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RÉSUMÉ Introduction – Depuis le début de la pandémie Covid-19, la TDM thoracique a joué un rôle clé dans le diagnostic, l'évaluation pronostique et le suivi de la pneumonie virale à SARS-CoV-2. Données récentes – La persistance de lésions pulmonaires sur la TDM de suivi d'une pneumopathie à Covid-19 grave concerne environ 60 % des patients. L'aspect TDM à 6 mois peut varier d'une résolution radiologique complète à des lésions fibrosantes pouvant imiter des pathologies interstitielles connues. Conclusion – Cet article illustre, à partir des images TDM de la cohorte Recovery from Covid-19 ardS (RECOVIDS) les aspects caractéristiques observés au suivi à 6 mois d'une pneumopathie sévère à SARS-CoV-2. En s'appuyant sur la présence de fibrose et le profil lésionnel prédominant, les radiologues peuvent reconnaître et intégrer ces images dans le diagnostic différentiel d'autres pneumopathies de présentations cliniques et TDM proches. SUMMARY Introduction- Since the beginning of the COVID-19 pandemic, chest computed tomography (CT) has played a key role in the diagnosis, prognostic evaluation, and follow-up of severe SARS-COVD-2 viral pneumonia. Recent Findings- Approximately 60 % of patients with severe COVID-19 exhibit persistent lung lesions on follow-up chest CT. The chest CT appearance at 6-month follow-up can range from complete resolution to severe fibrotic changes that may mimic known interstitial lung diseases. Conclusion- This article illustrates the typical appearance at 6-month using Chest-CT images from the "Recovery from COVID-19 ARDS” (RECOVIDS) cohort. An approach based on the presence of fibrosis and the predominant pattern will enable radiologists to recognize and incorporate these aspects into the differential diagnosis of other interstitial lung diseases that may present with similar clinical and CT features.
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INTRODUCTION: Prognosis of patients with COVID-19 depends on the severity of the pulmonary affection. The most severe cases may progress to acute respiratory distress syndrome (ARDS), which is associated with a risk of long-term repercussions on respiratory function and neuromuscular outcomes. The functional repercussions of severe forms of COVID-19 may have a major impact on quality of life, and impair the ability to return to work or exercise. Social inequalities in healthcare may influence prognosis, with socially vulnerable individuals more likely to develop severe forms of disease. We describe here the protocol for a prospective, multicentre study that aims to investigate the influence of social vulnerability on functional recovery in patients who were hospitalised in intensive care for ARDS caused by COVID-19. This study will also include an embedded qualitative study that aims to describe facilitators and barriers to compliance with rehabilitation, describe patients' health practices and identify social representations of health, disease and care. METHODS AND ANALYSIS: The "Functional Recovery From Acute Respiratory Distress Syndrome (ARDS) Due to COVID-19: Influence of Socio-Economic Status" (RECOVIDS) study is a mixed-methods, observational, multicentre cohort study performed during the routine follow-up of post-intensive care unit (ICU) functional recovery after ARDS. All patients admitted to a participating ICU for PCR-proven SARS-CoV-2 infection and who underwent chest CT scan at the initial phase AND who received respiratory support (mechanical or not) or high-flow nasal oxygen, AND had ARDS diagnosed by the Berlin criteria will be eligible. The primary outcome is the presence of lung sequelae at 6 months after ICU discharge, defined either by alterations on pulmonary function tests, oxygen desaturation during a standardised 6 min walk test or fibrosis-like pulmonary findings on chest CT. Patients will be considered to be socially disadvantaged if they have an "Evaluation de la Précarité et des Inégalités de santé dans les Centres d'Examen de Santé" (EPICES) score ≥30.17 at inclusion. ETHICS AND DISSEMINATION: The study protocol and the informed consent form were approved by an independent ethics committee (Comité de Protection des Personnes Sud Méditerranée II) on 10 July 2020 (2020-A02014-35). All patients will provide informed consent before participation. Findings will be published in peer-reviewed journals and presented at national and international congresses. TRIAL REGISTRATION NUMBER: NCT04556513.