Predictors for COVID-19 Complete Remission with HRCT Pattern Evolution: A Monocentric, Prospective Study

Abstract

There are growing concerns that some COVID-19 survivors may acquire fibrosis and other irreversible lung abnormalities. The purpose of this prospective study was to assess the rate and predictors of complete resolution of COVID-19 pneumonia by pursuing a hypothetical relation between time and imaging pattern evolution using HRCT findings. A monocentric prospective cohort study with a consecutive-case enrolment design was implemented during a five-month period, having a total of 683 post-COVID patients eligible for inclusion and 635 evaluations with complete follow-up for chest HRCT. The target for post-COVID evaluations consisted of performing HRCT 90 days after a confirmed SARS-CoV-2 infection. The studied patients had an average age of 54 years, ranging between 18 and 85 years old, and an average duration from the first symptoms until HRCT was performed of 74 days. At the post-COVID follow-up, 25.8% had a complete imagistic remission. The most common appearance with HRCT was “ground glass” in 86.6% in patients with persistent COVID-19, followed by reticulations, present in 78.8%, and respectively pleural thickening in 41.2% of cases. The mean total HRCT scores were statistically significantly higher in patients older than 65 years (10.6 ± 6.0) compared to the 40–65 group (6.1 ± 6.1) and the 18–40 age group (2.7 ± 4.8) (p < 0.001). Chest HRCT is a “time window” in documenting temporal persistent radiologic features of lung injury 90 days after SARS-CoV-2 infection, determining the pathologic basis of so-called “long COVID”. The complete remission was associated with a significantly higher average follow-up period and a significantly lower average patient age. Persistent HRCT features of ground glass, reticulation, and pleural thickening are associated with a higher total CT score and older age.

Laboratory Findings and Clinical Outcomes of ICU-admitted COVID-19 Patients: A Retrospective Assessment of Particularities Identified among Romanian Minorities

“…According to existing guidelines, the SARS-CoV-2 infection was considered mild, moderate, or severe [ 27 , 28 ]. Severe imaging features were considered for ground-glass opacities involving more than 50% of the lungs on chest X-ray or CT scan [ 6 ]. The COVID-19 status was defined by a positive polymerase chain reaction test (PCR) from oropharyngeal and nasal swabs, using a multiplex RT-PCR [ 29 , 30 ].…”

“…The most common symptoms of COVID-19 are generally nonspecific, including high prevalence rates of fever, tiredness, and a dry cough. On the other hand, interstitial pneumonia, thrombo-embolic events, and acute respiratory distress syndrome (ARDS) are all outcomes and possible severe manifestations of SARS-CoV-2 infection among populations at risk [ 4 , 5 , 6 , 7 , 8 ]. These forms of COVID-19 are likely to be triggered by an overactivation of the immune system, causing a cytokine storm [ 9 , 10 , 11 , 12 ].…”

Electrical Impedance Tomography (EIT) in a Patient Suffering from Post-COVID Syndrome with Dyspnea: A Case Report

“…Computed tomography showed ground-glass opacities in both lungs, consistent with changes after severe COVID-19 pneumonia [ 11 ]. There were no signs of structural changes in the pulmonary framework such as pulmonary fibrosis, pulmonary emphysema, or scars [ 12 ].…”

“…The resulting 208 values or frames are used to reconstruct an EIT cross-sectional image. The 208 frames are converted into an ellipsoidal EIT image using a linearized Newton–Raphson reconstruction algorithm based on the finite element method [ 11 ]. In spontaneously breathing patients, EIT has been used sporadically in clinical trials, and no reference values are available [ 12 ].…”

Disease Progression, Clinical Features, and Risk Factors for Pneumonia in Unvaccinated Children and Adolescents with Measles: A Re-Emerging Disease in Romania

“…Uncomplicated diseased patients may recover rather quickly and without complications or adverse effects. However, some of the following disease complications may occur: encephalitis (1 case in 1000) [ 8 ], middle ear infections [ 9 ], and measles-related pneumonia or secondary bacterial pneumonia affecting up to 60 in 1000 patients, and [ 10 , 11 , 12 ].…”