Dynamic Changes in Chest CT Images Over 167 Days in 11 Patients with COVID-19: A Case Series and Literature Review

Abstract

Background: Recently, CT findings have been widely reported to be associated with the clinical severity of COVID-19. However, few studies have reported the correlation between CT findings and long-term outcomes in patients with COVID-19. Case presentation: Herein, we conducted a 167 day long-term follow-up of CT examination on 11 patients with COVID-19 to evaluate their long-term prognosis, particularly in severe cases. We found that the course of COVID-19 can be divided into four stages according to the characteristics of CT images: 1) early stage (1–4 days), with chest CT showing quasi-circular ground-glass shadows and fine mesh shadows; 2) progressive stage (5–10 days), showing lesion spread through the axial interstitium along the bronchi and gradual diffusion to the whole lung; 3) recovery stage (11–74 days), showing gradual absorption of the fibre cord, ground-glass, and consolidation shadows; and 4) normal stage (74 days later), indicating no serious permanent lung injuries. Conclusions: Our data indicate that chest CT can enable early detection of COVID-19 and determination of the different stages of COVID-19. Furthermore, mild cases tended to have better prognosis, whereas severe cases still showed cord-like fibrosis in the lungs in follow-up at the 167th day after symptom onset.

Overlapping of Pulmonary Fibrosis of Postacute COVID-19 Syndrome and Tuberculosis in the Helminth Coinfection Setting in Sub-Saharan Africa

“…Clinical, chest CT, and postmortem findings have shown that fibrosis and restriction of pulmonary function are frequently present in patients who have recovered from COVID-19: (i) more than a third of the patients with severe forms of COVID-19 may show limited lung function after hospital discharge [12,13], (ii) PF on chest CT have been reported in patients who had recovered from severe or critical disease [12][13][14], and (iii) in an autopsy study involving patients with acute respiratory distress syndrome (ARDS), the finding of PF was more frequent as more time had elapsed since the onset of clinical manifestations of COVID-19 [15]. PF is already recognized among the most important sequelae of SARS-CoV-2 infection [16].…”

BCG Vaccination: A potential tool against COVID-19 and COVID-19-like Black Swan incidents

“…Currently, although WHO has approved more than ten vaccines for emergency use (https://www.who.int/teams/regulation-prequalification/eul/COVID-19), and dozens of vaccines are approved by different countries, the spread of the COVID-19 pandemic is still not effectively contained [3] , [4] , [5] , [6] . More notably, SARS-CoV-2 variants keep emerging and may break through the protection of existing vaccines [7] , [8] , [9] .…”