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Multidimensional 3-Month Follow-Up of Severe COVID-19: Airways beyond the Parenchyma in Symptomatic Patients.
Bonato, Matteo; Peditto, Piera; Landini, Nicholas; Fraccaro, Alessia; Catino, Cosimo; Cuzzola, Maria; Malacchini, Nicola; Savoia, Francesca; Roma, Nicola; Salasnich, Mauro; Turrin, Martina; Zampieri, Francesca; Zanardi, Giuseppe; Zeraj, Fabiola; Rattazzi, Marcello; Peta, Mario; Baraldo, Simonetta; Saetta, Marina; Fusaro, Michele; Morana, Giovanni; Romagnoli, Micaela.
  • Bonato M; Pulmonology Unit, Ca' Foncello Hospital, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Peditto P; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35122 Padova, Italy.
  • Landini N; Pulmonology Unit, Ca' Foncello Hospital, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Fraccaro A; Department of Radiology, Ca' Foncello Hospital, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Catino C; Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I Hospital, "Sapienza" Rome University, 00185 Rome, Italy.
  • Cuzzola M; Pulmonology Unit, Ca' Foncello Hospital, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Malacchini N; Pulmonology Unit, Ca' Foncello Hospital, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Savoia F; Pulmonology Unit, Ca' Foncello Hospital, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Roma N; Pulmonology Unit, Ca' Foncello Hospital, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Salasnich M; Pulmonology Unit, Ca' Foncello Hospital, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Turrin M; Department of Radiology, Ca' Foncello Hospital, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Zampieri F; Pulmonology Unit, Ca' Foncello Hospital, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Zanardi G; Pulmonology Unit, Ca' Foncello Hospital, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Zeraj F; Pulmonology Unit, Ca' Foncello Hospital, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Rattazzi M; Pulmonology Unit, Ca' Foncello Hospital, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Peta M; Pulmonology Unit, Ca' Foncello Hospital, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Baraldo S; Department of Internal Medicine, Ca' Foncello Hospital, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Saetta M; Department of Emergency, Anesthesiology, Intensive Care, Ca' Foncello Hospital, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Fusaro M; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35122 Padova, Italy.
  • Morana G; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35122 Padova, Italy.
  • Romagnoli M; Department of Radiology, Oderzo City Hospital, Azienda Unità Locale Socio-Sanitaria 2 Marca Trevigiana, 31046 Oderzo, Italy.
J Clin Med ; 11(14)2022 Jul 13.
Article in English | MEDLINE | ID: covidwho-1938853
ABSTRACT
SARS-CoV-2 may lead to a large spectrum of respiratory manifestations, including pulmonary sequelae. We conducted a single-center longitudinal study of survivors from severe COVID-19 cases who underwent a chest CT during hospitalization (CTH). Three months after being discharged, these patients were evaluated by a clinical examination, pulmonary function tests and a chest-CT scan (CTFU). Sixty-two patients were enrolled. At follow-up, 27% complained of exertional dyspnoea and 12% of cough. Dyspnoeic patients had a lower forced expiratory flow (FEF)25-75 (p = 0.015), while a CT scan (p = 0.016 showed that patients with cough had a higher extent of bronchiectasis. Lung volumes and diffusion of carbon monoxide (DLCO) at follow-up were lower in patients who had been invasively ventilated, which correlated inversely with the length of hospitalization and ground-glass extension at CTH. At follow-up, 14.5% of patients had a complete radiological resolution, while 85.5% presented persistence of ground-glass opacities, and 46.7% showed fibrotic-like alterations. Residual ground-glass at CTFU was related to the length of hospitalization (r = 0.48; p = 0.0002) and to the need for mechanical ventilation or high flow oxygen (p = 0.01) during the acute phase. In conclusion, although patients at three months from discharge showed functional impairment and radiological abnormalities, which correlated with a prolonged hospital stay and need for mechanical ventilation, the persistence of respiratory symptoms was related not to parenchymal but rather to airway sequelae.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Language: English Year: 2022 Document Type: Article Affiliation country: Jcm11144046

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Language: English Year: 2022 Document Type: Article Affiliation country: Jcm11144046