AIMSThis study, aims to estimate and characterize patients with pulmonary residuals as a late sequela of COVID-19 at 12 months from hospitalization for SARS-CoV-2, in terms of:radiological changes and functional impairment.As secondary endpoint the study focuses on the identification of predictors for the persistence of lung abnormalities.METHODS In this observational cohort study,patients have been prospectively enrolled at the post-COVID clinic after hospital discharge, with visits comprehensive of previous history, physical examination, PFTs, chest HRCT, lung ultrasounds.The total number of eligible patients was of 421, all of them were previously admitted to the University Hospital of Padova from the 22nd of Feb 2020 until the 30th of April 2021.HRCT was used to evaluate the persistence and the characteristics of radiological changes during follow-up visits. Based on the persistency of CT changes, the whole population was then categorized in two groups: 1)NOT-RECOVERY group when, at 12 months from hospital admission,CT still showed lung abnormalities;2)RECOVERYgroup when resolution was gained along the follow-up. The CT images were scored through a semiquantitative scale, particularly analyzing the percentage of GGO, interstitial thickening (IT), consolidations (Co) and the presence or absence of bronchiectasis and curvilinear or linear band opacities for each of the five lung lobes. Then, for each patient, a medium lung involvement (in GGO,IT,Co) was obtained as mean among each lung lobe score.Both a univariate logistic regression analysis and a multivariate regression model were set,comparing the RECand the NOT-RECgroup, to detect the predictive factors to do not recover at follow-up, entailing radiologic sequelae.RESULTSAmong the 421 initially enrolled patients, 74 were lost because of the exclusion criteria. The whole population (n=347) was categorized into REC (those who radiologically recovered on chest HRCT along the 12-month follow-up, n=323 - 93.1%) and NOT-REC group (those who did not recover on HRCT at 12 months, n=24 - 6.9%).The NOT-RECgroup resulted to be significantly older[respectively, 67.5y vs 63y; p=0.019],more frequently current smokers(n=4, 16.7% vs n=12, 3.8% p=0.019); with worsen parameters concerning clinical course and disease severity at hospitalization, in particular: higher maximum FiO2 required (75% vs 36%, p=0.01); longer hospital stay (17d vs 10d, p=0.001); lower P/F at admission (201 vs 295, p=0.015);and more frequently requiring high degree of care (n=12, 50% vs n=57, 17.6%, p=0.0006)and presenting dyspnoea (n=18 75% vs n=140 44.7%, p=0.0008). Comorbidities of the patients seemed to be equally distributed between the groups. Not even the PFTs did statistically differed between REC and NOT-REC,moreover, both groups presented dynamic lung volumes within normal range(FVCpred=99% and 95% FEV1pred=97% and 92%). In the RECgroup the median time for recovering was of 133 days (73-204). On chest HRCT at 12 months in the NOT-REC group, the most frequent alterations were IT(n=21 88%, median extension of 4%);GGO (n=19 79%, median extension of 3.5%);linear and curvilinear band opacities(n=16 66%); bronchiectasis (n=7 29%).At multivariate, being current-smoker was an independent predictor for lung sequalae after 12 months from infection[OR 5.6 (95% CI: 1.41 - 22.12),p0.01].CONCLUSIONSThe study demonstrates that after 12 months from hospital admission for COVID-19 pneumonia,a small percentage of our sample of hospitalized patients maintains abnormalities on HRCT(6.9%), which are exiguous in extension(<5%).The presence of these radiological sequelae does not impact the pulmonary function, which values are included within the normal range in both groups, since the first visit of follow-up.Finally,being current smoker at the time of being infected by SARS-CoV-2 is an independent predictive factor, at multivariate,to still present radiologic involvement at 12 months (OR 5.6), regardless of pneumonia severity.

