CT scan shows lung problems persist for up to a year after COVID-19

The phenomenon, which they called post-acute COVID-19 syndrome, also known as long COVID, underscores the importance of long-term follow-up of COVID-19 patients, with either imaging or testing of the lung function – or both, wrote a team led by Jong Hyuk Lee, PhD, of Seoul National University Hospital. Lee and his colleagues published their findings Sept. 6 in Respiratory research.

“[Our study showed that] a significant number of COVID-19 survivors presented with pulmonary sequelae as part of [post-acute COVID-19 syndrome] … [and] the prevalence of these sequelae only decreased one year after the initial infection,” the group reported. “Given the association between the severity of acute COVID-19 and the risk of pulmonary sequelae, patients recovering from severe COVID-19 require close respiratory monitoring. -at the top.”

Although many people who contract COVID-19 recover relatively quickly, some suffer from post-acute syndrome of COVID-19, which is defined as subacute (symptoms such as fatigue, shortness of breath and cough that persist four to 12 weeks after infection initial) or chronic (symptoms that persist beyond 12 weeks after infection).

But there could be more investigation into the prevalence of chronic lung sequelae such as carbon dioxide/oxygen transfer (diffusion) or pulmonary fibrosis in those with longer-term complications from COVID-19, Lee says. and his colleagues. To explore the question, the group conducted a review of 30 studies published between January 2020 and December 2021 and found in the PubMed, Embase and Cochrane Library databases.

The studies included 6,770 patients who had contracted COVID-19. Of the 30 studies, 25 included pulmonary function test data on study participants (length of follow-up, between six and 12 months) and 22 had CT data (length of follow-up, between 18 and 24 months) .

Pulmonary function tests showed that impaired diffusing capacity was the most common difficulty in COVID-19 patients with persistent symptoms, with a prevalence of 39% at six-month follow-up and 39% at 12-month follow-up. month.

Follow-up CT scan showed continued effects of COVID-19 in more than a third of people with post-acute COVID-19 syndrome: ground-glass opacities and pulmonary fibrosis persisted in 34% of patients at follow-up six months and 32% of patients at 12 months follow-up.

Lee’s group also found that the severity of initial COVID-19 infection affected the likelihood of patients having pulmonary sequelae 12 months after recovery, with patients with severe COVID-19 being 1.52 times more likely. than those with less severe disease to show impaired diffusion. capacity for up to one year after initial infection.

Findings from the literature review highlight the need to assess which patients can actually benefit from follow-up CT, because the more scans a patient undergoes, the more radiation exposure they are exposed to, the authors explained. And assessing demographic factors can help.

“Given its cost and radiation risk, chest CT cannot be performed for every symptomatic COVID-19 survivor,” they concluded. “In our study, in addition to the severity of acute COVID-19, patient demographic factors, including age and smoking status, were associated with the prevalence of pulmonary fibrosis, suggesting that these demographic factors should be considered when deciding whether chest CT should be performed in some patients with post-acute COVID-19 syndrome.”

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