Fibrotic Changes Depicted by Thin-Section CT in Patients With COVID-19 at the Early Recovery Stage: Preliminary Experience.

Objectives: To analyze follow-up CTs of patients recovering from COVID-19 in Wuhan, focusing on fibrotic change and its relevant risk factors. Methods: From January 13 to February 27, 2020, 166 hospitalized patients meeting our criteria were included. The scores of fibrotic patterns on follow-up CT were evaluated. Patients were designated as group 1 (with CT evidence of fibrotic pattern) and group 2 (without CT evidence of fibrotic pattern). Multivariate logistic regression was performed to explore risk factors for fibrotic change in patients with COVID-19. Results: The follow-up CTs were obtained on 56 days (median, IQR 51-63 days) after symptom onset. Of the 166 patients (mean age, 57 ± 15 years; 69/166 male), 46% (76/166) had CT evidence of fibrotic change and 77% (127/166) were severe or critical cases. Among patients with fibrotic change on CT, 84% (64/76) got a minimal or mild score of fibrosis. The high total score on peak CT, peak eosinophils, erythrocyte sedimentation rate (ESR) and advancing age were related to lung fibrotic change in patients with COVID-19. Conclusion: Forty six percentages of patients (mainly severe or critical cases) with COVID-19 showed fibrotic change on follow-up CT at early recovery phase, while the extent of fibrosis was not large. The advancing age, high total score on peak CT, peak eosinophils and ESR were associated with fibrotic change depicted by CT in patients recovering from COVID-19. An extended follow up by CT imaging and pulmonary function testing is necessary to fully assess the sequela of COVID-19.

Clinical efficacy of Lianhua Qingwen integrated with Western medicine on COVID-19 by Meta-analysis

Objective: To systematically evaluate the efficacy of Lianhua Qingwen (LQC) on COVID-19, and provide evidence for the formulation and optimization of clinical therapy on COVID-19. Methods: Six databases (PubMed, Cochrane Library, Wanfang, Weipu, CBM and CNKI) were searched up to May 27, 2020. The Cochrane collaborative bias risk tool was used for risk evaluation and quality assessment;Meta-analysis was carried out by Stata 15 software. Begg's test was used for publication bias. Results: Seven clinical trials were included with 665 COVID-19 patients. Compared with Western medicine alone, integrated Lianhua Qingwen significantly improved the effective rate of clinical symptoms [RR = 1.24, 95% CI (1.12, 1.38), P < 0.05] of COVID-19, increased CT improvement [RR = 1.14, 95% CI (1.02, 1.28), P < 0.05] and reduced the proportion of progressing into sever clinical level [RR = 0.48, 95% CI (0.31, 0.72), P < 0.05];In addition, integrated Lianhua Qingwen could effectively shorten the duration of fever [SMD = -0.87, 95% CI (-1.22,-0.52), P < 0.05], time of clinical symptoms disappearance [SMD = -1.19, 95% CI (-1.56, -0.82), P < 0.05] and hospital stay [SMD = -0.61, 95% CI (-0.91, -0.30), P < 0.05]. Conclusion: Lianhua Qingwen could be used as adaptive and complementary medicine to improve clinical symptoms and CT for COVID-19.