Evolution of lung function and chest CT 6 months after COVID-19 pneumonia: Real-life data from a Belgian University Hospital. (June 2021)

• Record Type: Journal Article
• Authors: Stylemans, Dimitri; Smet, Jelle; Hanon, Shane; Schuermans, Daniël; Ilsen, Bart; Vandemeulebroucke, Jef; Vanderhelst, Eef; Verbanck, Sylvia
• Is Part Of: Respiratory medicine. Volume 182(2021)
• Publication Date: 2021-06
• Subjects: Post COVID-19 -- Pulmonary function testing -- Chest CT -- LCI; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2021.106421
• Languages: English
• ISSNs: 0954-6111

Abstract

Abstract: Introduction: Most post COVID-19 follow-up studies are limited to a follow-up of 3 months. Whether a favorable evolution in lung function and/or radiological abnormalities is to be expected beyond 3 months is uncertain. Materials and methods: We conducted a real-life follow-up study assessing the evolution in lung function, chest CT and ventilation distribution between 10 weeks and 6 months after diagnosis of COVID-19 pneumonia. Results: Seventy-nine patients were assessed at 6 months of whom 63 had chest CT at both follow-up visits and 46 had multiple breath washout testing to obtain lung clearance index (LCI). The study group was divided into a restrictive (n = 39) and a non-restrictive subgroup (n = 40) based on TLC z-score. Restriction was associated with a history of intubation, neuromuscular blockade use and critical illness polyneuropathy. Restriction significantly improved over time, but was not resolved by 6 months (median TLC z-score of −2.2 [IQR: −2.7; −1.5] at 6 months versus −2.7 [IQR: −3.1; −2.1] at 10 weeks). LCI did not evolve between both follow-up visits. Symptoms and chest CT score improved irrespective of restriction. Conclusion: We observed a disconnect between the improvement of COVID-19 related symptoms, chest CT lesions, and corresponding lung function. While CT imaging is almost normalized at 6 months, a further reduction of pulmonary restriction may be hoped for beyond 6 months in those patients showing restriction at their first follow-up visit. Highlights: Chest CT and lung function improve between 10 weeks and 6 months after COVID-19. Improvements in chest CT and lung function after COVID-19 are disconnected. Restriction persists at 6 months when present at 10 weeks after COVID-19. Ventilation distribution remains unaltered during recovery from COVID-19.