Department of Public Health and Infectious Diseases, Sapienza University of Rome, Pulmonary Division, Policlinico Umberto I Hospital, Rome, Italy.
Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy.
Respiration. 2023;102(4):287-295. doi: 10.1159/000529441. Epub 2023 Feb 17.
Post-COVID-19 Interstitial Lung Disease (PC-ILD) is characterized by fibrotic-like signs at high-resolution computed tomography (HRCT) and pulmonary function tests (PFTs) abnormalities after SARS-CoV-2 infection. It is still not clear how frequent these tests should be performed to rule out long-term consequences of COVID-19 pneumonia.
The aims of our study were to evaluate the incidence and risk factors of PC-ILD and possibly to propose a long-term follow-up program.
One-hundred patients, hospitalized in our ward for moderate to critical COVID-19, underwent two follow-up visits at three and 15 months in which PFTs and HRCT were performed.
At the 15-month follow-up, 8% of patients showed residual radiological and functional signs consistent with PC-ILD. All but one of these patients had already demonstrated PFTs and HRCT alterations at first follow-up visit, and the last 1 patient showed worsening of lung function during follow-up. These findings highlight the negative predictive value of PFTs at 3-month follow-up for the development of PC-ILD. Aging, severity of COVID-19, and degree of pulmonary involvement during acute infection proved to be significant risk factors for developing PC-ILD.
Our study highlights the importance of PFTs in the long-term follow-up of patients affected by moderate to critical COVID-19 pneumonia. Further studies are needed to confirm our hypothesis that HRCT should be performed only in patients with PFTs abnormalities.
新冠病毒（SARS-CoV-2）感染后出现高分辨率计算机断层扫描（HRCT）纤维化样表现和肺功能测试（PFTs）异常的新冠后间质性肺病（PC-ILD），其 PFTs 和 HRCT 检查排除 COVID-19 肺炎长期后果的频率尚不清楚。
本研究旨在评估 PC-ILD 的发生率和危险因素，并可能提出长期随访方案。
100 名因中度至重度 COVID-19 住院的患者在 3 个月和 15 个月时进行了两次随访，进行了 PFTs 和 HRCT 检查。
在 15 个月的随访中，8%的患者出现了与 PC-ILD 一致的残留影像学和功能表现。除了 1 例患者外，所有患者在首次随访时就已经出现了 PFTs 和 HRCT 改变，最后 1 例患者在随访期间出现了肺功能恶化。这些发现强调了 3 个月随访时 PFTs 对 PC-ILD 发展的阴性预测值。年龄、COVID-19 严重程度和急性感染期间的肺部受累程度是发生 PC-ILD 的显著危险因素。
本研究强调了 PFTs 在中重度 COVID-19 肺炎患者长期随访中的重要性。需要进一步的研究来证实我们的假设，即仅在 PFTs 异常的患者中进行 HRCT。
