibrotic-like changes at 12 months. Results Among 488 hospitalized patients with COVID-19 pneumonia, 284 patients had completed the entire evaluation at 12 months. Median age was 60.5 ± 11.9 and 55.3% were men. We found between-group differences in male sex, length of hospital stay, radiological involvement and inflammatory laboratory parameters. The functional evaluation of pulmonary sequelae showed that severe patients had statistically worse levels of lung diffusion at 2 months but no between group differences were found in subsequent controls. At 12-month follow up, however, we found impaired lung diffusion in 39.8% unrelated to severity. Radiological fibrotic-like changes at 12 months were reported in 22.7% of patients (102/448), only associated with radiological involvement at admission (OR: 1.55, 95% CI 1.06–2.38; p = 0.02) and LDH (OR: 0.99, 95% CI 0.98–0.99; p = 0.046). Conclusion Our data suggest that a significant percentage of individuals would develop pulmonary sequelae after COVID 19 pneumonia, regardless of severity of the acute process. Trial registration clinicaltrials.gov NCT04409275 (June 1, 2020)

Post-COVID-19 interstitial lung disease: Insights from a machine learning radiographic model

“…Percentage of patients with functional and radiographic impairment is in line from data of other countries (24)(25)(26)(27)(28)(29)(30)(31)(32). In the 3-month follow-up, almost 30% of this cohort presented with DLCO% predicted below 80.…”

Predictors of pulmonary sequelae after COVID-19 pneumonia: A 12-month follow-up study

“…Besides, as in our cohort, the anatomical extension of these abnormalities was limited, with a mean lobar involvement that ranges between 13 and 17% of each entire single lobe ( 16 ). This report, together with our findings, is in contrast with Tarraso et al ( 17 ) who reported in a multicenter prospective study a higher percentage of patients (23%) with fibrotic-like sequelae after 1 year of follow-up. However, it should be mentioned that the authors did not score the extension of lung lesions on CT, thus limiting the comparison with our assessment ( 17 ).…”

“…This report, together with our findings, is in contrast with Tarraso et al ( 17 ) who reported in a multicenter prospective study a higher percentage of patients (23%) with fibrotic-like sequelae after 1 year of follow-up. However, it should be mentioned that the authors did not score the extension of lung lesions on CT, thus limiting the comparison with our assessment ( 17 ). When analyzing the main radiological characteristics presented in the NOT-REC group, our findings are in line with Huang et al ( 18 ) that found, at 6 months, a more severe involvement in those patients who required a higher degree of care, with the GGO as the most frequent radiological feature, followed by the irregular lines.…”

Identification of a protein expression signature distinguishing early from organising diffuse alveolar damage in COVID-19 patients

“…Notwithstanding these limitations, to our knowledge this is the first study to apply highly multiplexed DSP to discriminate between EDAD and ODAD. The extent to which the many is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) millions of COVID-19 survivors are at risk of developing pulmonary fibrosis is only beginning to be understood 10 . Importantly, many of the protein targets we have identified as being highly expressed at the early stages of DAD are amenable to therapeutic intervention with existing drugs or drugs in development.…”