Abstract
Objectives: To characterise chest CT abnormalities one year following severe-to-critical COVID-19 pneumonia, assess their functional significance and analyse the time-course of CT signs.
Methods: Retrospective observational monocentric study. Chest CT analysis of residual pulmonary opacities in patients having one year follow-up CT (between February 2021 and February 2022) after severe-to-critical COVID-19 pneumonia. Opacities were categorized into fibrotic-like and predominant ground-glass opacities and compared to pulmonary function tests. Sequential analysis of decreasing, stable or increasing signs at 3, 6, 12 and up to 24 months.
Results: One-year pulmonary opacities were present in 46 out of the 66 included patients, and were more frequent in patients admitted as compared to those not admitted to the intensive care unit (38/48, 79% versus 8/18, 44%, p=0.006), with an extent correlated to the length of ICU stay. Pulmonary function tests abnormalities were present in 24/29 patients (82.8%) having fibrotic-like residual opacities versus 6/13 patients (46.1%) having predominant ground-glass opacities (p=0.015). Bronchial distortions decreased in 29% of patients between 6 and 12 months, but CT abnormalities remained mostly stable thereafter in the 16 patients having follow-up CT up to 2 years.
Conclusion: One-year pulmonary opacities are more frequent in patients admitted to ICU as compared to non-ICU patients following severe-to-critical COVID-19 and seem related to the length of ICU stay. Fibrotic-like residual opacities are frequently associated to functional impairment.