One-Year Evolution of Pulmonary Patterns in High-Resolution Tomography of Patients Hospitalized for Covid-19 Pneumonia
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Abstract
Introduction: There´s growing information on the tomographic evolution of patients hospitalized by Covid-19 pneumonia.
Objective: To examine tomographic evolution of moderate/severe Covid-19 pneumonia at one year.
Materials and methods: Prospective study of patients hospitalized by moderate/severe Covid-19 pneumonia in the Metropolitan Area of Buenos Aires, between October 2020-March 2022, evaluated at one year. High-resolution chest tomography was performed, evaluated by two independent observers. Patterns were divided: fibrotic-like (FL) and non-fibrotic-like (NFL). Reversibility was considered as the disappearance of the tomographic pattern or a reduction >20%, and worsening was considered the opposite at one year.
Results: Of 96 patients, 58% had FL pattern and 42% NFL pattern at one year (p=0.1). Patients hospitalized in ICU (n=95), 52% had FL pattern vs. 43.5% NFL (p=NS). Ground-glass opacity (GGO) was the only sign with significant improvement (p<0.001). At one year, GGO (39.6%), interlobular septal thickening (26%), traction bronchiectasis (14.6%), and atelectasis bands (10.6%), persisted. At one year, NFL and FL patterns improved 71.8% and 77.4% (p=NS); remained the same 28.2% and 20.8% (p=NS) and worsened 0% and 1.9% (p=NS), respectively.
Conclusions: At one year, the FL pattern was the most frequent. GGO is associated with greater reversibility at one year. Unlike other authors, there were no significant differences in the evolution of FL vs. NFL patterns at one year, but there was improvement in both. The FL pattern does not necessarily indicate irreversibility, thereby NFL pattern is related to reversibility.
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Thiel V. Coronaviruses: Molecular and Cellular Biology. Caister Academic Press. 2007. ISBN 978-1-904455-16-5.
Shereen MA, Khan S, Kazmi A. COVID-19 infection: Emergence, transmission, and characteristics of human coronaviruses. J Adv Res 2020;24:91-8. https://doi:10.1016/j.jare.2020.03.005
Zhu N, Zhang D, Wang W et al. A Novel Coronavirus from Patients with Pneumonia in China. N Engl J Med 2020;382:727-33. https://doi.org/10.1056/nejmoa2001017
World Health Organization. Actualización epidemiológica de la COVID-1 al 25 de abril de 2025. [Internet]. [Consultado 14 may 2025]. Disponible en: https://data-who-int.translate.goog/dashboards/covid19/cases?_x_tr_sl=en&_x_tr_tl=es&_x_tr_hl=es&_x_tr_pto=tc
World Health Organization. Therapeutics and COVID-19. Living Document 10th November 2023. [Internet]. [Consultado 14 may 2025]. Disponible en: https://www-who-int.translate.goog/emergencies/diseases/novel-coronavirus-2019/situation-reports?_x_tr_sl=en&_x_tr_tl=es&_x_tr_hl=es&_x_tr_pto=tc
González A, Saldarini F, Sívori M et al. Secuelas respiratorias clínicas, funcionales y tomográficas de pacientes hospitalizados por COVID-19 al año del diagnóstico: estudio SECUELAR-19. Medicina (Buenos Aires). 2023;83:62-704.
Sívori M, González A, Saldarini F et al. Secuelas respiratorias clínicas, funcionales y tomográficas de pacientes hospitalizados por COVID-19 a seis meses del diagnóstico: estudio SECUELAR-19. Medicina (Buenos Aires) 2022; 82:673-83.
