Department of Radiology, Jiangxi Provincial People's Hospital, Nanchang, China.
Department of Radiology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China.
J Xray Sci Technol. 2020;28(3):383-389. doi: 10.3233/XST-200685.
To analyze clinical and thin-section computed tomographic (CT) data from the patients with coronavirus disease (COVID-19) to predict the development of pulmonary fibrosis after hospital discharge.
Fifty-nine patients (31 males and 28 females ranging from 25 to 70 years old) with confirmed COVID-19 infection performed follow-up thin-section thorax CT. After 31.5±7.9 days (range, 24 to 39 days) of hospital admission, the results of CT were analyzed for parenchymal abnormality (ground-glass opacification, interstitial thickening, and consolidation) and evidence of fibrosis (parenchymal band, traction bronchiectasis, and irregular interfaces). Patients were analyzed based on the evidence of fibrosis and divided into two groups namely, groups A and B (with and without CT evidence of fibrosis), respectively. Patient demographics, length of stay (LOS), rate of intensive care unit (ICU) admission, peak C-reactive protein level, and CT score were compared between the two groups.
Among the 59 patients, 89.8% (53/59) had a typical transition from early phase to advanced phase and advanced phase to dissipating phase. Also, 39% (23/59) patients developed fibrosis (group A), whereas 61% (36/59) patients did not show definite fibrosis (group B). Patients in group A were older (mean age, 45.4±16.9 vs. 33.8±10.2 years) (P = 0.001), with longer LOS (19.1±5.2 vs. 15.0±2.5 days) (P = 0.001), higher rate of ICU admission (21.7% (5/23) vs. 5.6% (2/36)) (P = 0.061), higher peak C-reactive protein level (30.7±26.4 vs. 18.1±17.9 mg/L) (P = 0.041), and higher maximal CT score (5.2±4.3 vs. 4.0±2.2) (P = 0.06) than those in group B.
Pulmonary fibrosis may develop early in patients with COVID-19 after hospital discharge. Older patients with severe illness during treatment were more prone to develop fibrosis according to thin-section CT results.
分析新冠肺炎（COVID-19）患者的临床和薄层计算机断层扫描（CT）数据，以预测出院后发生肺纤维化的情况。
59 名患者（31 名男性和 28 名女性，年龄 25 岁至 70 岁）经确诊患有 COVID-19 感染，进行了后续的薄层胸部 CT 检查。在住院治疗 31.5±7.9 天后（范围为 24 天至 39 天），对 CT 结果进行分析，以评估实质异常（磨玻璃影、间质增厚和实变）和纤维化证据（实质带、牵引性支气管扩张和不规则界面）。根据纤维化证据对患者进行分析，并将他们分为两组，即 A 组（有 CT 纤维化证据）和 B 组（无 CT 纤维化证据）。比较两组患者的人口统计学数据、住院时间（LOS）、入住重症监护病房（ICU）的比例、C 反应蛋白峰值水平和 CT 评分。
在 59 名患者中，89.8%（53/59）表现为从早期到晚期和晚期到消散期的典型过渡。此外，39%（23/59）的患者出现纤维化（A 组），而 61%（36/59）的患者没有出现明确的纤维化（B 组）。A 组患者年龄较大（平均年龄 45.4±16.9 岁 vs. 33.8±10.2 岁）（P = 0.001），住院时间较长（19.1±5.2 天 vs. 15.0±2.5 天）（P = 0.001），入住 ICU 的比例较高（21.7%（5/23）vs. 5.6%（2/36））（P = 0.061），C 反应蛋白峰值水平较高（30.7±26.4 比 18.1±17.9 mg/L）（P = 0.041），以及 CT 评分最高值较高（5.2±4.3 比 4.0±2.2）（P = 0.06）。
COVID-19 患者出院后可能会早期出现肺纤维化。根据薄层 CT 结果，治疗期间病情较重的老年患者更容易发生纤维化。
