Post-COVID-19 respiratory sequelae two years after hospitalization: an ambidirectional study

Area of Science:

• Pulmonology
• Infectious Diseases
• Radiology

Background:

• COVID-19 lung sequelae can significantly impact patient recovery and long-term health.
• Understanding the progression of pulmonary abnormalities post-hospitalization is crucial for patient management.

Purpose of the Study:

• To investigate the evolution of lung abnormalities in COVID-19 survivors 18-24 months after hospital discharge.
• To identify predictors for the development of fibrotic-like lung lesions in post-COVID-19 patients.

Main Methods:

• A cohort of hospitalized COVID-19 patients with pulmonary involvement was followed up 18-24 months post-discharge.
• Chest computed tomography (CT) scans and functional assessments were compared between 6-12 months and 18-24 months post-discharge.
• Retrospective and prospective data analysis was performed to identify predictors of lung sequelae.

Main Results:

• Among 237 participants, 58% had ground-glass opacities/reticulations and 33% had fibrotic-like lesions at 18-24 months.
• An increase in architectural distortion and traction bronchiectasis was observed compared to the 6-12 month follow-up.
• Persistent functional impairment, including restrictive patterns and reduced diffusion capacity, was noted.
• Length of hospitalization, invasive mechanical ventilation, and patient age predicted fibrotic-like lung lesions.

Conclusions:

• Post-COVID-19 lung sequelae can persist and progress, with new fibrotic-like lesions forming.
• Patients requiring intensive care unit (ICU) admission are particularly at risk for developing progressive lung damage.
• These findings highlight the need for long-term monitoring of COVID-19 survivors.