1
|
Roig-Martí C, Pérez-Catalán I, Varea-Villanueva M, Folgado-Escudero S, Navarro-Ballester A, Fernández-García MP, Segura-Fábrega A, Herrero-Rodríguez G, Domínguez-Bajo E, Fabra-Juana S, Esteve-Gimeno MJ, Mateu-Campos ML, Usó-Blasco J, Ramos-Rincón JM. Predictors of the presence of radiological abnormalities 6 months after severe COVID-19 pneumonia. BMC Infect Dis 2024; 24:883. [PMID: 39210255 PMCID: PMC11360858 DOI: 10.1186/s12879-024-09767-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 08/20/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND SARS-CoV-2 pneumonia can cause significant long-term radiological changes, even resembling pulmonary fibrosis. However, the risk factors for these long-term effects are unknown. This study aims to assess radiological abnormalities and their possible risk factors six months after hospital discharge due to COVID-19 pneumonia. MATERIAL AND METHODS This cross-sectional study in a tertiary hospital included adults admitted for COVID-19 pneumonia from March 2020 to February 2021, who underwent high-resolution computed tomography (HRCT) scans of the chest six months after hospital discharge. The primary outcome was radiological abnormalities on HRCT, while the main explanatory variables were drawn from the patient's medical history along with the disease course, analytical indicators, and the treatment received during admission. RESULTS The 189 included patients had a mean age of 61.5 years; 70.9% were male, and hypertension was the main comorbidity (45%). About two-thirds (67.2%) presented acute respiratory distress syndrome (ARDS). Most (97.9%) received systemic corticosteroid therapy, and 81% presented pathological findings on HRCT, most commonly ground glass (63.5%), followed by bronchial dilatation (36%) and subpleural bands (25.4%). The multivariable analysis showed that age was the main risk factor, associated with most radiological changes. Other factors were the duration of corticosteroid therapy for ground glass (adjusted odds ratio [aOR] 1.020) as well as a longer stay in the intensive care unit (ICU) (aOR 1.290) and high levels of IL-6 for bronchial dilation (aOR 1.002). CONCLUSION Radiological involvement of the lungs six months after COVID-19 pneumonia is frequent, especially ground glass. Elderly patients with prolonged ICU admission and a significant inflammatory response measured by IL-6 are more likely to present worse radiological evolution and are candidates for radiological follow-up after COVID-19 pneumonia.
Collapse
Affiliation(s)
- Celia Roig-Martí
- Internal Medicine Department, Castellón General University Hospital, Castellón, Spain.
| | - Ignacio Pérez-Catalán
- Internal Medicine Department, Castellón General University Hospital, Castellón, Spain.
| | | | | | | | | | - Ana Segura-Fábrega
- Internal Medicine Department, Castellón General University Hospital, Castellón, Spain
| | | | - Elena Domínguez-Bajo
- Internal Medicine Department, Castellón General University Hospital, Castellón, Spain
| | - Sergio Fabra-Juana
- Internal Medicine Department, Castellón General University Hospital, Castellón, Spain
| | | | | | - Jorge Usó-Blasco
- Internal Medicine Department, Castellón General University Hospital, Castellón, Spain
| | - José-Manuel Ramos-Rincón
- Internal Medicine Department, Alicante General University Hospital, Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
- Clinical Medicine Department, Miguel Hernández University of Elche, Elche, Spain
| |
Collapse
|
2
|
Rai DK, Tripathi S. Antifibrotic in interstitial lung diseases: When, where, and how long? Lung India 2022; 39:491-494. [PMID: 36629226 PMCID: PMC9746283 DOI: 10.4103/lungindia.lungindia_283_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 07/27/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Deependra K. Rai
- Department of Pulmonary Medicine, AIIMS, Patna, Bihar, India E-mail:
| | | |
Collapse
|
3
|
Structural and Functional Pulmonary Assessment in Severe COVID-19 Survivors at 12 Months after Discharge. Tomography 2022; 8:2588-2603. [PMID: 36287815 PMCID: PMC9611724 DOI: 10.3390/tomography8050216] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/06/2022] [Accepted: 10/08/2022] [Indexed: 11/19/2022] Open
