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Predictors of pulmonary sequelae after COVID-19 pneumonia: A 12-month follow-up study
Nicol Bernardinello1, Elisabetta Cocconcelli1, Chiara Giraudo2
1Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova and Padova City Hospital, Padova, Italy.
Insights
COVID-19 survivors may experience long-term lung issues, but most recover. Current smokers are at higher risk for persistent pulmonary sequelae after SARS-CoV-2 infection, even with mild disease.
Area of Science:
- Pulmonology
- Infectious Diseases
- Radiology
Background:
- The long-term pulmonary consequences of COVID-19 remain unclear despite over 550 million global infections.
- Understanding post-COVID-19 lung sequelae is crucial for patient management and recovery.
Purpose of the Study:
- To identify and characterize pulmonary sequelae 12 months after COVID-19 hospitalization.
- To identify predictors for persistent long-term lung consequences.
Main Methods:
- A single-center observational cohort study followed 347 patients hospitalized with SARS-CoV-2 pneumonia.
- Patients were categorized into NOT-RECOVERED (NOT-REC) and RECOVERED (REC) groups based on radiological changes at 12 months.
- High-resolution computed tomography (HRCT) and pulmonary function tests were used; logistic regression identified predictors.
Main Results:
- 6.9% of patients (n=24) showed persistent pulmonary sequelae at 12 months.
- The NOT-REC group was older, more likely to be current smokers, and had more severe respiratory failure at admission.
- Current smoking was an independent predictor for lung sequelae (OR 5.6, p=0.01).
Conclusions:
- A small proportion of COVID-19 patients exhibit persistent pulmonary sequelae 12 months post-hospitalization.
- Current smoking status is a significant independent predictor of long-term lung consequences following SARS-CoV-2 infection.
Background:
Since the beginning of the SARS-CoV-2 pandemic, over 550 million people have been infected worldwide. Despite these large numbers, the long-term pulmonary consequences of COVID-19 remain unclear.
Aims:
The aim of this single-center observational cohort study was to identify and characterize pulmonary sequelae of COVID-19 at 12 months from hospitalization and to reveal possible predictors for the persistence of long-term lung consequences.
Methods:
Based on the persistence or absence of radiological changes after 12 months from hospitalization, the whole population was categorized into NOT-RECOVERED (NOT-REC) and RECOVERED (REC) groups, respectively. Clinical and pulmonary function data tests and clinical data were also collected and compared in the two groups. In the NOT-REC group, high resolution computed tomography (HRCT) images were semiquantitatively scored analyzing ground-glass opacities (GGO), interstitial thickening (IT), consolidations (CO), linear and curvilinear band opacities, and bronchiectasis for each lung lobe. Logistic regression analyses served to detect the factors associated with 12-month radiological consequences.
Results:
Out of the 421 patients followed after hospitalization for SARS-CoV-2 pneumonia, 347 met inclusion and exclusion criteria and were enrolled in the study. The NOT-REC patients (n = 24; 6.9%) were significantly older [67 (62-76) years vs. 63 (53-71) years; p = 0.02], more frequently current smokers [4 (17%) vs. 12 (4%); p = 0.02], and with more severe respiratory failure at the time of hospitalization [PaO2/FiO2 at admission: 201 (101-314) vs. 295 (223-343); p = 0.01] compared to REC group (n = 323; 93.1%). On multivariable analysis, being a current smoker resulted in an independent predictor for lung sequelae after 12 months from hospitalization [5.6 OR; 95% CI (1.41-22.12); p = 0.01].
Conclusion:
After 12 months from hospital admission, a limited number of patients displayed persistent pulmonary sequelae with minimal extension. Being a current smoker at the time of SARS-CoV-2 infection is an independent predictive factor to lung consequences, regardless of the disease severity.
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