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- Title
Multidimensional 3-Month Follow-Up of Severe COVID-19: Airways beyond the Parenchyma in Symptomatic Patients.
- Authors
Bonato, Matteo; Peditto, Piera; Landini, Nicholas; Fraccaro, Alessia; Catino, Cosimo; Cuzzola, Maria; Malacchini, Nicola; Savoia, Francesca; Roma, Nicola; Salasnich, Mauro; Turrin, Martina; Zampieri, Francesca; Zanardi, Giuseppe; Zeraj, Fabiola; Rattazzi, Marcello; Peta, Mario; Baraldo, Simonetta; Saetta, Marina; Fusaro, Michele; Morana, Giovanni
- Abstract
SARS-CoV-2 may lead to a large spectrum of respiratory manifestations, including pulmonary sequelae. We conducted a single-center longitudinal study of survivors from severe COVID-19 cases who underwent a chest CT during hospitalization (CTH). Three months after being discharged, these patients were evaluated by a clinical examination, pulmonary function tests and a chest-CT scan (CTFU). Sixty-two patients were enrolled. At follow-up, 27% complained of exertional dyspnoea and 12% of cough. Dyspnoeic patients had a lower forced expiratory flow (FEF)25–75 (p = 0.015), while a CT scan (p = 0.016 showed that patients with cough had a higher extent of bronchiectasis. Lung volumes and diffusion of carbon monoxide (DLCO) at follow-up were lower in patients who had been invasively ventilated, which correlated inversely with the length of hospitalization and ground-glass extension at CTH. At follow-up, 14.5% of patients had a complete radiological resolution, while 85.5% presented persistence of ground-glass opacities, and 46.7% showed fibrotic-like alterations. Residual ground-glass at CTFU was related to the length of hospitalization (r = 0.48; p = 0.0002) and to the need for mechanical ventilation or high flow oxygen (p = 0.01) during the acute phase. In conclusion, although patients at three months from discharge showed functional impairment and radiological abnormalities, which correlated with a prolonged hospital stay and need for mechanical ventilation, the persistence of respiratory symptoms was related not to parenchymal but rather to airway sequelae.
- Subjects
KIRKENDALL effect; PULMONARY function tests; EXPIRATORY flow; LUNG volume; COMPUTED tomography
- Publication
Journal of Clinical Medicine, 2022, Vol 11, Issue 14, p4046
- ISSN
2077-0383
- Publication type
Article
- DOI
10.3390/jcm11144046