Abstract
Long-term pulmonary sequelae in COVID-19 patients are currently under investigation worldwide. Potential relationships between blood sampling and functional and radiological findings are crucial to guide the follow-up. In this study, we collected and evaluated clinical status, namely symptoms and patients’ reported outcome, pulmonary function tests (PFT), laboratory tests, and radiological findings at 3- and 12-months post-discharge in patients admitted between 25 February and 2 May 2020, and who survived severe COVID-19 pneumonia. A history of chronic pulmonary disease or COVID-19-unrelated complications were used as exclusion criteria. Unenhanced CTs were analyzed quantitatively (compromising lung volume %) and qualitatively, with main patterns of: ground-glass opacity (GGO), consolidation, and reticular configuration. Patients were subsequently divided into groups based on their radiological trends and according to the evolution in the percentage of compromised lung volume. At 12 months post-discharge, seventy-one patients showed significantly improved laboratory tests and PFT. Among them, 63 patients also underwent CT examination: all patients with negative CT findings at three months (n = 14) had negative CT also at 12 months; among the 49/63 patients presenting CT alterations at three months, 1/49 (2%) normalized, 40/49 (82%) improved, 7/49 (14%) remained stably abnormal, and 1/49 (2%) worsened. D-dimer values were low in patients with normal CT and higher in cases with improved or stably abnormal CT (median values 213 vs. 329 vs. 1000 ng/mL, respectively). The overall compromised lung volume was reduced compared with three months post-discharge (12.3 vs. 14.4%, p < 0.001). In stably abnormal CT, the main pulmonary pattern changed, showing a reduction in GGO and an increase in reticular configuration. To summarize, PFT are normal in most COVID-19 survivors 12 months post-discharge, but CT structural abnormalities persist (although sensibly improved over time) and are associated with higher D-dimer values.
Collapse
|
4
|
Huntley CC, Patel K, Bil Bushra SES, Mobeen F, Armitage MN, Pye A, Knight CB, Mostafa A, Kershaw M, Mughal AZ, McKemey E, Turner AM, Burge PS, Walters GI. Pulmonary function test and computed tomography features during follow-up after SARS, MERS and COVID-19: a systematic review and meta-analysis. ERJ Open Res 2022; 8:00056-2022. [PMID: 35642193 PMCID: PMC9035766 DOI: 10.1183/23120541.00056-2022] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/23/2022] [Indexed: 01/09/2023] Open
Abstract
Background The COVID-19 pandemic follows severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronavirus epidemics. Some survivors of COVID-19 infection experience persistent respiratory symptoms, yet their cause and natural history remain unclear. Follow-up after SARS and MERS may provide a model for predicting the long-term pulmonary consequences of COVID-19. Methods This systematic review and meta-analysis aims to describe and compare the longitudinal pulmonary function test (PFT) and computed tomography (CT) features of patients recovering from SARS, MERS and COVID-19. Meta-analysis of PFT parameters (DerSimonian and Laird random-effects model) and proportion of CT features (Freeman-Tukey transformation random-effects model) were performed. Findings Persistent reduction in the diffusing capacity for carbon monoxide following SARS and COVID-19 infection is seen at 6 months follow-up, and 12 months after MERS. Other PFT parameters recover in this time. 6 months after SARS and COVID-19, ground-glass opacity, linear opacities and reticulation persist in over 30% of patients; honeycombing and traction dilatation are reported less often. Severe/critical COVID-19 infection leads to greater CT and PFT abnormality compared to mild/moderate infection. Interpretation Persistent diffusion defects suggestive of parenchymal lung injury occur after SARS, MERS and COVID-19 infection, but improve over time. After COVID-19 infection, CT features are suggestive of persistent parenchymal lung injury, in keeping with a post-COVID-19 interstitial lung syndrome. It is yet to be determined if this is a regressive or progressive disease.
