AUTHOR=Cocconcelli Elisabetta , Bernardinello Nicol , Giraudo Chiara , Castelli Gioele , Giorgino Adelaide , Leoni Davide , Petrarulo Simone , Ferrari Anna , Saetta Marina , Cattelan Annamaria , Spagnolo Paolo , Balestro Elisabetta 

TITLE=Characteristics and Prognostic Factors of Pulmonary Fibrosis After COVID-19 Pneumonia

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.823600

DOI=10.3389/fmed.2021.823600

ISSN=2296-858X

ABSTRACT=<sec><title>Background</title><p>Few is known about the long-term pulmonary sequelae after COVID-19 infection. Hence, the aim of this study is to characterize patients with persisting pulmonary sequelae at follow-up after hospitalization. We also aimed to explore clinical and radiological predictors of pulmonary fibrosis following COVID-19.</p></sec><sec><title>Methods</title><p>Two hundred and 20 consecutive patients were evaluated at 3–6 months after discharge with high-resolution computed tomography (HRCT) and categorized as recovered (REC) or not recovered (NOT-REC). Both HRCTs at hospitalization (HRCT<sub>0</sub>), when available, and HRCT<sub>1</sub> during follow-up were analyzed semiquantitatively as follows: ground-glass opacities (alveolar score, AS), consolidations (CONS), and reticulations (interstitial score, IS).</p></sec><sec><title>Results</title><p>A total of 175/220 (80%) patients showed disease resolution at their initial radiological evaluation following discharge. NOT-REC patients (45/220; 20%) were mostly older men [66 (35–85) years vs. 56 (19–87); <italic>p</italic> = 0.03] with a longer in-hospital stay [16 (0–75) vs. 8 (1–52) days; <italic>p</italic> &lt; 0.0001], and lower P/F at admission [233 (40–424) vs. 318 (33–543); <italic>p</italic> = 0.04]. Moreover, NOT-REC patients presented, at hospital admission, higher ALV [14 (0.0–62.0) vs. 4.4 (0.0–44.0); <italic>p</italic> = 0.0005], CONS [1.9 (0.0–26.0) vs. 0.4 (0.0–18.0); <italic>p</italic> = 0.0064], and IS [11.5 (0.0– 29.0) vs. 0.0 (0.0–22.0); <italic>p</italic> &lt; 0.0001] compared to REC patients. On multivariate analysis, the presence of CONS and IS at HRCT<sub>0</sub> was independent predictors of radiological sequelae at follow-up [OR 14.87 (95% CI: 1.25–175.8; <italic>p</italic> = 0.03) and 28.9 (95% CI: 2.17–386.6; <italic>p</italic> = 0.01, respectively)].</p></sec><sec><title>Conclusions</title><p>In our population, only twenty percent of patients showed persistent lung abnormalities at 6 months after hospitalization for COVID-19 pneumonia. These patients are predominantly older men with longer hospital stay. The presence of reticulations and consolidation on HRCT at hospital admission predicts the persistence of radiological abnormalities during follow-up.</p></sec>