Han X, Fan Y, Alwalid O et al. Six-month Follow-up Chest CT Findings after Severe COVID-19 Pneumonia. Radiology 2021;299:E177–E186. https://doi.org/10.1148/radiol.2021203153
Han X, Fan Y, Alwalid O et al. Fibrotic Interstitial Lung Abnormalities at 1-year Follow-up CT after Severe COVID-19. Radiology 2021;301:E438–E440. https://doi.org/10.1148/radiol.2021210972
Amin H, Kakamad BJ, Ahmed GS et al. Post COVID-19 pulmonary fibrosis; a meta-analysis study. Ann Med Surg 2022;77:103590. https://doi:10.1016/j.amsu.2022.103590
Hansell DM, Bankier AA, MacMahon H, McLoud TC, Müller NL, Remy J. Fleischner Society: glossary of terms for thoracic imaging. Radiology 2008; 246:697–722. https://doi.org/10.1148/radiol.2462070712
Cao B, Wang Y, Wen W et al. A trial of lopinavir-ritonavir in adults hospitalized with severe COVID-19. N Engl J Med 2020;382:1787-99. https://doi.org/10.1056/nejmoa2001282
Wu X, Liu X, Zhou Y et al. 3-month, 6-month, 9-month and 12-month respiratory outcomes in patients following COVID-19 related hospitalization: a prospective study. Lancet Respir Med 2021; 9:747–54. https://doi.org/10.1016/s2213-2600(21)00174-0
Liu D, Zhang W, Pan F et al. The pulmonary sequalae in discharged patients with COVID-19: a shot-term observational study. Respir Res 2020; 21:125. https://doi.org/10.1186/s12931-020-01385-1
Prayer F, Kienast P, Strassl A et al. Detection of Post-COVID-19 Lung Abnormalities: Photon-counting CT versus Same-Day Energy-integrating Detector CT. Radiology 2023;307: e222087. https://doi.org/10.1148/radiol.222087
Tarraso J, Safont B, Carbonell-Asins JA et al. Lung function and radiological findings 1 year after COVID-19: a prospective follow-up. Respir Res 2022; 23:242. https://doi.org/10.1186/s12931-022-02166-8
Chen Y, Ding C, Yu L et al. One-year follow-up of chest CT findings in patients after SARS-CoV-2 infection. BMC Med 2021;19:191. https://doi.org/10.1186/s12916-021-02056-8
Watanabe A, So M, Iwagami M et al. One-year follow-up CT findings in COVID-19 patients: A systematic review and meta-analysis. Respirology 2022;27:605-16. https://doi.org/10.1111/resp.14311
Rivas Redonda KI, Cortés Arroyo JE. Sobre fisiopatología molecular de la permeabilidad vascular en el síndrome de distrés respiratorio. Carta al Editor. Med Crit 2017;31:258.
Desai SR, Wells AU, Rubens MB, Evans TW, Hansell DM. Acute respiratory distress syndrome: CT abnormalities at long-term follow-up. Radiology 1999; 210:29–35. https://doi.org/10.1148/radiology.210.1.r99ja2629
Jiang Y, Guo D, Li C, Chen T, Li R. High resolution CT features of the COVID-19 infection in Nanchong City: initial and follow-up changes among different clinical types. Radiol Inf Dis 2020;7:71-7. https://doi.org/10.1016/j.jrid.2020.05.001
Wells AU, Devaraj A, Desai SR. Interstitial Lung Disease after COVID-19 Infection: A Catalog of Uncertainties. Radiology 2021;299:E216-E218. https://doi.org/10.1148/radiol.2021204482
Huang C, Huang L, Wang Y et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet 2021;397:220–32. https://doi.org/10.1016/s0140-6736(23)00810-3
Mennella S, Alicino C, Anselmo M et al. (ACOD GROUP). COVID-19 after two years from hospital discharge: a pulmonary function and chest computed tomography follow-up study. Respiration 2024;103:22–31. https://doi.org/10.1159/000535732
Gonzalez J, de Batlle J, Benitez ID. Key factors associated with pulmonary sequelae in the follow-up of critically ill COVID-19 patients. Arch Bronconeumol 2023; 59:205-15. https://doi.org/10.1016/j.arbres.2022.12.017
Kelly JD, Curteis T, Rawal A et al. SARS-CoV2 post-acute sequelae in previously hospitalized patients: systematic literature review and meta-analysis. Eur Respir Rev 2023;32:220254. https://doi.org/10.1183/16000617.0254-2022
Zhang H, Li X, Huang L et al. Lung-function trajectories in COVID-19 survivors after discharge: A two-year longitudinal cohort study. eClinical Medicine 2022; 54:101668. https://doi.org/10.1016/j.eclinm.2022.101668