Collapse
Affiliation(s)
- Christopher C. Huntley
- Occupational and Interstitial Lung Disease Services, University Hospitals Birmingham (UHB) NHS Foundation Trust, Birmingham, UK,Institute of Applied Health Research, University of Birmingham, Birmingham, UK,Corresponding author: Christopher C. Huntley ()
| | - Ketan Patel
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK,UHB NHS Foundation Trust, Birmingham, UK
| | | | | | | | - Anita Pye
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | | | | | | | | | - Alice M. Turner
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK,UHB NHS Foundation Trust, Birmingham, UK
| | - P. Sherwood Burge
- Occupational and Interstitial Lung Disease Services, University Hospitals Birmingham (UHB) NHS Foundation Trust, Birmingham, UK
| | - Gareth I. Walters
- Occupational and Interstitial Lung Disease Services, University Hospitals Birmingham (UHB) NHS Foundation Trust, Birmingham, UK,Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| |
Collapse
|
5
|
Alkodaymi MS, Omrani OA, Fawzy NA, Shaar BA, Almamlouk R, Riaz M, Obeidat M, Obeidat Y, Gerberi D, Taha RM, Kashour Z, Kashour T, Berbari EF, Alkattan K, Tleyjeh IM. Prevalence of post-acute COVID-19 syndrome symptoms at different follow-up periods: a systematic review and meta-analysis. Clin Microbiol Infect 2022; 28:657-666. [PMID: 35124265 PMCID: PMC8812092 DOI: 10.1016/j.cmi.2022.01.014] [Citation(s) in RCA: 224] [Impact Index Per Article: 112.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Post-acute coronavirus 2019 (COVID-19) syndrome is now recognized as a complex systemic disease that is associated with substantial morbidity. OBJECTIVES To estimate the prevalence of persistent symptoms and signs at least 12 weeks after acute COVID-19 at different follow-up periods. DATA SOURCES Searches were conducted up to October 2021 in Ovid Embase, Ovid Medline, and PubMed. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTIONS Articles in English that reported the prevalence of persistent symptoms among individuals with confirmed severe acute respiratory syndrome coronavirus 2 infection and included at least 50 patients with a follow-up of at least 12 weeks after acute illness. METHODS Random-effect meta-analysis was performed to produce a pooled prevalence for each symptom at four different follow-up time intervals. Between-study heterogeneity was evaluated using the I2 statistic and was explored via meta-regression, considering several a priori study-level variables. Risk of bias was assessed using the Joanna Briggs Institute tool and the Newcastle-Ottawa Scale for prevalence studies and comparative studies, respectively. RESULTS After screening 3209 studies, a total of 63 studies were eligible, with a total COVID-19 population of 257 348. The most commonly reported symptoms were fatigue, dyspnea, sleep disorder, and difficulty concentrating (32%, 25%, 24%, and 22%, respectively, at 3- to <6-month follow-up); effort intolerance, fatigue, sleep disorder, and dyspnea (45%, 36%, 29%, and 25%, respectively, at 6- to <9-month follow-up); fatigue (37%) and dyspnea (21%) at 9 to <12 months; and fatigue, dyspnea, sleep disorder, and myalgia (41%, 31%, 30%, and 22%, respectively, at >12-month follow-up). There was substantial between-study heterogeneity for all reported symptom prevalences. Meta-regressions identified statistically significant effect modifiers: world region, male sex, diabetes mellitus, disease severity, and overall study quality score. Five of six studies including a comparator group consisting of COVID-19-negative cases observed significant adjusted associations between COVID-19 and several long-term symptoms. CONCLUSIONS This systematic review found that a large proportion of patients experience post-acute COVID-19 syndrome 3 to 12 months after recovery from the acute phase of COVID-19. However, available studies of post-acute COVID-19 syndrome are highly heterogeneous. Future studies need to have appropriate comparator groups, standardized symptom definitions and measurements, and longer follow-up.
