Related Experiment Video
Updated: Oct 18, 2025
Lung CT Segmentation to Identify Consolidations and Ground Glass Areas for Quantitative Assesment of SARS-CoV Pneumonia
Published on: December 19, 2020
Chest CT Patterns from Diagnosis to 1 Year of Follow-up in Patients with COVID-19
Feng Pan1, Lian Yang1, Bo Liang1
1From the Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Ave 1277, Wuhan 430022, China (F.P., L.Y., B.L., T.Y., Lingli Li, Lin Li, D.L., C.Z.); Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China (F.P., L.Y., B.L., T.Y., Lingli Li, Lin Li, D.L., C.Z.); MSC Clinical and Technical Solutions, Philips Healthcare, Beijing, China (J.W.); and Department of Radiology, University College London Hospital, London, England (R.L.H.).
Insights
One year after COVID-19, 25% of patients showed persistent chest CT abnormalities. Older age and severe acute respiratory distress syndrome were linked to lasting lung sequelae.
Area of Science:
- Radiology
- Pulmonology
- Infectious Diseases
Background:
- The long-term chest computed tomography (CT) findings of coronavirus disease 2019 (COVID-19) are not well understood.
- Assessing COVID-19's impact on lung structure over time is crucial for patient management.
Purpose of the Study:
- To evaluate the chest CT manifestations of COVID-19 patients up to one year post-symptom onset.
- To identify risk factors associated with persistent pulmonary abnormalities after COVID-19.
Main Methods:
- A prospective study involving 209 hospitalized COVID-19 patients who underwent serial chest CT scans at 3, 7, and 12 months.
- Longitudinal analysis of CT scans to assess pulmonary lobe involvement using a total CT score.
- Logistic regression analysis to determine independent risk factors for residual CT abnormalities.
Main Results:
- At 12 months post-symptom onset, 75% of patients had resolved CT abnormalities, while 25% (53 of 209) showed persistent findings.
- Residual abnormalities included linear opacities (12%) and multifocal reticular or cystic lesions (13%).
- Independent risk factors for 1-year residual CT abnormalities were older age (≥50 years), lymphopenia, and severe acute respiratory distress syndrome (ARDS).
Conclusions:
- Approximately 25% of COVID-19 patients exhibit persistent chest CT abnormalities one year after symptom onset.
- Older individuals with severe COVID-19 or ARDS are at higher risk for developing long-term lung sequelae.
- Reticular lesions and bronchial dilation were common persistent findings in patients with residual abnormalities.
Abstract:
Background The chest CT manifestations of COVID-19 from hospitalization to convalescence after 1 year are unknown. Purpose To assess chest CT manifestations of COVID-19 up to 1 year after symptom onset. Materials and Methods Patients were enrolled if they were admitted to the hospital because of COVID-19 and underwent CT during hospitalization at two isolation centers between January 27, 2020, and March 31, 2020. In a prospective study, three serial chest CT scans were obtained at approximately 3, 7, and 12 months after symptom onset and were longitudinally analyzed. The total CT score of pulmonary lobe involvement, ranging from 0 to 25, was assessed (score of 1-5 for each lobe). Univariable and multivariable logistic regression analyses were performed to explore independent risk factors for residual CT abnormalities after 1 year. Results A total of 209 study participants (mean age, 49 years ± 13 [standard deviation]; 116 women) were evaluated. CT abnormalities had resolved in 61% of participants (128 of 209) at 3 months and in 75% of participants (156 of 209) at 12 months. Among participants with chest CT abnormalities that had not resolved, there were residual linear opacities in 25 of the 209 participants (12%) and multifocal reticular or cystic lesions in 28 of the 209 participants (13%). Age 50 years or older, lymphopenia, and severe or aggravation of acute respiratory distress syndrome were independent risk factors for residual CT abnormalities at 1 year (odds ratios = 15.9, 18.9, and 43.9, respectively; P < .001 for each comparison). In 53 participants with residual CT abnormalities at 12 months, reticular lesions (41 of 53 participants [77%]) and bronchial dilation (39 of 53 participants [74%]) were observed at discharge and were persistent in 28 (53%) and 24 (45%) of the 53 participants, respectively. Conclusion One year after COVID-19 diagnosis, chest CT scans showed abnormal findings in 53 of the 209 study participants (25%), with 28 of the 209 participants (13%) showing subpleural reticular or cystic lesions. Older participants with severe COVID-19 or acute respiratory distress syndrome were more likely to develop lung sequelae that persisted at 1 year. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Lee and Wi et al in this issue.
More Related Videos
Related Concept Videos
01:27Pneumothorax-II
Clinical Manifestations:
01:19Pericarditis II: Clinical Features and Diagnostic Tests
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History
01:20COPD: Pathogenesis and Clinical Features
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
01:27Myocarditis II: Clinical Features and Diagnostic Tests