tetano
Editor, Senior Moderator
Respirology
. 2022 Jun 12.
doi: 10.1111/resp.14311. Online ahead of print.
One-year follow-up CT findings in COVID-19 patients: A systematic review and meta-analysis
Atsuyuki Watanabe[SUP] 1 [/SUP], Matsuo So[SUP] 2 [/SUP], Masao Iwagami[SUP] 3 [/SUP], Koichi Fukunaga[SUP] 4 [/SUP], Hisato Takagi[SUP] 5 [/SUP], Hiroki Kabata[SUP] 4 [/SUP], Toshiki Kuno[SUP] 6 [/SUP]
Affiliations
Abstract
Coronavirus disease 2019 (COVID-19) often causes radiological and functional pulmonary sequelae. However, evidence on 1-year follow-up of pulmonary sequelae is limited. We aimed to investigate the characteristics and time-course of pulmonary sequelae after recovery from COVID-19 through 1-year follow-up. We searched PubMed and EMBASE databases on 25 February 2022, and included studies with computed tomography (CT) findings at the 1-year follow-up. The extracted data on CT findings were analysed using a one-group meta-analysis. We further analysed the data in relation to COVID-19 severity, improvement rate and lung function. Fifteen eligible studies (N = 3134) were included. One year after COVID-19, 32.6% (95% CI 24.0-42.6, I[SUP]2[/SUP] = 92.9%) presented with residual CT abnormalities. Ground-glass opacity and fibrotic-like changes were frequently observed in 21.2% (95% CI 15.4-28.4, I[SUP]2[/SUP] = 86.7%) and 20.6% (95% CI 11.0-35.2, I[SUP]2[/SUP] = 91.9%), respectively. While the gradual recovery was seen on CT (52.9% [mid-term] vs. 32.6% [1 year]), the frequency of CT abnormalities was higher in the severe/critical cases than in the mild/moderate cases (37.7% vs. 20.7%). In particular, fibrotic changes showed little improvement between 4-7 months and 1 year after COVID-19. Pulmonary function tests at 1 year also showed the decline in diffusing capacity of the lung for carbon monoxide, especially in severe/critical cases. Our meta-analysis indicated that residual CT abnormalities were common in hospitalized COVID-19 patients 1 year after recovery, especially fibrotic changes in severe/critical cases. As these sequelae may last long, vigilant observations and longer follow-up periods are warranted.
Keywords: COVID-19; SARS-CoV-2; computed tomography; coronavirus disease; follow-up; pulmonary function test; sequelae.
. 2022 Jun 12.
doi: 10.1111/resp.14311. Online ahead of print.
One-year follow-up CT findings in COVID-19 patients: A systematic review and meta-analysis
Atsuyuki Watanabe[SUP] 1 [/SUP], Matsuo So[SUP] 2 [/SUP], Masao Iwagami[SUP] 3 [/SUP], Koichi Fukunaga[SUP] 4 [/SUP], Hisato Takagi[SUP] 5 [/SUP], Hiroki Kabata[SUP] 4 [/SUP], Toshiki Kuno[SUP] 6 [/SUP]
Affiliations
- PMID: 35694728
- DOI: 10.1111/resp.14311
Abstract
Coronavirus disease 2019 (COVID-19) often causes radiological and functional pulmonary sequelae. However, evidence on 1-year follow-up of pulmonary sequelae is limited. We aimed to investigate the characteristics and time-course of pulmonary sequelae after recovery from COVID-19 through 1-year follow-up. We searched PubMed and EMBASE databases on 25 February 2022, and included studies with computed tomography (CT) findings at the 1-year follow-up. The extracted data on CT findings were analysed using a one-group meta-analysis. We further analysed the data in relation to COVID-19 severity, improvement rate and lung function. Fifteen eligible studies (N = 3134) were included. One year after COVID-19, 32.6% (95% CI 24.0-42.6, I[SUP]2[/SUP] = 92.9%) presented with residual CT abnormalities. Ground-glass opacity and fibrotic-like changes were frequently observed in 21.2% (95% CI 15.4-28.4, I[SUP]2[/SUP] = 86.7%) and 20.6% (95% CI 11.0-35.2, I[SUP]2[/SUP] = 91.9%), respectively. While the gradual recovery was seen on CT (52.9% [mid-term] vs. 32.6% [1 year]), the frequency of CT abnormalities was higher in the severe/critical cases than in the mild/moderate cases (37.7% vs. 20.7%). In particular, fibrotic changes showed little improvement between 4-7 months and 1 year after COVID-19. Pulmonary function tests at 1 year also showed the decline in diffusing capacity of the lung for carbon monoxide, especially in severe/critical cases. Our meta-analysis indicated that residual CT abnormalities were common in hospitalized COVID-19 patients 1 year after recovery, especially fibrotic changes in severe/critical cases. As these sequelae may last long, vigilant observations and longer follow-up periods are warranted.
Keywords: COVID-19; SARS-CoV-2; computed tomography; coronavirus disease; follow-up; pulmonary function test; sequelae.