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Three-Dimensional Phase Resolved Functional Lung Magnetic Resonance Imaging
Published on: June 21, 2024
Three-month outcomes of recovered COVID-19 patients: prospective observational study
Jie Cao1, Xueying Zheng2, Wei Wei3
1Department of Pulmonary and Critical Care Medicine, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
Insights
COVID-19 survivors often experience persistent chest CT abnormalities and reduced exercise capacity three months post-recovery. Older age and steroid use during hospitalization predict worse lung imaging outcomes in these patients.
Area of Science:
- Pulmonology
- Infectious Diseases
- Radiology
Background:
- The long-term outcomes for Coronavirus disease 2019 (COVID-19) survivors remain incompletely understood.
- The novel coronavirus SARS-CoV-2 pandemic necessitates detailed evaluation of post-recovery health status.
Purpose of the Study:
- To assess the clinical and radiological outcomes of COVID-19 survivors at 1-month and 3-month follow-ups.
- To identify factors associated with persistent abnormalities and impaired recovery in COVID-19 survivors.
Main Methods:
- Prospective observational study of 81 COVID-19 survivors.
- Evaluations included chest computed tomography (CT) scans, pulmonary function tests, 6-minute walk distance (6MWD), and the SF-36 health survey.
- Statistical analysis identified predictors of adverse outcomes.
Main Results:
- At 3 months, 54% of patients had abnormal chest CT findings, with scores improving from hospitalization levels. Mild restrictive pulmonary impairment was noted in 10% of patients.
- Exercise capacity (6MWD) was significantly lower than in healthy controls. SF-36 scores showed impairments in role physical, role emotional, and social functioning domains.
- Older age (>40 years) and steroid administration during hospitalization were independently associated with worse chest CT scores at 3 months.
Conclusions:
- COVID-19 survivors frequently exhibit persistent chest CT abnormalities and reduced functional capacity up to 3 months post-infection.
- Older age and prior steroid treatment are linked to poorer radiological outcomes.
- Further follow-up and support programs may be beneficial for COVID-19 survivors.
Aims:
A novel coronavirus SARS-CoV-2 has resulted in an ongoing global pandemic of Coronavirus disease 2019 (COVID-19). However, the outcomes of recovered patients have not been well defined.
Methods:
This is a prospective observational follow-up study of survivors with COVID-19 from a designated tertiary center in Hefei, China. We examined chest computed tomography (CT) scanning, pulmonary function, 6-min walk distance (6MWD), and 36 item Short Form General Health Survey (SF-36).
Results:
Among 81 enrolled patients, 62 (77%) patients and 61 (75%) patients, respectively, completed 1-month and 3-month follow-ups. Abnormal CT findings were still present in 73% of patients at 1 month and 54% at 3 months, whereas chest CT scan scores improved progressively at 1-month (5.0 ± 5.1) and 3-month follow up (3.0 ± 4.5) compared with that during hospitalization (11 ± 6.8). Mild restrictive pulmonary impairment was detected in 11% and 10% of patients at 1-month and 3-month follow up, respectively. The 6MWD was 523 ± 77 m in male patients and 484 ± 58 m in female patients, which was significantly lower than in healthy controls (606 ± 68 m, 568 ± 78 m, p < 0.001). SF-36 scores were significantly impaired in the domains of role physical (RP), role emotional (RE), and social functioning (SF) compared with the normal age-matched population. RP was improved at 3-month compared with 1-month follow up in the 41-64 years group (p < 0.01). Multivariable analysis showed that older age (over 40 years) and steroid administration during hospitalization were independently associated with worse chest CT scores at 3-month follow up.
Conclusions:
At 3 months, chest CT abnormalities were present in one half of COVID-19 survivors and worse chest CT scores were independently associated with older age and steroid administration during hospitalization. Residual pulmonary function impairments were modest, whereas exercise capacity and SF-36 scores were significantly lower than the general population. Support program and further follow-up evaluations may be needed.The reviews of this paper are available via the supplemental material section.
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