ABSTRACT
Objective
The radiological and functional lung sequelae in COVID-19 survivors remain unclear. We compared the chest computed tomography findings of COVID-19 patients with normal and abnormal pulmonary function test results in the post-recovery phase.
Methods
The data of consecutive patients who underwent pulmonary function tests and chest computed tomography within 14 days after recovery from COVID-19 at two medical centers between May and October 2020 were collected retrospectively. Two thoracic radiologists who were blinded to the clinical information and pulmonary function test results classified the patients according to the computed tomography features, evidence of fibrotic-like changes, and semi-quantitative quantification of the extent of pulmonary abnormalities. The clinical characteristics and computed tomography findings of patients with normal pulmonary function test results were compared with those of patients with abnormal results.
Results
A total of 101 COVID-19 survivors, comprising 48 ambulatory and 53 hospitalized patients, were included at a median of 95 days from initial symptom onset. Computed tomography revealed fibrotic-like changes in 10.9% of patients. A reduction in the diffusion capacity of carbon monoxide was the most common lung function abnormality (19.8%). Abnormal diffusion capacity of carbon monoxide was associated with the presence and extension of lung opacities on chest computed tomography scans and fibrotic pulmonary abnormalities. The sensitivity, specificity, and accuracy of reduced diffusion capacity of carbon monoxide for detecting fibrotic-like pulmonary changes on chest computed tomography scans were 72.7%, 87.8%, and 86.1%, respectively.
Conclusion
Our study suggests that the presence of an abnormal diffusion capacity of carbon monoxide in the post-recovery phase of COVID-19 is associated with a greater risk of long-term parenchymal lung disease, as evidenced by the presence of fibrotic-like changes on chest computed tomography scans, such as traction bronchiectasis and architectural distortion.
COVID-19; Coronavirus infections; SARS-CoV-2; Respiratory function tests; Pulmonar fibrosis; Pulmonary diffusing capacity; Carbon monoxide; Tomography, X-ray computed
In Brief
Teles et al. evaluated the chest computed tomography findings of COVID-19 survivors with normal and abnormal pulmonary function test results in the post-recovery phase. They demonstrated that an abnormal carbon monoxide diffusing capacity is associated with the extension of lung opacities on chest computed tomography and the presence of fibrotic-like changes, such as traction bronchiectasis and architectural distortion.
Highlights
Computed tomography revealed fibrotic-like lung changes in 10.9% of patients.
Higher computed tomography scores were associated with a reduced DLCO (median computed tomography score, 6 versus 3; p=0.016).
Fibrotic-like computed tomography changes were more prevalent in patients with DLCO impairment (p<0.001).
Reduced DLCO had sensitivity and specificity of 73% and 88%, respectively, for predicting fibrotic-like computed tomography changes.