Fibrotic-like abnormalities notably prevalent one year after hospitalization with COVID-19

Raaij, Bas F. M. van; Stöger, J. Lauran; Hinnen, Chris; Penfornis, Kristell M.; Jong, Cindy M.M. de; Klok, Frederikus A.; Roukens, Anna H E; Veldhuijzen, Dieuwke S.; Arbous, Sesmu; Noordam, Raymond; Marges, E.R.; Geelhoed, J.J. Miranda

doi:10.1016/j.resmer.2022.100973

Cited by 4 publications

(12 citation statements)

References 41 publications

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“…A total of 2517 studies were identified, of which 43 met the inclusion (N = 8858 patients) ( Figure 1 ) [ 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 ]. The majority of studies were from China (14 studies [ 51 , 58 , 59 , 60 , 61 , 64 , 65 , …”

Section: Resultsmentioning

confidence: 99%

“…The median age of the patients was 60.3 years (57–63), with 61.5% being males and 37.8% being current/former smokers. Thirty-nine studies [ 47 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 65 , 66 , 67 , 68 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 ] reported outcomes stratified by disease severity; 17 for non-severe disease, 31 for severe disease, and 7 for mixed disease severity ( Table 1 ). The most common comorbidities were hypertension (35.8%), cardiovascular disease, (28%), and obesity (24.9%) ( Supplemental Table S1 ).…”

Section: Resultsmentioning

confidence: 99%

“…A total of 37 studies [ 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 56 , 57 , 60 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 ] reported chest-CT findings at 12 months, while only 3 studies [ 55 , 59 , 61 ] reported findings at 24 months. When comparing CT abnormalities between the 12- and 24-month follow-ups, consolidation (12 months: 3.6% vs. 24 months: 0.9%, p = 0.036) and interlobular septal thickening (12 months: 17.3% vs. 24 months: 7%, p = 0.043) significantly decreased over time.…”

Section: Resultsmentioning

confidence: 99%

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Short- and Long-Term Chest-CT Findings after Recovery from COVID-19: A Systematic Review and Meta-Analysis

Babar,

Jamil,

Mehta

et al. 2024

Diagnostics

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While ground-glass opacity, consolidation, and fibrosis in the lungs are some of the hallmarks of acute SAR-CoV-2 infection, it remains unclear whether these pulmonary radiological findings would resolve after acute symptoms have subsided. We conducted a systematic review and meta-analysis to evaluate chest computed tomography (CT) abnormalities stratified by COVID-19 disease severity and multiple timepoints post-infection. PubMed/MEDLINE was searched for relevant articles until 23 May 2023. Studies with COVID-19-recovered patients and follow-up chest CT at least 12 months post-infection were included. CT findings were evaluated at short-term (1–6 months) and long-term (12–24 months) follow-ups and by disease severity (severe and non-severe). A generalized linear mixed-effects model with random effects was used to estimate event rates for CT findings. A total of 2517 studies were identified, of which 43 met the inclusion (N = 8858 patients). Fibrotic-like changes had the highest event rate at short-term (0.44 [0.3–0.59]) and long-term (0.38 [0.23–0.56]) follow-ups. A meta-regression showed that over time the event rates decreased for any abnormality (β = −0.137, p = 0.002), ground-glass opacities (β = −0.169, p < 0.001), increased for honeycombing (β = 0.075, p = 0.03), and did not change for fibrotic-like changes, bronchiectasis, reticulation, and interlobular septal thickening (p > 0.05 for all). The severe subgroup had significantly higher rates of any abnormalities (p < 0.001), bronchiectasis (p = 0.02), fibrotic-like changes (p = 0.03), and reticulation (p < 0.001) at long-term follow-ups when compared to the non-severe subgroup. In conclusion, significant CT abnormalities remained up to 2 years post-COVID-19, especially in patients with severe disease. Long-lasting pulmonary abnormalities post-SARS-CoV-2 infection signal a future public health concern, necessitating extended monitoring, rehabilitation, survivor support, vaccination, and ongoing research for targeted therapies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Short- and Long-Term Chest-CT Findings after Recovery from COVID-19: A Systematic Review and Meta-Analysis

