A study of determinants of pulmonary fibrosis in covid-19 survivors

ABSTRACT

Background: COVID-19 pandemic has affected majorly the lungs besides many other organs. Many of the patients later developed pulmonary-fibrosis. This study was planned to know the determinants resulting in pulmonary-fibrosis in post COVID survivors. Methods: Hospital-based, cross-sectional study done over a period of one year. A pre-designed proforma used to collect necessary information and follow-up HRCT and other investigations were evaluated. Results: Out of 87 patients 41.3% (n=36) developed pulmonary fibrosis among which majority i.e., 66.6% (n=24) were males. Out of 87 patient 49.42% (n=43) belonged to the age group of 51-70 years among which 48.83% (n=21) developed fibrosis. Infection was more common in urban 63.2% (n=55), middle-class family 55.17% (n=48), non-smoker 65.51% (n=57), homemaker and office worker 49.4% (n=43). Out of 87 patients 57.47% (n=50) had different comorbidities out of which 52% (n=26) developed pulmonary fibrosis. The proportion of fibrosis among diabetic patients was 67.7% (n=21, p=0.036). A total of 27 patients were treated in ICU, out of which 66.67% (n=18) developed pulmonary fibrosis. About 57.14% (n=28) of the patient with leucocytosis developed pulmonary fibrosis. Pulmonary fibrosis developed more in which steroid are not used 9/19, 47% (n=9) compared to those where was steroid used 27/68, 39.7% (n=27). Majority of the patient i.e.,>90% fibrotic patient had raised inflammatory marker. Higher CT severity score and consolidation are predictive for post covid fibrosis Conclusion: Post-COVID-19 pulmonary-fibrosis was observed in about half of the survivors. This study emphasized the relation of pulmonary-fibrosis with many factors like age, comorbidities, ICU-admission, steroid usage, inflammatory-markers and secondary-infections.