Radiological management and follow-up of post-COVID-19 patients

Alarcón-Rodríguez, Javier; Fernández-Velilla, M.; Ureña-Vacas, Almudena; Martín-Pinacho, Jesús Javier; Rigual-Bobillo, J; Jaureguízar-Oriol, A.; Gorospe‐Sarasúa, Luis

doi:10.1016/j.rxeng.2021.02.002

Cited by 19 publications

(15 citation statements)

References 31 publications

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“…In a large cohort of patients from Wuhan, China, over 50% of patients who underwent CT scans 6 months after admission had abnormal radiographic findings; pulmonary interstitial changes, reported as ground-glass opacities and irregular lines, were the most common findings [ 4 ]. In patients with severe acute symptoms of COVID-19 evidence of radiographic fibrosis, bronchial dilatation, parenchymal bands and coarse subpleural reticulation without honeycombing are common [ 43 ].…”

Section: Screening For Pasc-pulmonary Fibrosismentioning

confidence: 99%

Recovering from a pandemic: pulmonary fibrosis after SARS-CoV-2 infection

et al. 2021

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Acute manifestations of SARS-CoV-2 infection continue to impact the lives of many across the world. Post-acute sequelae of coronavirus disease 2019 (COVID-19) may affect 10–30% of survivors of COVID-19, and post-acute sequelae of COVID-19 (PASC)-pulmonary fibrosis is a long-term outcome associated with major morbidity. Data from prior coronavirus outbreaks (severe acute respiratory syndrome and Middle East respiratory syndrome) suggest that pulmonary fibrosis will contribute to long-term respiratory morbidity, suggesting that PASC-pulmonary fibrosis should be thoroughly screened for through pulmonary function testing and cross-sectional imaging. As data accumulates on the unique pathobiologic mechanisms underlying critical COVID-19, a focus on corollaries to the subacute and chronic profibrotic phenotype must be sought as well. Key aspects of acute COVID-19 pathobiology that may account for increased rates of pulmonary fibrosis include monocyte/macrophage–T-cell circuits, profibrotic RNA transcriptomics, protracted elevated levels of inflammatory cytokines, and duration of illness and ventilation. Mechanistic understanding of PASC-pulmonary fibrosis will be central in determining therapeutic options and will ultimately play a role in transplant considerations. Well-designed cohort studies and prospective clinical registries are needed. Clinicians, researchers and healthcare systems must actively address this complication of PASC to minimise disability, maximise quality of life and confront a post-COVID-19 global health crisis.

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Section: Screening For Pasc-pulmonary Fibrosismentioning

confidence: 99%

Recovering from a pandemic: pulmonary fibrosis after SARS-CoV-2 infection

et al. 2021

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“…[52,53] Three additional small observational studies reported conflicting findingsone found reticular opacities/peripheral atelectasis in 88% and ground-glass opacities in 61% of X-rays performed at 8-12 weeks; the other two studies found only 12% and 7% abnormalities. [51,54,55] (Table 5) Long follow up data are lacking. Among survivors of SARS and MERS severe illness, chest X-ray was found to have residual abnormalities in about a third of patients at 3 and even 6 months.…”

Section: Chest Imagingmentioning

confidence: 99%

“…These changes are reported in ~60-75% at 3 months. [42,54,[58][59][60] A systematic review summarizing chest CT findings at 3-6 month after COVID-19 with any severity, rates of polled CT abnormalities were 59% (IQR 44-73%), with GGO being the most prevalent pattern (39%, IQR 26-52%), flowed by fibrosis and reticulation (each ~30%). [26] According to two studies including ~500 patients, approximately 60% still had parenchymal findings at 6 months.…”

Section:  Chest Ct/mrimentioning

confidence: 99%

ESCMID rapid guidelines for assessment and management of long COVID

Yelin

Moschopoulos

Margalit

et al. 2022

Clinical Microbiology and Infection

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“…If any of the results were abnormal, more advanced tests would be performed, such as a chest X-ray, chest CT or CT angiography. 98 NICE guidelines recommend a holistic assessment that focuses on the overall health of the patient, requesting tests deemed necessary for physical, psychological, social and spiritual wellbeing. 20 In cases of long COVID, a chest X-ray may be required with another medical test 34 , 99 especially with 12-week post-positive COVID-19 pneumonia, or ongoing respiratory symptoms.…”

Section: Current Diagnosis Of Long Covid and The Impact On Imaging Se...mentioning

confidence: 99%