Collapse
Affiliation(s)
| | - Osama Ali Omrani
- The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom,Barts and the London School of Medicine and Dentistry, Queen Mary University, London, United Kingdom
| | - Nader A. Fawzy
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | | | | | - Muhammad Riaz
- Center for Trial Research, School of Medicine, Cardiff University, United Kingdom
| | - Mustafa Obeidat
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Yasin Obeidat
- UMass Chan Medical School–Baystate, Springfield, MA, USA
| | - Dana Gerberi
- Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, USA
| | - Rand M. Taha
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Zakaria Kashour
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Tarek Kashour
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Elie F. Berbari
- Infectious Diseases Section, Department of Medical Specialties King Fahad Medical City, Riyadh, Saudi Arabia
| | - Khaled Alkattan
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Imad M. Tleyjeh
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia,Infectious Diseases Section, Department of Medical Specialties King Fahad Medical City, Riyadh, Saudi Arabia,Division of Infectious Diseases, Mayo Clinic College of Medicine and Science, Rochester, MN, USA,Department of Epidemiology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA,Corresponding author. Imad M. Tleyjeh, Section of Infectious Diseases, King Fahd Medical City, PO Box 59046, Riyadh 11525, Saudi Arabia
| |
Collapse
|
6
|
Rai D, Kumar S, Pandey S, Vardhan H. Radiological Lung Sequelae of Severe COVID-19: A Retrospective Observational Study From a Dedicated COVID Centre of Eastern India. Cureus 2022; 14:e21416. [PMID: 35198321 PMCID: PMC8855736 DOI: 10.7759/cureus.21416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2022] [Indexed: 11/05/2022] Open
Abstract
Background: The pulmonary sequelae of severe COVID-19 infection are yet to be fully defined. The authors undertook this study to find out the proportion of severe COVID-19 patients having fibrosis-like lung sequelae during a medium-term follow-up period. Materials and methods: This was a retrospective observational study from a dedicated COVID centre of Eastern India. Severe COVID-19 patients who had undergone chest computerized tomography (CT) during the acute phase of illness and at least one follow-up CT with a gap of minimum two months between the two scans were included in the study. Result: A total of 39 patients who had recovered from severe COVID-19 pneumonia and presented to the pulmonary medicine OPD in the months of July and August 2021 were included. Patients with pre-existing lung disease (n-4), mild to moderate (n-11), and due to unavailability of CT scan (n-2) were excluded. A total of 22 patients (thirteen males, nine females) were thus included for analysis. Follow-up scans were performed with a mean of 2.5 months after the onset of the disease. Out of 22 patients, only one patient’s follow-up scan was normal. Predominant fibrotic-like features were present in six (27.2%) patients, though some evidence of fibrosis-like changes were seen in 20 out of 22 (90.9%) patients. The remaining 15 (68.2%) patients with abnormal scans had predominant non-fibrotic changes like ground-glass opacities (GGOs), consolidation, cavity, or nodule. The most common presenting symptoms at the follow-up examination were dyspnoea (81.8%), cough (54.1%) followed by fatigue in 40.9% of patients. Conclusion: This study concluded that most of the severe COVID-19 patients have some residual radiological findings during medium-term follow-up. Fibrotic-like lesions are present in almost all patients but most of them get resolved with time. True fibrotic features like honeycombing are rarely seen as residual lung sequelae.
Collapse
|
7
|
Luchian ML, Motoc A, Lochy S, Magne J, Belsack D, De Mey J, Roosens B, Van den Bussche K, Boeckstaens S, Chameleva H, Geers J, Houard L, De Potter T, Allard S, Weytjens C, Droogmans S, Cosyns B. Subclinical Myocardial Dysfunction in Patients with Persistent Dyspnea One Year after COVID-19. Diagnostics (Basel) 2021; 12:diagnostics12010057. [PMID: 35054224 PMCID: PMC8775030 DOI: 10.3390/diagnostics12010057] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 12/16/2022] Open
Abstract
Long coronavirus disease 2019 (COVID-19) was described in patients recovering from COVID-19, with dyspnea being a frequent symptom. Data regarding the potential mechanisms of long COVID remain scarce. We investigated the presence of subclinical cardiac dysfunction, assessed by transthoracic echocardiography (TTE), in recovered COVID-19 patients with or without dyspnea, after exclusion of previous cardiopulmonary diseases. A total of 310 consecutive COVID-19 patients were prospectively included. Of those, 66 patients (mean age 51.3 ± 11.1 years, almost 60% males) without known cardiopulmonary diseases underwent one-year follow-up consisting of clinical evaluation, spirometry, chest computed tomography, and TTE. From there, 23 (34.8%) patients reported dyspnea. Left ventricle (LV) ejection fraction was not significantly different between patients with or without dyspnea (55.7 ± 4.6 versus (vs.) 57.6 ± 4.5, p = 0.131). Patients with dyspnea presented lower LV global longitudinal strain, global constructive work (GCW), and global work index (GWI) compared to asymptomatic patients (−19.9 ± 2.1 vs. −21.3 ± 2.3 p = 0.039; 2183.7 ± 487.9 vs. 2483.1 ± 422.4, p = 0.024; 1960.0 ± 396.2 vs. 2221.1 ± 407.9, p = 0.030). GCW and GWI were inversely and independently associated with dyspnea (p = 0.035, OR 0.998, 95% CI 0.997–1.000; p = 0.040, OR 0.998, 95% CI 0.997–1.000). Persistent dyspnea one-year after COVID-19 was present in more than a third of the recovered patients. GCW and GWI were the only echocardiographic parameters independently associated with symptoms, suggesting a decrease in myocardial performance and subclinical cardiac dysfunction.
