Persistence of post-COVID lung parenchymal abnormalities during the three-month follow-up

Adv Respir Med. 2021;89(5):477-483. doi: 10.5603/ARM.a2021.0090. Epub 2021 Oct 6.

Abstract

Introduction: COVID-19-associated pulmonary sequalae have been increasingly reported after recovery from acute infection. Therefore, we aim to explore the charactersitics of persistent lung parenchymal abnormalities in patients with COVID-19.

Material and methods: An observational study was conducted in patients with post-COVID lung parenchymal abnormalities from April till September 2020. Patients ≥18 years of age with COVID-19 who were diagnosed as post-COVID lung parenchymal abnormality based on respiratory symptoms and HRCT chest imaging after the recovery of acute infection. Data was recorded on a structured pro forma, and descriptive analysis was performed using Stata version 12.1.

Results: A total of 30 patients with post-COVID lung parenchymal abnormalities were identified. The mean age of patients was 59.1 (SD 12.6), and 27 (90.0%) were males. Four HRCT patterns of lung parenchymal abnormalities were seen; organizing pneumonia in 10 (33.3%), nonspecific interstitial pneumonitis in 17 (56.7%), usual interstitial pneumonitis in 12 (40.0%) and probable usual interstitial pneumonitis in 14 (46.7%). Diffuse involvement was found in 15 (50.0%) patients, while peripheral predominance in 15 (50.0%), and other significant findings were seen in 8 (26.7%) patients. All individuals were treated with corticosteroids. The case fatality rate was 16.7%. Amongst the survivors, 32.0% recovered completely, 36.0% improved, while 32.0% of the patients had static or progressive disease.

Conclusion: This is the first study from Southeast Asia that identified post-COVID lung parenchymal abnormalities in patients who had no pre-existing lung disease highlighting the importance of timely recognition and treatment of this entity that might lead to fatal outcome.

Keywords: COVID-19; SARS-CoV-2; lung parenchymal abnormalities; pulmonary sequelae.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • COVID-19 / complications
  • COVID-19 / diagnostic imaging*
  • COVID-19 / pathology*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Patient Discharge
  • Pulmonary Fibrosis / diagnostic imaging*
  • Pulmonary Fibrosis / pathology*
  • SARS-CoV-2 / isolation & purification
  • Tomography, X-Ray Computed