Chest CT in COVID-19 pneumonia: what are the findings in mid-term follow-up?

Tabatabaei, S M; Rajebi, Hamid; Moghaddas, Fahimeh; Ghasemiadl, Mojtaba; Talari, Hamid Reza

doi:10.1007/s10140-020-01869-z

Cited by 81 publications

(96 citation statements)

References 32 publications

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“…It is informative that in the study by Zhao et al (9) despite the high incidence of persistent CT abnormalities in their study, only 25.4% of the cohort demonstrated impairment in DLCO% predicted suggesting signi cant parenchymal lung disease. In two studies Tabatabaei et al (8) and Shah et al (7) demonstrate that persistent radiological abnormality at 12-week follow-up is associated with increased length of stay (8) and the number of days on oxygen therapy (7). Further to the ndings of these studies we identify that length of stay is an independent risk factor for persistent radiological abnormality post hospitalisation for COVID-19.…”

Section: Discussionsupporting

confidence: 52%

“…A prospective study of sixty COVID-19 survivors has identi ed ground-glass opacities and reticulation affecting greater than 10% lung volume on computed-tomography (CT) scanning in 55% of patients at 3-month follow-up (7). Further in two retrospective studies, persistent CT abnormalities were identi ed in 42.3% (8) and 70% ( 9) of patients at 3-months. Zhao et al (9) identify serum urea as a signi cant independent risk factor for persisting abnormal radiology at follow-up.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for persistent abnormality on chest radiographs at 12-weeks post hospitalisation with PCR confirmed COVID-19

Wallis

Heiden

Horno

et al. 2021

Preprint

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BackgroundThe long-term consequences of COVID-19 remain unclear. There is concern a proportion of patients will progress to develop pulmonary fibrosis. We aimed to assess the temporal change in CXR infiltrates in a cohort of patients following hospitalisation for COVID-19.MethodsWe conducted a single-centre prospective cohort study of patients admitted to University Hospital Southampton with confirmed SARS-CoV2 infection between 20th March – 3rd June 2020. Patients were approached for standard-of-care follow-up 12-weeks after hospitalisation. Inpatient and follow-up CXRs were scored by the assessing clinician for extent of pulmonary infiltrates; 0-4 per lung (Nil=0, <25%=1, 25-50%=2, 51-75%=3, >75%=4). Results 101 patients with paired CXRs were included. Demographics: 53% male with a median (IQR) age 53.0 (45-63) years and length of stay 9 (5-17.5) days. The median CXR follow-up interval was 82 (77-86) days with median baseline and follow-up CXR scores of 4.0 (3-5) and 0.0 (0-1) respectively. 32% of patients had persistent CXR abnormality at 12-weeks. In multivariate analysis length of stay (LOS), smoking-status and obesity were identified as independent risk factors for persistent CXR abnormality. Serum LDH was significantly higher at baseline and at follow-up in patients with CXR abnormalities compared to those with resolution. A 5-point composite risk score (1-point each; LOS≥15 days, Level 2/3 admission, LDH>750 U/L, obesity and smoking-status) strongly predicted risk of persistent radiograph abnormality (0.81).ConclusionPersistent CXR abnormality 12-weeks post COVID-19 was common in this cohort. LOS, obesity, increased serum LDH, and smoking-status were risk factors for radiograph abnormality. These findings require further prospective validation.

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Section: Discussionsupporting

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Risk factors for persistent abnormality on chest radiographs at 12-weeks post hospitalisation with PCR confirmed COVID-19

Wallis

Heiden

Horno

et al. 2021

Preprint

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“…Also, a significant association was found between dyspnea severity score on 12-week follow-up and predicted DLCO% (67). Moreover, in a report of 52 cases of COVID pneumonia with at least 2 chest CT scans of around 3 months apart, a higher initial CT severity score, ICU admission, longer hospitalization, underlying medical conditions, higher initial WBC count, and development of leukocytosis during hospitalization were predictors of persistent pulmonary abnormalities on the second CT scan (32).…”

Section: ) the Risk Factors For Developing Long Covidmentioning

confidence: 97%

<strong>Long COVID, A Comprehensive Systematic Scoping Review</strong>

Akbarialiabad¹,

Taghrir²,

Abdollahi³

et al. 2021

Preprint

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Introduction: Despite more than one year passed since the first cases of SARS-CoV-2 were reported, there is still no consensus on the definition and clinical management of post-acute-COVID-19. The condition has heterogeneously been named as Chronic COVID syndrome, Post COVID-19 Syndrome, post-acute sequela of SARS-CoV-2 (PASC), and the more familiar long COVID. Method: In order to capture all relevant published studies, we undertook a multi-step search with no language restriction. The following four-step search strategy was utilized: First, a preliminary (limited) search was conducted on January 20, 2021, in Google Scholar and PubMed to identify the appropriate keywords. Then, on January 30, 2021, we adopted a search strategy of electronic databases from Cochrane Library, PsycINFO, PubMed, Embase, Scopus, and Web of sciences, using those keywords. Then, after duplicate removal, we screened all titles, abstracts, and full texts. This resulted in 66 eligible studies. Subsequently, after a forward and backward search of their references and citations an additional 54 publications were found, resulting in a total of 120 publications that formed the basis of the present analysis. The titles, abstracts, and full-texts of non-English articles were translated using Google Translate for further evaluation. We conducted our scoping review based on the PRISMA-ScR Checklist.Results: We found only one randomized clinical trial in our search. Of the 67 original studies, 22 were cohort and 28 were cross-sectional studies totaling 74.6% of the original studies. Of the total of 120 publications, 59 (49.1%) focused on signs and symptoms, 28 (23.3%) were focused on management, and 13 (10.8%) focused on pathophysiology. Ten (9%) publications focused on imaging studies. Ninety-one percent of the original investigations came from high and upper-middle-income countries, highlighting the scarcity of reports originating from low-income and lower-middle-income countries.Conclusion: The predominant symptoms among those with the so-called “Long COVID” were: fatigue, breathlessness, arthralgia, sleep difficulties, and chest pain. Recent reports also point to the risk of long-term sequela with cutaneous, respiratory, cardiovascular, musculoskeletal, mental health, neurologic, and renal involvement in those who survive the acute phase of the illness. The ambiguity and controversies in its definition have impaired proper recognition and management of those requiring additional support following the resolution of the acute phase of this infection. This has resulted in long-standing distress for the patients and their families. Our findings highlight the need for a multidisciplinary approach, support, and rehabilitation for these patients in terms of long-term mental and physical health.

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“…Case series have mainly focussed on all hospitalised patients, including patients with less severe disease 2, 3 . Studies in critically ill populations have been limited to functional status assessments or have focussed on the residual radiological features in these patients 4,5 .…”

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confidence: 99%

Recovery after critical illness in COVID-19 ICU survivors

Parker

Humbir

Tiwary

et al. 2021

British Journal of Anaesthesia

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Chest CT in COVID-19 pneumonia: what are the findings in mid-term follow-up?

Cited by 81 publications

References 32 publications

Risk factors for persistent abnormality on chest radiographs at 12-weeks post hospitalisation with PCR confirmed COVID-19

Risk factors for persistent abnormality on chest radiographs at 12-weeks post hospitalisation with PCR confirmed COVID-19

<strong>Long COVID, A Comprehensive Systematic Scoping Review</strong>

Recovery after critical illness in COVID-19 ICU survivors

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