Collapse
Affiliation(s)
- Maria-Luiza Luchian
- Department of Cardiology, (Centrum voor Hart-en Vaatziekten), Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium; (A.M.); (S.L.); (B.R.); (K.V.d.B.); (S.B.); (J.G.); (L.H.); (C.W.); (S.D.); (B.C.)
- Correspondence:
| | - Andreea Motoc
- Department of Cardiology, (Centrum voor Hart-en Vaatziekten), Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium; (A.M.); (S.L.); (B.R.); (K.V.d.B.); (S.B.); (J.G.); (L.H.); (C.W.); (S.D.); (B.C.)
| | - Stijn Lochy
- Department of Cardiology, (Centrum voor Hart-en Vaatziekten), Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium; (A.M.); (S.L.); (B.R.); (K.V.d.B.); (S.B.); (J.G.); (L.H.); (C.W.); (S.D.); (B.C.)
| | - Julien Magne
- Service Cardiologie, CHU Limoges, Hôpital Dupuytren, 87000 Limoges, France;
- 16 INSERM 1094 Faculté de Médecine de Limoges, 87000 Limoges, France
| | - Dries Belsack
- Department of Radiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium; (D.B.); (J.D.M.)
| | - Johan De Mey
- Department of Radiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium; (D.B.); (J.D.M.)
| | - Bram Roosens
- Department of Cardiology, (Centrum voor Hart-en Vaatziekten), Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium; (A.M.); (S.L.); (B.R.); (K.V.d.B.); (S.B.); (J.G.); (L.H.); (C.W.); (S.D.); (B.C.)
| | - Karen Van den Bussche
- Department of Cardiology, (Centrum voor Hart-en Vaatziekten), Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium; (A.M.); (S.L.); (B.R.); (K.V.d.B.); (S.B.); (J.G.); (L.H.); (C.W.); (S.D.); (B.C.)
| | - Sven Boeckstaens
- Department of Cardiology, (Centrum voor Hart-en Vaatziekten), Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium; (A.M.); (S.L.); (B.R.); (K.V.d.B.); (S.B.); (J.G.); (L.H.); (C.W.); (S.D.); (B.C.)
| | - Hadischat Chameleva
- Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium; (H.C.); (T.D.P.)
| | - Jolien Geers
- Department of Cardiology, (Centrum voor Hart-en Vaatziekten), Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium; (A.M.); (S.L.); (B.R.); (K.V.d.B.); (S.B.); (J.G.); (L.H.); (C.W.); (S.D.); (B.C.)
| | - Laura Houard
- Department of Cardiology, (Centrum voor Hart-en Vaatziekten), Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium; (A.M.); (S.L.); (B.R.); (K.V.d.B.); (S.B.); (J.G.); (L.H.); (C.W.); (S.D.); (B.C.)
| | - Tom De Potter
- Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium; (H.C.); (T.D.P.)
| | - Sabine Allard
- Department of Internal Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium;
| | - Caroline Weytjens
- Department of Cardiology, (Centrum voor Hart-en Vaatziekten), Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium; (A.M.); (S.L.); (B.R.); (K.V.d.B.); (S.B.); (J.G.); (L.H.); (C.W.); (S.D.); (B.C.)
| | - Steven Droogmans
- Department of Cardiology, (Centrum voor Hart-en Vaatziekten), Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium; (A.M.); (S.L.); (B.R.); (K.V.d.B.); (S.B.); (J.G.); (L.H.); (C.W.); (S.D.); (B.C.)
| | - Bernard Cosyns
- Department of Cardiology, (Centrum voor Hart-en Vaatziekten), Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium; (A.M.); (S.L.); (B.R.); (K.V.d.B.); (S.B.); (J.G.); (L.H.); (C.W.); (S.D.); (B.C.)
