18 months computed tomography follow-up after Covid-19 interstitial pneumonia

Abstract

Background: Our aim is to evaluate the possible persistence of lung parenchyma alterations, in patients who have recovered from Covid-19. Design and methods: We enrolled a cohort of 115 patients affected by Covid-19, who performed a chest CT scan in the Emergency Department and a chest CT 18 months after hospital discharge. We performed a comparison between chest CT scan 18 months after discharge and spirometric data of patients enrolled. We obtained quantitative scores related to well-aerated parenchyma, interstitial lung disease and parenchymal consolidation. A radiologist recorded the characteristics indicated by the Fleischner Society and “fibrotic like” changes, expressed through a CT severity score ranging from 0 (no involvement) to 25 (maximum involvement). Results: 115 patients (78 men, 37 women; mean age 60.15 years old ±12.52). On quantitative analysis, after 18 months, the volume of normal ventilated parenchyma was significantly increased (16.34 points on average ±14.54, p<0.0001). Ground-glass opacities and consolidation values tend to decrease (-9.80 and -6.67 points, p<0.0001). On semiquantitative analysis, pneumonia extension, reactive lymph nodes and crazy paving reached statistical significance (p<0.0001). The severity score decreased by 2.77 points on average (SD 4.96; p<0.0001). There were not statistically significant changes on “fibrotic-like” changes correlated with level of treatment and there was not a statistically significant correlation between CT lung score and spirometric results obtained 18 months after discharge. Conclusions: Patients recovered from Covid-19 seem to have an improvement of ventilated parenchyma and “fibrotic-like” alterations. The level of treatment does not appear to influence fibrotic changes.

Keywords

• Covid-19
• coronavirus
• CT
• lung
• pneumonia