AIMSThis study, aims to estimate and characterize patients with pulmonary residuals as a late sequela of COVID-19 at 12 months from hospitalization for SARS-CoV-2, in terms of:radiological changes and functional impairment.As secondary endpoint the study focuses on the identification of predictors for the persistence of lung abnormalities.METHODS In this observational cohort study,patients have been prospectively enrolled at the post-COVID clinic after hospital discharge, with visits comprehensive of previous history, physical examination, PFTs, chest HRCT, lung ultrasounds.The total number of eligible patients was of 421, all of them were previously admitted to the University Hospital of Padova from the 22nd of Feb 2020 until the 30th of April 2021.HRCT was used to evaluate the persistence and the characteristics of radiological changes during follow-up visits. Based on the persistency of CT changes, the whole population was then categorized in two groups: 1)NOT-RECOVERY group when, at 12 months from hospital admission,CT still showed lung abnormalities;2)RECOVERYgroup when resolution was gained along the follow-up. The CT images were scored through a semiquantitative scale, particularly analyzing the percentage of GGO, interstitial thickening (IT), consolidations (Co) and the presence or absence of bronchiectasis and curvilinear or linear band opacities for each of the five lung lobes. Then, for each patient, a medium lung involvement (in GGO,IT,Co) was obtained as mean among each lung lobe score.Both a univariate logistic regression analysis and a multivariate regression model were set,comparing the RECand the NOT-RECgroup, to detect the predictive factors to do not recover at follow-up, entailing radiologic sequelae.RESULTSAmong the 421 initially enrolled patients, 74 were lost because of the exclusion criteria. The whole population (n=347) was categorized into REC (those who radiologically recovered on chest HRCT along the 12-month follow-up, n=323 - 93.1%) and NOT-REC group (those who did not recover on HRCT at 12 months, n=24 - 6.9%).The NOT-RECgroup resulted to be significantly older[respectively, 67.5y vs 63y; p=0.019],more frequently current smokers(n=4, 16.7% vs n=12, 3.8% p=0.019); with worsen parameters concerning clinical course and disease severity at hospitalization, in particular: higher maximum FiO2 required (75% vs 36%, p=0.01); longer hospital stay (17d vs 10d, p=0.001); lower P/F at admission (201 vs 295, p=0.015);and more frequently requiring high degree of care (n=12, 50% vs n=57, 17.6%, p=0.0006)and presenting dyspnoea (n=18 75% vs n=140 44.7%, p=0.0008). Comorbidities of the patients seemed to be equally distributed between the groups. Not even the PFTs did statistically differed between REC and NOT-REC,moreover, both groups presented dynamic lung volumes within normal range(FVCpred=99% and 95% FEV1pred=97% and 92%). In the RECgroup the median time for recovering was of 133 days (73-204). On chest HRCT at 12 months in the NOT-REC group, the most frequent alterations were IT(n=21 88%, median extension of 4%);GGO (n=19 79%, median extension of 3.5%);linear and curvilinear band opacities(n=16 66%); bronchiectasis (n=7 29%).At multivariate, being current-smoker was an independent predictor for lung sequalae after 12 months from infection[OR 5.6 (95% CI: 1.41 - 22.12),p0.01].CONCLUSIONSThe study demonstrates that after 12 months from hospital admission for COVID-19 pneumonia,a small percentage of our sample of hospitalized patients maintains abnormalities on HRCT(6.9%), which are exiguous in extension(<5%).The presence of these radiological sequelae does not impact the pulmonary function, which values are included within the normal range in both groups, since the first visit of follow-up.Finally,being current smoker at the time of being infected by SARS-CoV-2 is an independent predictive factor, at multivariate,to still present radiologic involvement at 12 months (OR 5.6), regardless of pneumonia severity.

Post Coronavirus Disease 2019 (COVID-19) pulmonary fibrosis: a 12 month follow-up study

