18 months computed tomography follow-up after Covid-19 interstitial pneumonia

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  • Michela Barini
    Department of Diagnosis and Treatment Services, Radiodiagnostics, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy.
  • Ilaria Percivale
    Department of Diagnosis and Treatment Services, Radiodiagnostics, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy. https://orcid.org/0000-0001-9388-8667
  • Pietro S.C. Danna
    Department of Diagnosis and Treatment Services, Radiodiagnostics, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy. https://orcid.org/0000-0001-8928-7666
  • Vittorio Longo
    Department of Diagnosis and Treatment Services, Radiodiagnostics, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy. https://orcid.org/0000-0003-4332-9757
  • Pietro Costantini
    Department of Diagnosis and Treatment Services, Radiodiagnostics, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy. https://orcid.org/0000-0002-5365-7028
  • Andrea Paladini
    Department of Diagnosis and Treatment Services, Radiodiagnostics, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy. https://orcid.org/0000-0003-1968-1590
  • Chiara Airoldi
    Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.
  • Mattia Bellan
    Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.
  • Luca Saba
    Department of Medical Science, University of Cagliari, Italy.
  • Alessandro Carriero
    Department of Diagnosis and Treatment Services, Radiodiagnostics, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy.

ABSTRACT

Background: Our aim is to evaluate the possible persistence of lung parenchyma alterations, in patients who have recovered from Covid-19.
Design and methods: We enrolled a cohort of 115 patients affected by Covid-19, who performed a chest CT scan in the Emergency Department and a chest CT 18 months after hospital discharge. We performed a comparison between chest CT scan 18 months after discharge and spirometric data of patients enrolled. We obtained quantitative scores related to well-aerated parenchyma, interstitial lung disease and parenchymal consolidation. A radiologist recorded the characteristics indicated by the Fleischner Society and “fibrotic like” changes, expressed through a CT severity score ranging from 0 (no involvement) to 25 (maximum involvement).

Results:
 115 patients (78 men, 37 women; mean age 60.15 years old ±12.52). On quantitative analysis, after 18 months, the volume of normal ventilated parenchyma was significantly increased (16.34 points on average ±14.54, p<0.0001). Ground-glass opacities and consolidation values tend to decrease (-9.80 and -6.67 points, p<0.0001). On semiquantitative analysis, pneumonia extension, reactive lymph nodes and crazy paving reached statistical significance (p<0.0001). The severity score decreased by 2.77 points on average (SD 4.96; p<0.0001). There were not statistically significant changes on “fibrotic-like” changes correlated with level of treatment and there was not a statistically significant correlation between CT lung score and spirometric results obtained 18 months after discharge.

Conclusions:
 Patients recovered from Covid-19 seem to have an improvement of ventilated parenchyma and “fibrotic-like” alterations. The level of treatment does not appear to influence fibrotic changes.

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