One‐year follow‐up CT findings in COVID ‐19 patients: A systematic review and meta‐analysis

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Abstract

<p id="d7771069e360">Coronavirus disease 2019 (COVID‐19) often causes radiological and functional pulmonary sequelae. However, evidence on 1‐year follow‐up of pulmonary sequelae is limited. We aimed to investigate the characteristics and time‐course of pulmonary sequelae after recovery from COVID‐19 through 1‐year follow‐up. We searched PubMed and EMBASE databases on 25 February 2022, and included studies with computed tomography (CT) findings at the 1‐year follow‐up. The extracted data on CT findings were analysed using a one‐group meta‐analysis. We further analysed the data in relation to COVID‐19 severity, improvement rate and lung function. Fifteen eligible studies ( <i>N</i> = 3134) were included. One year after COVID‐19, 32.6% (95% CI 24.0–42.6, <i>I</i> <sup>2</sup> = 92.9%) presented with residual CT abnormalities. Ground‐glass opacity and fibrotic‐like changes were frequently observed in 21.2% (95% CI 15.4–28.4, <i>I</i> <sup>2</sup> = 86.7%) and 20.6% (95% CI 11.0–35.2, <i>I</i> <sup>2</sup> = 91.9%), respectively. While the gradual recovery was seen on CT (52.9% [mid‐term] vs. 32.6% [1 year]), the frequency of CT abnormalities was higher in the severe/critical cases than in the mild/moderate cases (37.7% vs. 20.7%). In particular, fibrotic changes showed little improvement between 4–7 months and 1 year after COVID‐19. Pulmonary function tests at 1 year also showed the decline in diffusing capacity of the lung for carbon monoxide, especially in severe/critical cases. Our meta‐analysis indicated that residual CT abnormalities were common in hospitalized COVID‐19 patients 1 year after recovery, especially fibrotic changes in severe/critical cases. As these sequelae may last long, vigilant observations and longer follow‐up periods are warranted. </p><p class="first" id="d7771069e385"> <div class="boxed-text panel" id="resp14311-blkfxd-0001"> <a class="named-anchor" id="resp14311-blkfxd-0001">  </a> <div class="figure-container so-text-align-c"> <img alt="" class="figure" src="/document_file/d3038856-a546-408b-bd4e-8fdad9f0c1e3/PubMedCentral/image/RESP-27-605-g002.jpg"/> </div> <div class="panel-content"/> </div> </p>

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Clinical Characteristics of Coronavirus Disease 2019 in China

Wei-jie Guan, Zheng-yi Ni, Yu Hu … (2020)

Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. Methods We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Results The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. Conclusions During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)

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Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area

Safiya Richardson, Jamie Hirsch, Mangala Narasimhan … (2020)

There is limited information describing the presenting characteristics and outcomes of US patients requiring hospitalization for coronavirus disease 2019 (COVID-19).

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Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19

Maximilian Ackermann, Stijn Verleden, Mark Kuehnel … (2020)

Progressive respiratory failure is the primary cause of death in the coronavirus disease 2019 (Covid-19) pandemic. Despite widespread interest in the pathophysiology of the disease, relatively little is known about the associated morphologic and molecular changes in the peripheral lung of patients who die from Covid-19.