BOVO, MATTEO
2021/2022

Abstract

AIMSThis study, aims to estimate and characterize patients with pulmonary residuals as a late sequela of COVID-19 at 12 months from hospitalization for SARS-CoV-2, in terms of:radiological changes and functional impairment.As secondary endpoint the study focuses on the identification of predictors for the persistence of lung abnormalities.METHODS In this observational cohort study,patients have been prospectively enrolled at the post-COVID clinic after hospital discharge, with visits comprehensive of previous history, physical examination, PFTs, chest HRCT, lung ultrasounds.The total number of eligible patients was of 421, all of them were previously admitted to the University Hospital of Padova from the 22nd of Feb 2020 until the 30th of April 2021.HRCT was used to evaluate the persistence and the characteristics of radiological changes during follow-up visits. Based on the persistency of CT changes, the whole population was then categorized in two groups: 1)NOT-RECOVERY group when, at 12 months from hospital admission,CT still showed lung abnormalities;2)RECOVERYgroup when resolution was gained along the follow-up. The CT images were scored through a semiquantitative scale, particularly analyzing the percentage of GGO, interstitial thickening (IT), consolidations (Co) and the presence or absence of bronchiectasis and curvilinear or linear band opacities for each of the five lung lobes. Then, for each patient, a medium lung involvement (in GGO,IT,Co) was obtained as mean among each lung lobe score.Both a univariate logistic regression analysis and a multivariate regression model were set,comparing the RECand the NOT-RECgroup, to detect the predictive factors to do not recover at follow-up, entailing radiologic sequelae.RESULTSAmong the 421 initially enrolled patients, 74 were lost because of the exclusion criteria. The whole population (n=347) was categorized into REC (those who radiologically recovered on chest HRCT along the 12-month follow-up, n=323 - 93.1%) and NOT-REC group (those who did not recover on HRCT at 12 months, n=24 - 6.9%).The NOT-RECgroup resulted to be significantly older[respectively, 67.5y vs 63y; p=0.019],more frequently current smokers(n=4, 16.7% vs n=12, 3.8% p=0.019); with worsen parameters concerning clinical course and disease severity at hospitalization, in particular: higher maximum FiO2 required (75% vs 36%, p=0.01); longer hospital stay (17d vs 10d, p=0.001); lower P/F at admission (201 vs 295, p=0.015);and more frequently requiring high degree of care (n=12, 50% vs n=57, 17.6%, p=0.0006)and presenting dyspnoea (n=18 75% vs n=140 44.7%, p=0.0008). Comorbidities of the patients seemed to be equally distributed between the groups. Not even the PFTs did statistically differed between REC and NOT-REC,moreover, both groups presented dynamic lung volumes within normal range(FVCpred=99% and 95% FEV1pred=97% and 92%). In the RECgroup the median time for recovering was of 133 days (73-204). On chest HRCT at 12 months in the NOT-REC group, the most frequent alterations were IT(n=21 88%, median extension of 4%);GGO (n=19 79%, median extension of 3.5%);linear and curvilinear band opacities(n=16 66%); bronchiectasis (n=7 29%).At multivariate, being current-smoker was an independent predictor for lung sequalae after 12 months from infection[OR 5.6 (95% CI: 1.41 - 22.12),p0.01].CONCLUSIONSThe study demonstrates that after 12 months from hospital admission for COVID-19 pneumonia,a small percentage of our sample of hospitalized patients maintains abnormalities on HRCT(6.9%), which are exiguous in extension(<5%).The presence of these radiological sequelae does not impact the pulmonary function, which values are included within the normal range in both groups, since the first visit of follow-up.Finally,being current smoker at the time of being infected by SARS-CoV-2 is an independent predictive factor, at multivariate,to still present radiologic involvement at 12 months (OR 5.6), regardless of pneumonia severity.
2021
Post Coronavirus Disease 2019 (COVID-19) pulmonary fibrosis: a 12 month follow-up study
AIMSThis study, aims to estimate and characterize patients with pulmonary residuals as a late sequela of COVID-19 at 12 months from hospitalization for SARS-CoV-2, in terms of:radiological changes and functional impairment.As secondary endpoint the study focuses on the identification of predictors for the persistence of lung abnormalities.METHODS In this observational cohort study,patients have been prospectively enrolled at the post-COVID clinic after hospital discharge, with visits comprehensive of previous history, physical examination, PFTs, chest HRCT, lung ultrasounds.The total number of eligible patients was of 421, all of them were previously admitted to the University Hospital of Padova from the 22nd of Feb 2020 until the 30th of April 2021.HRCT was used to evaluate the persistence and the characteristics of radiological changes during follow-up visits. Based on the persistency of CT changes, the whole population was then categorized in two groups: 1)NOT-RECOVERY group when, at 12 months from hospital admission,CT still showed lung abnormalities;2)RECOVERYgroup when resolution was gained along the follow-up. The CT images were scored through a semiquantitative scale, particularly analyzing the percentage of GGO, interstitial thickening (IT), consolidations (Co) and the presence or absence of bronchiectasis and curvilinear or linear band opacities for each of the five lung lobes. Then, for each patient, a medium lung involvement (in GGO,IT,Co) was obtained as mean among each lung lobe score.Both a univariate logistic regression analysis and a multivariate regression model were set,comparing the RECand the NOT-RECgroup, to detect the predictive factors to do not recover at follow-up, entailing radiologic sequelae.RESULTSAmong the 421 initially enrolled patients, 74 were lost because of the exclusion criteria. The whole population (n=347) was categorized into REC (those who radiologically recovered on chest HRCT along the 12-month follow-up, n=323 - 93.1%) and NOT-REC group (those who did not recover on HRCT at 12 months, n=24 - 6.9%).The NOT-RECgroup resulted to be significantly older[respectively, 67.5y vs 63y; p=0.019],more frequently current smokers(n=4, 16.7% vs n=12, 3.8% p=0.019); with worsen parameters concerning clinical course and disease severity at hospitalization, in particular: higher maximum FiO2 required (75% vs 36%, p=0.01); longer hospital stay (17d vs 10d, p=0.001); lower P/F at admission (201 vs 295, p=0.015);and more frequently requiring high degree of care (n=12, 50% vs n=57, 17.6%, p=0.0006)and presenting dyspnoea (n=18 75% vs n=140 44.7%, p=0.0008). Comorbidities of the patients seemed to be equally distributed between the groups. Not even the PFTs did statistically differed between REC and NOT-REC,moreover, both groups presented dynamic lung volumes within normal range(FVCpred=99% and 95% FEV1pred=97% and 92%). In the RECgroup the median time for recovering was of 133 days (73-204). On chest HRCT at 12 months in the NOT-REC group, the most frequent alterations were IT(n=21 88%, median extension of 4%);GGO (n=19 79%, median extension of 3.5%);linear and curvilinear band opacities(n=16 66%); bronchiectasis (n=7 29%).At multivariate, being current-smoker was an independent predictor for lung sequalae after 12 months from infection[OR 5.6 (95% CI: 1.41 - 22.12),p0.01].CONCLUSIONSThe study demonstrates that after 12 months from hospital admission for COVID-19 pneumonia,a small percentage of our sample of hospitalized patients maintains abnormalities on HRCT(6.9%), which are exiguous in extension(<5%).The presence of these radiological sequelae does not impact the pulmonary function, which values are included within the normal range in both groups, since the first visit of follow-up.Finally,being current smoker at the time of being infected by SARS-CoV-2 is an independent predictive factor, at multivariate,to still present radiologic involvement at 12 months (OR 5.6), regardless of pneumonia severity.
long covid
pulmonary fibrosis
12 month follow-up
thorax CT
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.12608/31008