Long-term pulmonary assessment in Iranian severe COVID-19 ICU survivors in 2020-2021: A Cohort Study
Mahmoud Khandashpour1 
, Mahtab Rakhshaie2 , Rahmatollah Sharififar3 , Somayeh Livani4 , Nafiseh Abdollahi5 , Mahdi Soleimannejad6 , Fahimeh Abdollahi7 , Mahila Monajati 8
, Mahtab Rakhshaie2 , Rahmatollah Sharififar3 , Somayeh Livani4 , Nafiseh Abdollahi5 , Mahdi Soleimannejad6 , Fahimeh Abdollahi7 , Mahila Monajati 8
1- Department of Internal Medicine, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran ; Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran
2- School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
3- Department of Infectious Diseases, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
4- Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran; Department of Radiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
5- Department of Internal Medicine, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran; Golestan Rheumatology Research Center, Golestan University of Medical Sciences, Gorgan, Iran
6- Department of Radiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
7- Department of Internal Medicine, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
8- Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran ,mahilamonajati@gmail.com
2- School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
3- Department of Infectious Diseases, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
4- Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran; Department of Radiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
5- Department of Internal Medicine, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran; Golestan Rheumatology Research Center, Golestan University of Medical Sciences, Gorgan, Iran
6- Department of Radiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
7- Department of Internal Medicine, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
8- Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran ,
Abstract: (283 Views)
Background: Severe coronavirus infections may lead to long-term effects, such as persistent lung dysfunction and residual involvement. This study aimed to evaluate pulmonary function tests (PFT) and chest computed tomography (CT) scans of severe COVID-19 intensive care unit (ICU) survivors one year after discharge.
Methods: A cohort study was conducted, assessing spirometry and chest CT scans in patients with severe COVID-19 admitted to the ICU. Patients with pre-existing lung disease were excluded. Initial laboratory tests, clinical information, and medication (antivirals and corticosteroids) were reported in patients with and without fibrosis on chest CTs.
Results: Thirty patients (57% female) with a mean (SD) age of 50 (13.5) years were included. Initial pulmonary involvement had a mean score of 16 (4), with ground-glass opacification (GGO) observed in all patients, consolidation in 88%, and pneumomediastinum in 10% of patients. One-year chest CT scans revealed mild fibrotic changes in 70% of patients, presenting as a fibrotic band (47%) or a fibrotic band with GGO (23%). Patients with fibrosis had lower serum albumin levels, lower platelet counts, and were older. One-year follow-up spirometry showed that 73% had normal results, 20% had mild obstruction, and 7% exhibited a hyperreactive airway pattern. Spirometry parameters did not significantly differ between the fibrosis and non-fibrosis groups.
Conclusion: Most patients who survived severe COVID-19 infection showed significant improvement in one-year follow-up chest CT scans, and their PFT was not severely impaired. Importantly, our findings indicate no association between the severity of initial lung involvement, medication use, and follow-up chest CT results. This lack of association provides reassurance and confidence in the management of severe COVID-19 cases, suggesting that the long-term pulmonary effects may not be as dire as previously thought. We hope these findings will instill confidence in the medical community and provide reassurance to patients and their families.
Methods: A cohort study was conducted, assessing spirometry and chest CT scans in patients with severe COVID-19 admitted to the ICU. Patients with pre-existing lung disease were excluded. Initial laboratory tests, clinical information, and medication (antivirals and corticosteroids) were reported in patients with and without fibrosis on chest CTs.
Results: Thirty patients (57% female) with a mean (SD) age of 50 (13.5) years were included. Initial pulmonary involvement had a mean score of 16 (4), with ground-glass opacification (GGO) observed in all patients, consolidation in 88%, and pneumomediastinum in 10% of patients. One-year chest CT scans revealed mild fibrotic changes in 70% of patients, presenting as a fibrotic band (47%) or a fibrotic band with GGO (23%). Patients with fibrosis had lower serum albumin levels, lower platelet counts, and were older. One-year follow-up spirometry showed that 73% had normal results, 20% had mild obstruction, and 7% exhibited a hyperreactive airway pattern. Spirometry parameters did not significantly differ between the fibrosis and non-fibrosis groups.
Conclusion: Most patients who survived severe COVID-19 infection showed significant improvement in one-year follow-up chest CT scans, and their PFT was not severely impaired. Importantly, our findings indicate no association between the severity of initial lung involvement, medication use, and follow-up chest CT results. This lack of association provides reassurance and confidence in the management of severe COVID-19 cases, suggesting that the long-term pulmonary effects may not be as dire as previously thought. We hope these findings will instill confidence in the medical community and provide reassurance to patients and their families.
Type of Article: Original article |
Subject:
General medicine
Received: 2023/12/28 | Accepted: 2024/06/10 | Published: 2024/09/22
Received: 2023/12/28 | Accepted: 2024/06/10 | Published: 2024/09/22
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