The Role of Pulmonary Function Testing and Lung Imaging in the Long-Term Follow-Up of Patients with COVID-19 Pneumonia.


Journal

Respiration; international review of thoracic diseases
ISSN: 1423-0356
Titre abrégé: Respiration
Pays: Switzerland
ID NLM: 0137356

Informations de publication

Date de publication:
2023
Historique:
received: 10 10 2022
accepted: 23 01 2023
medline: 13 4 2023
pubmed: 23 2 2023
entrez: 22 2 2023
Statut: ppublish

Résumé

Post-COVID-19 Interstitial Lung Disease (PC-ILD) is characterized by fibrotic-like signs at high-resolution computed tomography (HRCT) and pulmonary function tests (PFTs) abnormalities after SARS-CoV-2 infection. It is still not clear how frequent these tests should be performed to rule out long-term consequences of COVID-19 pneumonia. The aims of our study were to evaluate the incidence and risk factors of PC-ILD and possibly to propose a long-term follow-up program. One-hundred patients, hospitalized in our ward for moderate to critical COVID-19, underwent two follow-up visits at three and 15 months in which PFTs and HRCT were performed. At the 15-month follow-up, 8% of patients showed residual radiological and functional signs consistent with PC-ILD. All but one of these patients had already demonstrated PFTs and HRCT alterations at first follow-up visit, and the last 1 patient showed worsening of lung function during follow-up. These findings highlight the negative predictive value of PFTs at 3-month follow-up for the development of PC-ILD. Aging, severity of COVID-19, and degree of pulmonary involvement during acute infection proved to be significant risk factors for developing PC-ILD. Our study highlights the importance of PFTs in the long-term follow-up of patients affected by moderate to critical COVID-19 pneumonia. Further studies are needed to confirm our hypothesis that HRCT should be performed only in patients with PFTs abnormalities.

Sections du résumé

BACKGROUND
Post-COVID-19 Interstitial Lung Disease (PC-ILD) is characterized by fibrotic-like signs at high-resolution computed tomography (HRCT) and pulmonary function tests (PFTs) abnormalities after SARS-CoV-2 infection. It is still not clear how frequent these tests should be performed to rule out long-term consequences of COVID-19 pneumonia.
OBJECTIVES
The aims of our study were to evaluate the incidence and risk factors of PC-ILD and possibly to propose a long-term follow-up program.
METHOD
One-hundred patients, hospitalized in our ward for moderate to critical COVID-19, underwent two follow-up visits at three and 15 months in which PFTs and HRCT were performed.
RESULTS
At the 15-month follow-up, 8% of patients showed residual radiological and functional signs consistent with PC-ILD. All but one of these patients had already demonstrated PFTs and HRCT alterations at first follow-up visit, and the last 1 patient showed worsening of lung function during follow-up. These findings highlight the negative predictive value of PFTs at 3-month follow-up for the development of PC-ILD. Aging, severity of COVID-19, and degree of pulmonary involvement during acute infection proved to be significant risk factors for developing PC-ILD.
CONCLUSIONS
Our study highlights the importance of PFTs in the long-term follow-up of patients affected by moderate to critical COVID-19 pneumonia. Further studies are needed to confirm our hypothesis that HRCT should be performed only in patients with PFTs abnormalities.

Identifiants

pubmed: 36806049
pii: 000529441
doi: 10.1159/000529441
pmc: PMC9981778
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

287-295

Commentaires et corrections

Type : ErratumIn

Informations de copyright

© 2023 S. Karger AG, Basel.

Auteurs

Arianna Sanna (A)

Department of Public Health and Infectious Diseases, Sapienza University of Rome, Pulmonary Division, Policlinico Umberto I Hospital, Rome, Italy.

Daniela Pellegrino (D)

Department of Public Health and Infectious Diseases, Sapienza University of Rome, Pulmonary Division, Policlinico Umberto I Hospital, Rome, Italy.

Emanuele Messina (E)

Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy.

Leonardo Maria Siena (LM)

Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.

Valentina Baccolini (V)

Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.

Letizia D'Antoni (L)

Department of Public Health and Infectious Diseases, Sapienza University of Rome, Pulmonary Division, Policlinico Umberto I Hospital, Rome, Italy.

Nicholas Landini (N)

Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy.

Pia Baiocchi (P)

Department of Public Health and Infectious Diseases, Sapienza University of Rome, Pulmonary Division, Policlinico Umberto I Hospital, Rome, Italy.

Paolo Villari (P)

Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.

Carlo Catalano (C)

Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy.

Valeria Panebianco (V)

Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy.

Paolo Palange (P)

Department of Public Health and Infectious Diseases, Sapienza University of Rome, Pulmonary Division, Policlinico Umberto I Hospital, Rome, Italy.

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