Three and six months follow up chest CT findings after COVID-19 pneumonia

Introduction: Since its emergence in December 2019, coronavirus disease 2019 has impacted healthcare resources causing a global public threat. His long-term complications are still being evaluated and little is known about the longterm pulmonary sequelae. Method(s): We conducted a prospective observational study at the University Hospital of Gabes. Eighty-nine patients were included. Radiological evolution was assessed at 3 and 6 months from acute presentation by chest CT. Result(s): A total of 89 patients (52% women versus 48% men ;mean age 58 years +/- 13) were studied prospectively. The extension in the initial chest CT was severe to critical in 48%. They had repeat imaging after 3 months. Among those (88,5%) had persistent parenchymal changes residual ground-glass opacification (42%) or interstitial thickening (27%), and 23 (52%) patients developed post COVID-19 fibrosis with CT evidence of fibrotic-like changes : traction bronchiectasis (29%), parenchymal bands (32%), and honeycombing (2%). Six-month follow-up CT was performed in 27 patients and showed fibrotic-like changes in the lung in 30% : traction bronchiectasis (22%), parenchymal bands (26%). These persistent radiological abnormalities in the lung at 6 months were associated with an older age > 65 years (p = 0,03), longer hospital stays > 15 days (p=0,001), and higher initial chest CT score (p=0,026). Conclusion(s): Age, initial CT scan scoring and duration of hospital care were the main predictors of fibrosis-like changes at 6 months found in our study ;further research with prolonged follow-up is needed to provide a better understanding of outcomes for COVID-19 patients.

Respiratory function in patients post-infection by COVID19

Introduction: As the number of recovering COVID-19 patients increases worldwide, the persistence of symptoms and signs through the post-acute phase indicates an urgent need for prolonged follow-up care. Material(s) and Method(s): A retrospective cohort study was conducted in 38 COVID-19 confirmed cases who recovered and were discharged from the university hospital of Gabes. At the follow-up visit on day 90 after onset of symptoms, patients underwent an evaluation by spirometry and a six minute- walk- test. Result(s): There were 19 men and 19 women, with a mean age of 57+/-12 years. 2. Of all, 77,4% had non-severe pneumonia, and 22,6% had severe to critical pneumonia. Length of stay in hospital was 16.7 +/- 21 days. Persistent respiratory symptoms at 3 months were dyspnea (80%), hyperventilation syndrome (29%), and dry cough (23%). Abnormality in spirometry was observed in 28 (73%) cases, with (70%) of restrictive defect, and (5,4%) of obstructive defect. The most frequent abnormality was low FVC (26 patients(70%) followed by low FEV1 (10 patients (26%). We observed that those with reduced FVC had more frequently severe to critical pneumonia (56 vs 26%, p=0.046). The mean six-minute-walk distance was 533+/-57 meters. The severe pneumonia group tended to have a shorter mean 6- min walk 432 +/- 68 meters. Conclusion(s): Severe COVID-19 pneumonia patients had a higher rate of abnormal spirometry and reduced six - minute-walk-distance when compared to patients with mild symptoms and non-severe pneumonia. Long-term following up of patients after recovery from SAR-CoV-2 infection is essential, especially in severe pneumonia groups.

Incidence of dyspnea and hyperventilation syndrome after COVID-19

Introduction: Coronavirus disease 2019 (COVID-19) has caused an unprecedented pandemic with a high rate of morbidity and mortality worldwide. There are a considerable number of patients recovered from the initial disease who continue with various clinical manifestation. Method(s): A prospective study in 61 patients who were hospitalized for COVID-19 pneumonia and who were followed up one month after their release from the Gabes University Hospital. Patients demographics comorbid disorders, clinical findings were recorded. Result(s): A total of 61 patients (52% women versus 48% men ;mean age 58 years +/- 13) were studied prospectively. One month after discharge, fourty-seven patients (77 %) reported dyspnea, with mean mMRC dyspnea scale 1,43 (1-3). Fifteen patients (24,5%) had a Nijmegen questionnaire >=23/ 64 with mean score 31+/- 4,5 which suggests a positive diagnosis of HVS. Older patients (age > 65 years)and patients with cardiovascular comorbidities were more likely to report dyspnea(p= 0,040 and p=0,025 respectively). On the contrary, patients aged under 65 years and female patients were more likely to report HVS (p=0,032, p=008 respectively) We did not notice a correlation between initial symptom severity and residual symptoms. Conclusion(s): Emerging evidence is showing that many COVID-19 infected patients continue to long-lasting symptoms. We suggest that dyspnea may be linked to the age and comorbidities. In the other hand, physicians should be aware that HVS is a frequent manifestation of the post-COVID-19 period especially for young female, and may leads to chronic dyspnea.