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Published on: December 19, 2020
COVID-19 Chest Manifestation on CT Scan and Associated Risk Factors for Developing Pulmonary Fibrosis
1Department of Medicine, Division of Radiology, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, SAU.
Insights
Pulmonary fibrosis developed in 9.6% of coronavirus disease 2019 (COVID-19) patients. Hypertension and coronary artery disease were risk factors for developing lung fibrosis post-COVID-19.
Area of Science:
- Radiology
- Pulmonology
- Infectious Diseases
Background:
- Coronavirus disease 2019 (COVID-19) can lead to long-term respiratory complications.
- Pulmonary fibrosis is a potential sequela of severe COVID-19 pneumonia.
Purpose of the Study:
- To describe chest computed tomography (CT) imaging findings in COVID-19 patients.
- To determine the prevalence of pulmonary fibrosis after COVID-19.
- To identify risk factors associated with developing pulmonary fibrosis.
Main Methods:
- Retrospective analysis of chest CT scans from adult COVID-19 patients (January 2020 - April 2022).
- Evaluation of imaging findings and pulmonary severity scores (PSS).
- Comparison of clinical and radiological data between patients with and without fibrotic lung changes.
Main Results:
- Pulmonary fibrosis was identified in 9.6% of patients.
- Hypertension and coronary artery disease (CAD) were significantly associated with increased risk of pulmonary fibrosis.
- Patients with pulmonary fibrosis had higher pneumonia severity scores and longer hospitalizations.
Conclusions:
- Pulmonary fibrosis is a notable complication in COVID-19 survivors.
- Close monitoring is recommended for patients with severe pneumonia, prolonged hospitalization, hypertension, or CAD.
- Further large-scale, long-term studies are warranted to fully understand COVID-19-related pulmonary fibrosis.
Purpose:
This retrospective study describes the imaging findings on chest computed tomography (CT) scans of coronavirus disease 2019 (COVID-19) patients as well as the prevalence of pulmonary fibrosis and the potential risk factors for the disease.
Methods:
One of the major COVID-19 centers in the western province of Saudi Arabia, the King Abdullah Medical Complex in Jeddah, was the site of this study. All adult COVID-19 patients who got a CT chest scan between January 2020 and April 2022 were included in the trial. The imaging findings and pulmonary severity scores (PSS) were obtained from the patients' CT chest. Patients were divided into two groups according to the evidence of fibrotic-like lung changes; clinical and radiological data between the two groups were subsequently compared. Data from the patients' electronic records was collected.
Results:
The average patient age was 56.4 years, and most (73.5%) patients were men. Two-thirds of the patients had comorbidities (69.1%). CT scans revealed that diffuse lung infiltration is reported in 61% of cases, followed by lower lobes in 19.9%. Ground glass opacity (94.1%), consolidation (76.5%), septal thickening, and/or reticulation (24.4%) were the main chest findings during the initial CT scan. Fibrotic-like lung changes were developed in 9.6% of patients. Patients known to have a positive history of hypertension (p-value = 0.031) and coronary artery disease (CAD) (p-value = 0.011) were found to be significantly more likely to develop lung fibrosis. The patients' pneumonia severity score was significantly higher among the lung fibrotic patients (p-value = 0.026). Also, patients who were diagnosed with pulmonary fibrosis stayed longer in the hospital (p-value 0.001). Sex and age did not correlate significantly with risk of lung fibrosis.
Conclusion:
Pulmonary fibrosis was observed in 9.6% of COVID-19 patients. A close follow-up of patients with severe pneumonia, prolonged hospitalization, and pre-existing CAD and hypertension was necessary, as pulmonary fibrosis was more likely to occur as a result of these factors. There is a need for a thorough, long-term investigation with a large sample size.
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