Lung Abnormalities in Severe Acute Respiratory Syndrome Coronavirus 2 Infection: An Analysis of Paired Computed Tomography Scans Before and After Infection

Katrine K Iversen; Andreas Ronit; Thomas S Kristensen; Shoaib Afzal; Jelena Jankovic; Anna Kalhauge; Magnus G Ahlström; Børge G Nordestgaard; Klaus F Kofoed; Thomas Benfield

doi:10.1093/ofid/ofac596

Lung Abnormalities in Severe Acute Respiratory Syndrome Coronavirus 2 Infection: An Analysis of Paired Computed Tomography Scans Before and After Infection

Open Forum Infect Dis. 2022 Nov 4;9(11):ofac596. doi: 10.1093/ofid/ofac596. eCollection 2022 Nov.

Authors

Affiliations

¹ Department of Infectious Diseases 144, Copenhagen University Hospital-Amager Hvidovre, Hvidovre, Denmark.
² Department of Radiology and Cardiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
³ Department of Clinical Biochemistry, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark.
⁴ Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
⁵ The Copenhagen General Population Study, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark.
⁶ Department of Clinical Microbiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.

Abstract

Background: Studies on the pulmonary consequences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are impeded by limited access to pre-SARS-CoV-2 examinations.

Methods: We invited Copenhagen General Population Study participants with a confirmed SARS-CoV-2 polymerase chain reaction (PCR) test during the first and second coronavirus disease 2019 waves in Denmark for a repeat chest computed tomography (CT) scan. Paired CT scans were independently assessed for interstitial and noninterstitial abnormalities by 2 trained radiologists. A semiquantitative CT score (ranging from 0 to 20) was used to quantify the extent of interstitial abnormalities.

Results: Of 111 SARS-CoV-2-infected individuals, 102 (91.2%) experienced symptoms and 12 (11.2%) were hospitalized. Follow-up examination was performed at median of 5.4 (interquartile range, 4.1-7.8) months after a positive SARS-CoV-2 PCR test. Of 67 individuals with paired CT scans, ground glass opacities and reticulation were present in 31 (46.3%) individuals post-SARS-CoV-2 compared to 23 (34.1%) pre-SARS-CoV-2 (mean CT score, 3.0 vs 1.3; P = .011). Results were similar for nonhospitalized individuals. We did not detect development of bronchiectasis, emphysema, or nodules.

Conclusions: SARS-CoV-2 infection in predominantly nonhospitalized individuals with mild disease was associated with a small increase in only interstitial lung abnormalities.

Keywords: COVID-19; chest CT; lung abnormalities; lung function test; paired analysis.