Department of Radiology, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital, The Second Affiliated Hospital, School of Medicine Southern University of Science and Technology, 29 Bulan Road, Longgang District, Shenzhen, 518000, Guangdong, China.
Department of Infectious Disease, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital, The Second Affiliated Hospital, School of Medicine Southern University of Science and Technology, 29 Bulan Road, Longgang District, Shenzhen, 518000, Guangdong, China.
Eur Radiol. 2021 Sep;31(9):7172-7183. doi: 10.1007/s00330-021-07799-9. Epub 2021 Mar 11.
This study analyzed and compared CT findings and longitudinal variations after discharge between severe and non-severe coronavirus disease (COVID-19) patients who had residual pulmonary sequelae at pre-discharge.
A total of 310 patients were included and stratified into severe and non-severe COVID-19 groups. Cross-sectional CT features across different time periods (T0: pre-discharge, T1: 1-4 weeks after discharge, T2: 5-8 weeks after discharge, T3: 9-12 weeks after discharge, T4: > 12 weeks after discharge) were compared, and the longitudinal variations of CT findings were analyzed and compared in both groups.
The cumulative absorption rate of fibrosis-like findings in the severe and non-severe groups at T4 was 24.3% (17/70) and 52.0% (53/102), respectively. In both groups, ground-glass opacity (GGO) with consolidation showed a clear decreasing trend at T1, after which they maintained similar lower levels. The GGO in the severe group showed an increasing trend first at T1 and then decreasing at T4; however, the incidence decreased gradually in the non-severe group. Most fibrosis-like findings showed a tendency to decrease rapidly and then remained stable. Bronchial dilatation in the severe group persisted at an intermediate level.
After discharge, the characteristics and changing trends of pulmonary sequelae caused by COVID-19 were significantly different between the two groups. Pulmonary sequelae were more serious and recovery was slower in patients with severe/critical disease than in patients with moderate disease. A portion of the fibrosis-like findings were completely absorbed in patients with moderate and severe/critical diseases.
• Lung sequelae were more serious and recovery was slower in severe/critical COVID-19 patients. • Complete absorption of fibrosis-like findings after a short-term follow-up was observed in at least 17/70 (24.3%) of COVID-19 patients with severe/critical disease and 53/102 (52.0%) of COVID-19 patients with moderate disease. • The most common fibrosis-like findings was a parenchymal band; irregular interface was a nonspecific sign of COVID-19, and the percentage of bronchial dilatation in patients with severe/critical disease remained at a relatively stable medium level (range, 31.6 to 47.8%) at all stages.
本研究分析比较了出院时存在肺部后遗症的重症和非重症新型冠状病毒病（COVID-19）患者的 CT 表现和出院后纵向变化。
共纳入 310 例患者，分为重症和非重症 COVID-19 组。比较不同时间点（T0：出院前，T1：出院后 1-4 周，T2：出院后 5-8 周，T3：出院后 9-12 周，T4：>12 周）的横断面 CT 特征，并分析比较两组 CT 表现的纵向变化。
重症和非重症组在 T4 时纤维化样表现的累积吸收率分别为 24.3%（17/70）和 52.0%（53/102）。两组磨玻璃影（GGO）伴实变均在 T1 时呈明显下降趋势，之后维持在较低水平。重症组 GGO 在 T1 时先呈上升趋势，然后在 T4 时下降，但在非重症组中，发生率逐渐下降。大多数纤维化样表现呈快速下降后稳定趋势。重症组支气管扩张持续处于中等水平。
出院后，COVID-19 引起的肺部后遗症的特征和变化趋势在两组间有显著差异。重症/危重症患者的肺部后遗症更严重，恢复更慢。部分纤维化样表现可在中重度 COVID-19 患者中完全吸收。
重症/危重症 COVID-19 患者的肺部后遗症更严重，恢复更慢。
在重症/危重症 COVID-19 患者中，至少有 17/70（24.3%）和 53/102（52.0%）纤维化样表现完全吸收，而在中症 COVID-19 患者中观察到至少 17/70（24.3%）和 53/102（52.0%）纤维化样表现完全吸收。
最常见的纤维化样表现为肺实质带；界面不规则是非 COVID-19 的非特异性表现，重症/危重症患者支气管扩张的比例在各阶段均保持在相对稳定的中等水平（31.6%至 47.8%）。