| |
Collapse
|
8
|
Nune A, Durkowski V, Titman A, Gupta L, Hadzhiivanov M, Ahmed A, Musat C, Sapkota HR. Incidence and risk factors of long COVID in the UK: a single-centre observational study. J R Coll Physicians Edinb 2021; 51:338-343. [PMID: 34882130 DOI: 10.4997/jrcpe.2021.405] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Studies to evaluate long COVID symptoms and their risk factors are limited. We evaluated the presence of long COVID and its risk factors in patients discharged from a hospital with COVID-19 illness. METHODS This observational study included 271 COVID-19 patients admitted between February and July 2020 in a hospital in the UK. The primary outcome measure was to assess the duration and severity of long COVID and its predictors at 3, 6 and 9 months. Logistic regression was performed to assess the potential risk factors for long COVID. RESULTS Out of 89 patients interviewed, 55 (62%) had long COVID for 3 months, 46 (52%) for 6 months and 37 of the 75 patients admitted to the hospital with acute COVID-19 had long COVID for 9 months (49%). The most common long COVID symptoms were fatigue and breathlessness. CONCLUSION Nearly two-thirds of patients at 3 months and a half at 9 months had long COVID. COVID-19 pneumonia was the strongest predictor of long COVID in Caucasians at 3 months.
Collapse
Affiliation(s)
- Arvind Nune
- Southport and Ormskirk Hospital NHS Trust, Southport PR8 6PN, UK,
| | | | | | - Latika Gupta
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | | | - Ashar Ahmed
- Southport and Ormskirk NHS Trust, Southport, UK
| | | | - Hem R Sapkota
- The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| |
Collapse
|
9
|
Musat CA, Hadzhiivanov M, Durkowski V, Banerjee A, Chiphang A, Diwan M, Mahmood MS, Shami MN, Nune A. Observational study of clinico-radiological follow-up of COVID-19 pneumonia: a district general hospital experience in the UK. BMC Infect Dis 2021; 21:1233. [PMID: 34879817 PMCID: PMC8651500 DOI: 10.1186/s12879-021-06941-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/15/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The British Thoracic Society (BTS) recommends that all patients admitted with COVID-19 pneumonia should have a chest X-ray (CXR) and clinical follow-up at 6 or 12 weeks, depending on the disease severity. Little data is available on long-term CXR follow-up for moderate and severe COVID-19 pneumonia. This study aims to evaluate compliance with clinico-radiological follow-up of patients recovering from COVID-19 pneumonia at a local hospital in the UK, as per the BTS guidance, and to analyse radiological changes at clinical follow-up at 12 weeks, in order to risk-stratify and improve patient outcomes. METHODS This is a single-centre retrospective audit of 255 consecutive COVID-19 positive patients admitted to a local hospital in the UK over 5 months between May and October 2020. All CXRs and clinic follow-up at 12 ± 8 weeks were checked on an electronic database. RESULTS Over one in two (131/255) patients had CXR evidence of COVID-19 pneumonia during the initial hospital admission. Half of the patients (60/131) died before CXR or clinic follow-up. Fifty-eight percent (41/71) of the surviving patients had a follow-up CXR, and only two developed respiratory complications- one had residual lung fibrosis, another a pulmonary embolism. Eighty-eight percent (36/41) of the patients had either resolution or improved radiological changes at follow-up. Most patients who had abnormal follow-up CXR were symptomatic (6/8), and many asymptomatic patients at follow-up had a normal CXR (10/12). CONCLUSIONS Although there were concerns about interstitial lung disease (ILD) incidence in patients with COVID-19 pneumonia, most of our patients with COVID-19 pneumonia had no pulmonary complications at follow-up with CXR. This emphasises that CXR, a cost-effective investigation, can be used to risk-stratify patients for long term pulmonary complications following their COVID-19 pneumonia. However, we acknowledge the limitations of a low CXR and clinic follow-up rate in our cohort.
