Computed tomography at every step: Long coronavirus disease

Abstract

Background Some patients continue to experience symptoms related to Coronavirus disease (COVID-19) after the acute phase of infection. Imaging studies, especially computed tomography (CT) of the chest, have gained importance since the beginning of the pandemic. CT can help diagnose COVID-19, assess the extent of pulmonary involvement, and predict the disease severity. We aimed to define the frequency of persistent symptoms and correlate their presence with the results of laboratory findings and the severity of the disease based on the findings of chest CT. Methods We examined patients discharged from the hospital after treatment for COVID-19 and whose nasopharyngeal swab sample tested positive for severe acute respiratory syndrome coronavirus 2 after at least 4 weeks from the initial diagnosis. The patients were asked about the presence of persisting symptoms. In addition to the demographic data, laboratory results and severity levels seen on the chest CT were recorded. Results In all, 116 patients were included in the study, of which 61 reported at least one persisting symptom (52.5%). The mean age of the study population was 48.90 ± 17.74 years. The persistent symptoms included shortness of breath, chest pain, cough, muscle weakness, dizziness, headache, fatigue, and palpitations. The mean CT severity score was 3.80 ± 0.38 and it was lower in patients without any persistent symptoms. Conclusions Levels of C-reactive protein and fibrinogen, anemia, and female sex were associated with some of the persistent symptoms., the severity of the disease seen on CT was a successful predictor for the disease severity/prognosis and was also correlated with prolonged COVID infection and more persistent symptoms.

Prevalence, risk factors and treatments for post-COVID-19 breathlessness: a systematic review and meta-analysis

“…Regarding underlying mechanisms, several papers reported that post-COVID breathlessness was correlated with reduced spirometry parameters (n=5) [ 32 , 42 , 58 – 60 ], lower diffusion capacity for carbon monoxide ( D LCO ) (n=7) [ 32 , 36 , 55 , 58 , 59 , 61 , 62 ] and lung imaging abnormalities (computed tomography (CT) (n=3) [ 40 , 58 , 63 ], lung ultrasound (n=1) [ 36 ], chest radiograph (n=1) [ 42 ]), but four [ 26 , 37 , 55 , 61 ], four [ 26 , 37 , 60 , 64 ] and three papers [ 35 , 37 , 65 ] found no significant associations with these three measurements, respectively. One paper [ 26 ] reported that patients with post-COVID breathlessness had reduced exercise capacity based on the 6-minute walk test, lower predicted peak oxygen consumption and worse performance in cardiopulmonary exercise testing; another paper [ 59 ] also found a reduced 6-minute walk distance and lower end-exercise oxygen saturation, and two additional papers [ 38 , 66 ] supported the findings in cardiopulmonary exercise testing.…”

“…Four papers [ 26 , 32 , 61 , 66 ] assessed echocardiogram results during follow-up but only one [ 66 ] detected an association with post-COVID breathlessness. One paper [ 63 ] identified a correlation with higher C-reactive protein (CRP) level at the follow-up visit, but another paper [ 42 ] did not. Three papers [ 32 , 35 , 48 ] reported significant associations between post-COVID breathlessness and symptoms of depression and anxiety, one of which also reported an association with post-traumatic stress disorder [ 35 ].…”

“…Significant between-subgroup heterogeneity was detected ( p=0.014). AUL [91] AYDIN [63] BALDINI [62] FERNÁNDEZ-DE-LAS-PEÑAS [105] SUÁREZ-ROBLES [128] MAESTRE-MUÑIZ [113] DARCIS [101] CARFI [96] BOARI [94] LUND [77] VIJAYAKUMAR [65] Subtotal (I 2 =98.3%, p<0.001) Subtotal (I 2 =98.4%, p<0.001) ZHANG [39] ZHAO [138] Non-hospitalisation Heterogeneity between groups: p=0.020 TOSATO [133] SUN [130] SHOUCRI [126] SHANG [27] SATHYAMURTHY [124] RIOU [52] QIN [47] MUNBLIT [119] MUMOLI [118] COMEBAC STUDY GROUP [85] MORADIAN [117] MEIJE [56] MAHMUD [114] LANDI [112] JACOBS [109] GHOSN [11] GARRIGUES [53] FORTINI [36] BLOMBERG [93] ARNOLD [89] ANAYA [49] ANAYA [49] HUANG [12] STAVEM [127] NEHME [120] BELL [92] AUGUSTIN [90] ARMANGE [88] BLOMBERG [93] LUND [ Both the funnel plots (supplementary figure 1) and Egger's tests ( p>0.10) suggested no evidence of publication bias. The...…”

“…The influential analysis indicated no single study had a major impact on the pooled prevalence estimate (supplementary table 3). [63] BALDINI [62] BELL [92] DARCIS [101] CARFI [96] CARVALHO-SCHNEIDER [97] CORTÉS-TELLES [59] DANKOWSKI [100] DIAZ-FUENTES [102] DREYER [103] EROL [25] GABER [106] GALVÁN-TEJADA [19] ÇALIK KÜTÜKCÜ [95] BOARI [94] MORADIAN [117] MEIJE [56] MAHMUD [114] LANDI [112] JACOBS [109] KLEIN [111] MALLIA [115] COMEBAC STUDY GROUP [85] MOTIEJUNAITE [64] GHOSN [11] GARRIGUES [53] FORTINI [36] BLOMBERG [93] ARNOLD [89] AUGUSTIN [90] ARMANAGE [88] SUÁREZ-ROBLES [128] VIJAYAKUMAR [65] VARGHESE [134] VENTURELLI [135] Subtotal (I 2 =97.8%, p<0.001) Heterogeneity between groups: p=0.014 ZHAO [138] TOSATO [133] SZEKELY [66] TAWLIK [14] TAYLOR [131] SUN [130] SHOUCRI [126] SULTANA [129] STAVEM [127] SONNWEBER ...…”

Evaluation of thorax computed tomographic findings in COVID-19 variant cases

“…Thorax computed tomographic (CT) findings have been reported to be useful for the diagnosis, prognostic assessment, and detection of complications of COVID-19 infection [ 4 ]. CT severity score assessed based on the percentage of lung involvement has been shown to be a good prognostic predictor in patients with COVID-19 [ 5 ].…”