Residual Lung Lesions at 1-year CT after COVID-19

Lee, Kyung Soo; Wi, Yu Mi

doi:10.1148/radiol.2021212350

Cited by 7 publications

(3 citation statements)

References 10 publications

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“…However, in a study by Luger and colleagues ( 103 ), 54% of patients showed CT abnormalities at 1 year after the onset of COVID-19 symptoms, demonstrating extensive GGO, reticulations, bronchial dilation, microcystic changes, or, in 20% of patients, a combination of these ( Fig 12 ). Factors associated with persistent CT abnormalities at 1-year follow-up include older age, male sex, peripheral blood lymphopenia, critical COVID-19 severity, and severe pneumonia and/or ARDS ( 104 ).…”

Section: Complications and Their Clinical And Imaging Featuresmentioning

confidence: 99%

Current and Emerging Knowledge in COVID-19

Jeong

Park

et al. 2023

Radiology

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COVID-19 has emerged as a pandemic leading to a global public health crisis of unprecedented morbidity. A comprehensive insight into the imaging of COVID-19 has enabled early diagnosis, stratification of disease severity, and identification of potential sequelae. The evolution of COVID-19 can be divided into early infectious, pulmonary, and hyperinflammatory phases. Clinical features, imaging features, and management are different among the three phases. In the early stage, peripheral ground-glass opacities are predominant CT findings, and therapy directly targeting SARS-CoV-2 is effective. In the later stage, organizing pneumonia or diffuse alveolar damage pattern are predominant CT findings and anti-inflammatory therapies are more beneficial. The risk of severe disease or hospitalization is lower in breakthrough or Omicron variant infection compared with nonimmunized or Delta variant infections. The protection rates of the fourth dose of mRNA vaccination were 34% and 67% against overall infection and hospitalizations for severe illness, respectively. After acute COVID-19 pneumonia, most residual CT abnormalities gradually decreased in extent, but they may remain as linear or multifocal reticular or cystic lesions. Advanced insights into the pathophysiologic and imaging features of COVID-19 along with vaccine benefits have improved patient care, but emerging knowledge of post–COVID-19 condition, or long COVID, also presents radiology with new challenges. © RSNA, 2023 Supplemental material is available for this article.

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Section: Complications and Their Clinical And Imaging Featuresmentioning

confidence: 99%

Current and Emerging Knowledge in COVID-19

Jeong

Park

et al. 2023

Radiology

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“…Sonographic evaluation of COVID-19-induced lung damage has played a significant role since the first phases of the pandemic. Imaging follow-up of lung lesions after moderate-to-severe symptomatic COVID-19 has been suggested to help identifying patients who deserve a tighter clinical and rehabilitative care and who could benefit from further investigations or treatment [ 1 ]. Chest X-ray and Chest Computed Tomography Scan (CT-Scan) are the main imaging techniques used for such follow-up purposes [ 2 ] because of their wide use and the growing experience on SARS COV-2 infection patterns.…”

Section: Introductionmentioning

confidence: 99%

A mid-term follow-up with a lung ultrasonographic score correlates with the severity of COVID-19 acute phase

et al. 2022

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Lung ultrasound (LUS) has rapidly emerged in COVID-19 diagnosis and for the follow-up during the acute phase. LUS is not yet used routinely in lung damage follow-up after COVID-19 infection. We investigated the correlation between LUS score, and clinical and laboratory parameters of severity of SARS-COV-2 damage during hospitalization and at follow-up visit. Observational retrospective study including all the patients discharged from the COVID-19 wards, who attended the post-COVID outpatient clinic of the IRCCS Policlinico San Matteo in April–June 2020. 115 patients were enrolled. Follow-up visits with LUS score measurements were at a median of 38 days (IQR 28–48) after discharge. LUS scores were associated with the length of hospitalization ( p < 0.001), patients’ age ( p = 0.036), use of non-invasive ventilation (CPAP p < 0.001 or HFNC p = 0.018), administration of corticosteroids therapy ( p = 0.030), and laboratory parameters during the acute phase (WBC p < 0.001, LDH p < 0.001, CRP p < 0.001, D-dimer p = 0.008, IL-6 p = 0.045), and inversely correlated with lymphocyte count ( p = 0.007). We found correlation between LUS score and both LDH ( p = 0.001) and the antibody anti-SARS-CoV-2 titers ( p value = 0.008). Most of these finding were confirmed by dichothomizing the LUS score (≤ 9 or > 9 points). We found a significantly higher LUS score at the follow-up in the patients with persistent dyspnea (7.00, IQR 3.00–11.00) when compared to eupnoeic patients (3.00, IQR 0–7.00 p < 0.001). LUS score at follow-up visit correlates with more severe lung disease. These findings support the hypothesis that ultrasound could be a valid tool in the follow-up medium-term COVID-19 lung damage.

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“…When most of the lungs are involved, a "whited out lung" may occur (Figure 2) [17,18]. After pneumonia remission, residual lung injury could be detected on CT scan, such as architectural distortion, reticular lesions, traction bronchiolectasis, GGOs, mosaic attenuation, and honey combing [19], showing a similarity with radiation induced pulmonary fibrosis.…”

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confidence: 99%

Radiation Induced Lung Injury (RILI) and COVID-19 Pneumonia: Are There Similarities by The Radiation Oncologist’s Point of View?

Lazzari¹,

Giua²,

Verdolino³

et al. 2022

Int J Res Oncol

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Coronavirus disease 2019 (COVID-19), is a novel infectious disease responsible for a severe acute respiratory syndrome due to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, which was firstly reported in January 2020 in Wuhan, Hubei Province, China, and then rapidly spread to other countries beyond China with a pandemic proportion in these last two years. In its severe lung expression, disease onset may result in death due to massive alveolar damage and progressive respiratory failure due to acute lung injury (ALI) which predisposes to fatal acute respiratory distress syndrome (ARDS). Autopsies reports describe a diffuse alveolar damage with vascular congestion, inflammatory cell population entrapped, thrombosis with hyaline membrane formation in the alveolar walls allowing to an irreversible lung destruction. Altogether these findings remind the radiation oncologists many similarities with radiation induced lung injury which is a well-known side effect of radiotherapy for lung cancer. A fascinating hypothesis is that a common inflammatory paradoxical response of lung could be underlying the injury whatever the causes may be, virus, drugs or ionizing radiation. In this paper we will review the similarities between these two illnesses just going through the mechanisms of ALI-ARDS and the role of the most important immune cells and cytokines involved.

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Residual Lung Lesions at 1-year CT after COVID-19

Cited by 7 publications

References 10 publications

Current and Emerging Knowledge in COVID-19

Current and Emerging Knowledge in COVID-19

A mid-term follow-up with a lung ultrasonographic score correlates with the severity of COVID-19 acute phase

Radiation Induced Lung Injury (RILI) and COVID-19 Pneumonia: Are There Similarities by The Radiation Oncologist’s Point of View?

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