Post-COVID-19 pulmonary changes: A retrospective study of 72 patients based upon chest computed tomography findings

Abstract

Background: During COVID-19 world-wide pandemic, there are increasing needs to evaluate pulmonary changes at follow up chest Computed Tomography (CT) scans and to explore the risk factors for out coming fibrotic like sequel in the lung of the patients who recovered from severe COVID-19, the incidence of chronic manifestations in patients with novel coronavirus (COVID-19) are now declared to increase the clinician`s orientation of this issue and to limit long-lasting chronic pulmonary affection. Objectives: The main intended objectives of this study to evaluate the expected post- COVID-19 intermediate -long term pulmonary sequels, namely fibrosis, as a chronic morbidity. Patients and methods: An observational single center study on 100 subjects were confirmed having COVID-19 by clinical and/or laboratory findings. After applying the exclusion criteria, study included 72 participants who were exposed to full clinical history taken (was available in their files) then two series of CT chest with 3 month apart between them; the data were collected during the period from March 2022 to December 2022 Results: In this retrospective single center cross sectional study, and in view of participant’s clinical presentation; our initial and 3 months follow up Computed Tomography scan findings in 72 patients, who were divided into 2 groups according to the CT Severity score (CT-SS) at time of presentation; into Group 1 and Group 2, were recorded; 39 were male (54.2%) and 33 were female (45.8%) with clinically proven COVID-19. Mean age was (44.8 ± 16.7). At 1st CT series; evidence of Ground glass patches (GGP) which considered main radiological findings were seen in 45 patients (90 %) in Group 1, while it was seen in 22 patients (100%) in Group 2. At CT follow up exam; CT abnormalities had resolved in (65.3 %) while Post Covid pulmonary fibrosis was observed in 25 patients (34.7 %) distributed as follow 10 patients from group 1 (40 %) and 15 patients from group 2 (60 %) . Conclusion: On follow up CT chest scans; various pulmonary changes in post COVID-19 patients are recorded. However, Post- COVID-19 pulmonary fibrosis remains one of the most worrying pulmonary complications as it causes permanent lung damage, so prediction of potential high-risk patients; giving special attention to risk factors as exposure to mechanical ventilation& general as well as local co-morbidities; may help in applying early medical treatment strategies such as anti-fibrotic drugs, thus reducing disease morbidity and mortality rates.

Keywords

• covid-19
• follow up
• pulmonary sequel
• post- covid-19 fibrosis
• ct imaging