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J Thorac Dis . Development of prognostic models to estimate the probability of lung injury one year after COVID-19-related hospitalization-a prospe

tetano

Editor, Senior Moderator
J Thorac Dis


. 2023 Jun 30;15(6):2971-2983.
doi: 10.21037/jtd-22-1565. Epub 2023 Apr 26. Development of prognostic models to estimate the probability of lung injury one year after COVID-19-related hospitalization-a prospective study

Ana Casal-Mouriño[SUP] 1 [/SUP], José Manuel Álvarez-Dobaño[SUP] 1 [/SUP], María Jesús Domínguez[SUP] 2 [/SUP], Francisco Gude[SUP] 3 [/SUP], María E Toubes[SUP] 1 [/SUP], Óscar Lado-Baleato[SUP] 4 5 [/SUP], Anxo Martínez de Alegría[SUP] 6 [/SUP], Manuel Taboada[SUP] 7 [/SUP], Vanessa Riveiro[SUP] 1 [/SUP], Nuria Rodríguez-Núñez[SUP] 1 [/SUP], Adriana Lama[SUP] 1 [/SUP], Lucía Ferreiro[SUP] 1 [/SUP], Borja Otero[SUP] 8 [/SUP], Juan Suárez-Antelo[SUP] 1 [/SUP], Antonio Pose[SUP] #[/SUP][SUP] 2 4 8 [/SUP], Luis Valdés[SUP] #[/SUP][SUP] 1 4 9 [/SUP]



Affiliations
Abstract

Background: Long-term effects of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection still under study. The objectives of this study were to identify persistent pulmonary lesions 1 year after coronavirus disease 2019 (COVID-19) hospitalization and assess whether it is possible to estimate the probability that a patient develops these complications in the future.
Methods: A prospective study of ≥18 years old patients hospitalized for SARS-COV-2 infection who develop persistent respiratory symptoms, lung function abnormalities or have radiological findings 6-8 weeks after hospital discharge. Logistic regression models were used to identify prognostic factors associated with a higher risk of developing respiratory problems. Models performance was assessed in terms of calibration and discrimination.
Results: A total of 233 patients [median age 66 years [interquartile range (IQR): 56, 74]; 138 (59.2%) male] were categorized into two groups based on whether they stayed in the critical care unit (79 cases) or not (154). At the end of follow-up, 179 patients (76.8%) developed persistent respiratory symptoms, and 22 patients (9.4%) showed radiological fibrotic lesions with pulmonary function abnormalities (post-COVID-19 fibrotic pulmonary lesions). Our prognostic models created to predict persistent respiratory symptoms [post-COVID-19 functional status at initial visit (the higher the score, the higher the risk), and history of bronchial asthma] and post-COVID-19 fibrotic pulmonary lesions [female; FVC% (the higher the FVC%, the lower the probability); and critical care unit stay] one year after infection showed good (AUC 0.857; 95% CI: 0.799-0.915) and excellent performance (AUC 0.901; 95% CI: 0.837-0.964), respectively.
Conclusions: Constructed models show good performance in identifying patients at risk of developing lung injury one year after COVID-19-related hospitalization.

Keywords: Post-acute coronavirus disease 2019 syndrome (post-acute COVID-19 syndrome); clinical prediction models; fibrotic pulmonary lesions; radiological findings; respiratory functional test; respiratory symptoms.

 
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