Babar,

Jamil,

Mehta

et al. 2024

Diagnostics

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“…Regarding the quantitative assessment of the extent of residual lung abnormalities on CT images, only 5/16 (38%) studies (3 from Europe and 2 from China) estimated the overall percentage of lung involvement: 3 with dedicated software [20,28,44], and 2 with a visual method [25,42] (Table 5). As shown in Table 5, the overall percentage of lung volume affected by residual lung abnormalities on CT images ranged from 0 to 12%, with As shown in Table 4, the prevalence of reticular and linear opacities was reported in 6/7 (86%) studies, reticular opacities were not reported in the study by Zhou et al [20], and linear opacities were not included in the study by Han et al [11].…”

Section: Resultsmentioning

confidence: 99%

“…Based on the literature, residual lung abnormalities on chest CT are relatively common in survivors of COVID-19 . At one-year follow-up chest CT, survivors with the lowest frequency of lung parenchymal abnormalities were those with previous mild to moderate disease [14,20,21,[24][25][26]29,32,33,35,[43][44][45][46][47][48][49]. These patients have mild to moderate symptoms with a blood oxygen saturation ≥ 90% and without signs of severe pneumonia [50].…”

Section: Introductionmentioning

confidence: 99%

Residual Lung Abnormalities in Survivors of Severe or Critical COVID-19 at One-Year Follow-Up Computed Tomography: A Narrative Review Comparing the European and East Asian Experiences

Borghesi,

Ciolli,

Antonelli

et al. 2023

Tomography

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The literature reports that there was a significant difference in the medical impact of the coronavirus disease (COVID-19) pandemic between European and East Asian countries; specifically, the mortality rate of COVID-19 in Europe was significantly higher than that in East Asia. Considering such a difference, our narrative review aimed to compare the prevalence and characteristics of residual lung abnormalities at one-year follow-up computed tomography (CT) after severe or critical COVID-19 in survivors of European and East Asian countries. A literature search was performed to identify articles focusing on the prevalence and characteristics of CT lung abnormalities in survivors of severe or critical COVID-19. Database analysis identified 16 research articles, 9 from Europe and 7 from East Asia (all from China). Our analysis found a higher prevalence of CT lung abnormalities in European than in Chinese studies (82% vs. 52%). While the most prevalent lung abnormalities in Chinese studies were ground-glass opacities (35%), the most prevalent lung abnormalities in European studies were linear (59%) and reticular opacities (55%), followed by bronchiectasis (46%). Although our findings required confirmation, the higher prevalence and severity of lung abnormalities in European than in Chinese survivors of COVID-19 may reflect a greater architectural distortion due to a more severe lung damage.

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A predictive model for post-COVID-19 pulmonary parenchymal abnormalities based on dual-center data

Yao,

Wu,

Zou

et al. 2024

Sci Rep

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Documented radiological and physiological anomalies among coronavirus disease 2019 survivors necessitate prompt recognition of residual pulmonary parenchymal abnormalities for effective management of chronic pulmonary consequences. This study aimed to devise a predictive model to identify patients at risk of such abnormalities post-COVID-19. Our prognostic model was derived from a dual-center retrospective cohort comprising 501 hospitalized COVID-19 cases from July 2022 to March 2023. Of these, 240 patients underwent Chest CT scans three months post-infection. A predictive model was developed using stepwise regression based on the Akaike Information Criterion, incorporating clinical and laboratory parameters. The model was trained and validated on a split dataset, revealing a 33.3% incidence of pulmonary abnormalities. It achieved strong discriminatory power in the training set (area under the curve: 0.885, 95% confidence interval 0.832–0.938), with excellent calibration and decision curve analysis suggesting substantial net benefits across various threshold settings. We have successfully developed a reliable prognostic tool, complemented by a user-friendly nomogram, to estimate the probability of residual pulmonary parenchymal abnormalities three months post-COVID-19 infection. This model, demonstrating high performance, holds promise for guiding clinical interventions and improving the management of COVID-19-related pulmonary sequela. Supplementary Information The online version contains supplementary material available at 10.1038/s41598-024-79715-2.

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Fibrotic-like abnormalities notably prevalent one year after hospitalization with COVID-19

Cited by 4 publications

References 41 publications

Short- and Long-Term Chest-CT Findings after Recovery from COVID-19: A Systematic Review and Meta-Analysis

Short- and Long-Term Chest-CT Findings after Recovery from COVID-19: A Systematic Review and Meta-Analysis

Residual Lung Abnormalities in Survivors of Severe or Critical COVID-19 at One-Year Follow-Up Computed Tomography: A Narrative Review Comparing the European and East Asian Experiences

A predictive model for post-COVID-19 pulmonary parenchymal abnormalities based on dual-center data

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