Collapse
Affiliation(s)
- C A Musat
- Southport and Ormskirk NHS Trust, Southport, PR8 6PN, UK
| | - M Hadzhiivanov
- Southport and Ormskirk NHS Trust, Southport, PR8 6PN, UK
| | - V Durkowski
- Southport and Ormskirk NHS Trust, Southport, PR8 6PN, UK
| | - A Banerjee
- Southport and Ormskirk NHS Trust, Southport, PR8 6PN, UK
| | - A Chiphang
- Southport and Ormskirk NHS Trust, Southport, PR8 6PN, UK
| | - M Diwan
- Southport and Ormskirk NHS Trust, Southport, PR8 6PN, UK
| | - M S Mahmood
- Southport and Ormskirk NHS Trust, Southport, PR8 6PN, UK
| | - M N Shami
- Southport and Ormskirk NHS Trust, Southport, PR8 6PN, UK
| | - A Nune
- Southport and Ormskirk NHS Trust, Southport, PR8 6PN, UK.
| |
Collapse
|
10
|
Pednekar P, Amoah K, Homer R, Ryu C, Lutchmansingh DD. Case Report: Bullous Lung Disease Following COVID-19. Front Med (Lausanne) 2021; 8:770778. [PMID: 34869488 PMCID: PMC8635639 DOI: 10.3389/fmed.2021.770778] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 10/12/2021] [Indexed: 12/24/2022] Open
Abstract
More than 87% of patients report the persistence of at least one symptom after recovery from the Coronavirus disease 2019 (COVID-19). Dyspnea is one of the most frequently reported symptoms following severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) infection with persistent chest radiological abnormalities up to 3 months after symptom onset. These radiological abnormalities are variable and most commonly include ground-glass opacities, reticulations, mosaic attenuation, parenchymal bands, interlobular septal thickening, bronchiectasis, and fibrotic-like changes. However, in this case report, we describe findings of bullous lung disease as a complication of SARS CoV-2 infection. As the pandemic continues, there is a need to understand the multiple respiratory manifestations of post-acute sequelae of COVID-19. We, therefore, present this case to add to the current body of literature describing pulmonary disease as a consequence of SARS CoV-2 infection.
Collapse
Affiliation(s)
- Prachi Pednekar
- Department of Internal Medicine, Bridgeport Hospital, Bridgeport, CT, United States
| | - Kwesi Amoah
- Section of Pulmonary, Critical Care, and Sleep Medicine, Bridgeport Hospital, Bridgeport, CT, United States
| | - Robert Homer
- Department of Pathology, Yale School of Medicine, New Haven, CT, United States
| | - Changwan Ryu
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Denyse D Lutchmansingh
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT, United States
| |
Collapse
|
11
|
Nabahati M, Ebrahimpour S, Khaleghnejad Tabari R, Mehraeen R. Post-COVID-19 pulmonary fibrosis and its predictive factors: a prospective study. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [PMCID: PMC8491185 DOI: 10.1186/s43055-021-00632-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background We aimed to prospectively assess the lung fibrotic-like changes, as well as to explore their predictive factors, in the patients who survived Coronavirus Disease 2019 (COVID-19) infection. In this prospective cross-sectional study, we recruited patients who had been treated for moderate or severe COVID-19 pneumonia as inpatients and discharged from Rohani hospital in Babol, northern Iran, during March 2020. The clinical severity of COVID-19 pneumonia was classified as per the definition by World Health Organization. We also calculated the CT severity score (CSS) for all patients at admission. Within the 3 months of follow-up, the next chest CT scan was performed. As the secondary outcome, the patients with fibrotic abnormalities in their second CT scan were followed up in the next 3 months. Results Totally, 173 COVID-19 patients were finally included in the study, of whom 57 (32.9%) were male and others were female. The mean age was 53.62 ± 13.67 years old. At 3-month CT follow-up, evidence of pulmonary fibrosis was observed in 90 patients (52.0%). Consolidation (odds ratio [OR] = 2.84), severe disease (OR 2.40), and a higher CSS (OR 1.10) at admission were associated with increased risk of fibrotic abnormalities found at 3-month CT follow-up. Of 62 patients who underwent chest CT scan again at 6 months of follow-up, 41 patients (66.1%) showed no considerable changes in the fibrotic findings, while the rest of 21 patients (33.9%) showed relatively diminished lung fibrosis. Conclusion Post-COVID-19 lung fibrosis was observed in about half of the survivors. Also, patients with severe COVID-19 pneumonia were at a higher risk of pulmonary fibrosis. Moreover, consolidation, as well as a higher CSS, in the initial chest CT scan, was associated with increased risk of post-COVID-19 lung fibrosis. In addition, some patients experienced diminished fibrotic abnormalities in their chest CT on 6-month follow-up, while some others did not.
Collapse
|