Pulmonary Sequelae in Patients After Recovery From Coronavirus Disease 2019: A Follow-Up Study With Chest CT

Xuejiao Liao; Dapeng Li; Zhi Liu; Zhenghua Ma; Lina Zhang; Jingke Dong; Yirong Shi; Xiaowen Gu; Guangping Zheng; Ling Huang; Lijun Yuan; Jing Cao; Dan Shu; Xiangyi Yang; Qing He; Guobao Li; Zheng Zhang; Lei Liu

doi:10.3389/fmed.2021.686878

Pulmonary Sequelae in Patients After Recovery From Coronavirus Disease 2019: A Follow-Up Study With Chest CT

Front Med (Lausanne). 2022 Jan 13:8:686878. doi: 10.3389/fmed.2021.686878. eCollection 2021.

Authors

Xuejiao Liao^{1

2}, Dapeng Li^{2

3}, Zhi Liu⁴, Zhenghua Ma¹, Lina Zhang¹, Jingke Dong¹, Yirong Shi¹, Xiaowen Gu¹, Guangping Zheng⁵, Ling Huang⁴, Lijun Yuan³, Jing Cao³, Dan Shu², Xiangyi Yang², Qing He³, Guobao Li⁴, Zheng Zhang^{2

3}, Lei Liu³

Affiliations

¹ Department of Chronic Follow-Up, Shenzhen Third People's Hospital, Shenzhen, China.
² National Clinical Research Center for Infectious Disease, Institute of Hepatology, Shenzhen Third People's Hospital, Shenzhen, China.
³ School of Medicine, The Second Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China.
⁴ Department of the Third Pulmonary Disease, Shenzhen Third People's Hospital, Shenzhen, China.
⁵ Department of Radiology, Shenzhen Third People's Hospital, Shenzhen, China.

Abstract

Objective: The pulmonary sequelae of coronavirus disease 2019 (COVID-19) have not been comprehensively evaluated. We performed a follow-up study analyzing chest computed tomography (CT) findings of COVID-19 patients at 3 and 6 months after hospital discharge. Methods: Between February 2020 and May 2020, a total of 273 patients with COVID-19 at the Shenzhen Third People's Hospital were recruited and followed for 6 months after discharge. Chest CT scanning was performed with the patient in the supine position at end-inspiration. A total of 957 chest CT scans was obtained at different timepoints. A semi-quantitative score was used to assess the degree of lung involvement. Results: Most chest CT scans showed bilateral lung involvement with peripheral location at 3 and 6 months follow-up. The most common CT findings were ground-glass opacity and parenchymal band, which were found in 136 (55.3%) and 94 (38.2%) of the 246 patients at 3 months follow-up, and 82 (48.2%) and 76 (44.7%) of 170 patients at 6 months follow-up, respectively. The number of lobes involved and the total CT severity score declined over time. The total CT score gradually increased with the increasement of disease severity at both 3 months follow-up (trend test P < 0.001) and 6 months follow-up (trend test P < 0.001). Patients with different disease severity represented diverse CT patterns over time. Conclusions: The most common CT findings were ground-glass opacity and parenchymal bands at the 3 and 6 months follow-up. Patients with different disease severity represent diverse CT manifestations, indicating the necessary for long-term follow-up monitoring of patients with severe and critical conditions.

Keywords: computed tomography; coronavirus disease 2019 (COVID-19); follow-up; pulmonary sequelae; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).