Impact of pre-existing respiratory disease on radiological outcomes in COVID -19 pneumonia

ABSTRACT

Introduction: COVID-19 pneumonia usually presents as multifocal infiltrates or consolidation. The British Thoracic Society proposes a Chest X Ray based follow up. We looked at the radiological outcomes of patients admitted with COVID-19 pneumonia to our District General Hospital. Aim and Objectives: To investigate the radiological outcomes of COVID pneumonia and explore if pre-existing respiratory disease affected these outcomes Methods: A retrospective analysis of COVID 19 pneumonia patients admitted between 03/03/2020 & 22/03/2021 was performed. Study cohort identified using Radiology reporting software and clinical coding data. Information collected of repeat imaging, medical comorbidities and categorised as per Fleischer society glossary Results: 293 patients with follow up imaging were included with a mean age of 66.1 years, (17.1 to 99.8 years). Males 50.8% and females 49.2%. 106 (36%) patients had persistent lung opacities (PLO) including consolidation, ground glass opacification or residual changes, 25 (8%) had fibrotic changes and 15 (5%) had atelectasis. Of 106 patients with PLO, 38 (35%) patients had respiratory co-morbidities i.e., 6 emphysema, 14 COPD, 14 asthma, 2 bronchiectasis and 1 fibrosis. 147 (50%) patients who had complete resolution, out of these 30 (20%) patients had respiratory comorbidities i.e., 2 emphysema, 8 COPD, 18 asthma & 2 had bronchiectasis. Out of 25 patients with fibrotic changes 6 (24%) had respiratory co-morbidities. Conclusion(s) The prevalence of PLO in repeat imaging of COVID pneumonia patients in our centre was 36%, out of those 35% patients had pre-existing respiratory disease. COPD patients were at higher risk of having PLO compared to asthma patients.