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

Abstract

IntroductionPost-acute sequelae of COVID-19 seem to be an emerging global crisis. Machine learning radiographic models have great potential for meticulous evaluation of post-COVID-19 interstitial lung disease (ILD).MethodsIn this multicenter, retrospective study, we included consecutive patients that had been evaluated 3 months following severe acute respiratory syndrome coronavirus 2 infection between 01/02/2021 and 12/5/2022. High-resolution computed tomography was evaluated through Imbio Lung Texture Analysis 2.1.ResultsTwo hundred thirty-two (n = 232) patients were analyzed. FVC% predicted was ≥80, between 60 and 79 and <60 in 74.2% (n = 172), 21.1% (n = 49), and 4.7% (n = 11) of the cohort, respectively. DLCO% predicted was ≥80, between 60 and 79 and <60 in 69.4% (n = 161), 15.5% (n = 36), and 15.1% (n = 35), respectively. Extent of ground glass opacities was ≥30% in 4.3% of patients (n = 10), between 5 and 29% in 48.7% of patients (n = 113) and <5% in 47.0% of patients (n = 109). The extent of reticulation was ≥30%, 5–29% and <5% in 1.3% (n = 3), 24.1% (n = 56), and 74.6% (n = 173) of the cohort, respectively. Patients (n = 13, 5.6%) with fibrotic lung disease and persistent functional impairment at the 6-month follow-up received antifibrotics and presented with an absolute change of +10.3 (p = 0.01) and +14.6 (p = 0.01) in FVC% predicted at 3 and 6 months after the initiation of antifibrotic.ConclusionPost-COVID-19-ILD represents an emerging entity. A substantial minority of patients presents with fibrotic lung disease and might experience benefit from antifibrotic initiation at the time point that fibrotic-like changes are “immature.” Machine learning radiographic models could be of major significance for accurate radiographic evaluation and subsequently for the guidance of therapeutic approaches.

Lung function at three months after hospitalization due to COVID‑19 pneumonia: Comparison of alpha, delta and omicron variant predominance periods

“…In the cohort of the present study, abnormal values of FVC% pred was observed in 8 (6.9%) patients of DLCO% pred in 33 patients (28.4%) and of TLC% pred in 24 (20.7%) patients. These findings agree with reports from the existing literature ( 23 , 32 , 33 ).…”

Risk of newly diagnosed interstitial lung disease after COVID-19 and impact of vaccination: a nationwide population-based cohort study

“…Many previous studies have reported persistent ILD after COVID-19 ( 5 , 6 , 10 , 28 – 32 ); however, the number of subjects included in these studies was relatively small, and the follow-up duration was relatively short ranging from a few weeks ( 30 ) to 1 year after COVID-19 ( 6 , 10 , 28 , 29 , 31 ). For example, a Chinese study reported that 118 out of 1,279 patients underwent CT, and among these patients, 65 (55%) had persistent CT abnormalities ( 28 ).…”

Efficacy of respiratory rehabilitation in patients with COVID-19: a retrospective study

“…Previous studies have shown that Autotaxin can be used as a therapeutic target for COVID-19 [ 17 ], in addition, baricitinib and Tocilizumab are effective in the treatment of COVID-19 [ 18 , 19 ]. And, there are also reports on the after-effects of COVID-19 [ 20 , 21 ]. However, in the clinical diagnosis and treatment of patients, we found that the lungs of patients with severe novel coronavirus infection were often accompanied by poor deep sputum drainage [ 22 ].…”