Bakhsh Noha, Banjar Mai
Department of Medicine, Division of Radiology, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, SAU.
Department of Medical Imaging, King Abdullah Medical Complex, Jeddah, SAU.
Cureus. 2024 Mar 21;16(3):e56616. doi: 10.7759/cureus.56616. eCollection 2024 Mar.
This retrospective study describes the imaging findings on chest computed tomography (CT) scans of coronavirus disease 2019 (COVID-19) patients as well as the prevalence of pulmonary fibrosis and the potential risk factors for the disease.
One of the major COVID-19 centers in the western province of Saudi Arabia, the King Abdullah Medical Complex in Jeddah, was the site of this study. All adult COVID-19 patients who got a CT chest scan between January 2020 and April 2022 were included in the trial. The imaging findings and pulmonary severity scores (PSS) were obtained from the patients' CT chest. Patients were divided into two groups according to the evidence of fibrotic-like lung changes; clinical and radiological data between the two groups were subsequently compared. Data from the patients' electronic records was collected.
The average patient age was 56.4 years, and most (73.5%) patients were men. Two-thirds of the patients had comorbidities (69.1%). CT scans revealed that diffuse lung infiltration is reported in 61% of cases, followed by lower lobes in 19.9%. Ground glass opacity (94.1%), consolidation (76.5%), septal thickening, and/or reticulation (24.4%) were the main chest findings during the initial CT scan. Fibrotic-like lung changes were developed in 9.6% of patients. Patients known to have a positive history of hypertension (p-value = 0.031) and coronary artery disease (CAD) (p-value = 0.011) were found to be significantly more likely to develop lung fibrosis. The patients' pneumonia severity score was significantly higher among the lung fibrotic patients (p-value = 0.026). Also, patients who were diagnosed with pulmonary fibrosis stayed longer in the hospital (p-value 0.001). Sex and age did not correlate significantly with risk of lung fibrosis.
Pulmonary fibrosis was observed in 9.6% of COVID-19 patients. A close follow-up of patients with severe pneumonia, prolonged hospitalization, and pre-existing CAD and hypertension was necessary, as pulmonary fibrosis was more likely to occur as a result of these factors. There is a need for a thorough, long-term investigation with a large sample size.
本回顾性研究描述了2019冠状病毒病（COVID-19）患者胸部计算机断层扫描（CT）的影像表现、肺纤维化的患病率以及该疾病的潜在危险因素。
本研究地点为沙特阿拉伯西部省份的主要COVID-19中心之一，吉达的阿卜杜拉国王医疗中心。纳入2020年1月至2022年4月期间接受胸部CT扫描的所有成年COVID-19患者。从患者的胸部CT中获取影像表现和肺部严重程度评分（PSS）。根据类似纤维化的肺部改变证据将患者分为两组；随后比较两组之间的临床和放射学数据。收集患者电子记录中的数据。
患者的平均年龄为56.4岁，大多数（73.5%）患者为男性。三分之二的患者有合并症（69.1%）。CT扫描显示，61%的病例有弥漫性肺浸润，其次是下叶，占19.9%。初次CT扫描时的主要胸部表现为磨玻璃影（94.1%）、实变（76.5%）、小叶间隔增厚和/或网状改变（24.4%）。9.6%的患者出现了类似纤维化的肺部改变。已知有高血压病史（p值=0.031）和冠状动脉疾病（CAD）病史（p值=0.011）的患者被发现发生肺纤维化的可能性显著更高。肺纤维化患者的肺炎严重程度评分显著更高（p值=0.026）。此外，被诊断为肺纤维化的患者住院时间更长（p值=0.001）。性别和年龄与肺纤维化风险无显著相关性。
在9.6%的COVID-19患者中观察到肺纤维化。由于这些因素更易发生肺纤维化，因此对重症肺炎、长期住院以及既往有CAD和高血压的患者进行密切随访很有必要。需要进行大规模样本的全面长期调查。
