Predictors of the appearance of radiological alterations at 12 months after COVID-19 pneumonia

Abstract

Background and objective

The radiological evolution after COVID-19 pneumonia is unknown. We propose to analyze the main radiological findings one year after COVID-19 pneumonia, as well as identify possible factors that may influence it.

Material and methods

Cohort study of patients with COVID-19 pneumonia undergoing high-resolution computed tomography (HRCT) 12 months after hospital discharge. A descriptive study of the radiological findings and a multivariate analysis are carried out to identify the factors of the appearance of radiological anomalies.

Results

n = 139 patients, with a mean age of 63 years and 66.2% male. The most frequent radiological findings were ground-glass opacities (59%), followed by bronchiectasis (42.4%), subpleural parenchymal bands (32.4%), atelectasis (13.7%), septal thickening (12.9%) and fibrotic tracts (9.4%). Male sex was associated with the presence of bronchiectasis (ORa = 3.55; p = 0.026), peak admission IL-6 levels > 133 ng/L with the detection of subpleural parenchymal bands (ORa = 3.58; p = 0.048) and obesity with the occurrence of atelectasis (ORa = 3.70; p = 0.014). Systemic corticotherapy during admission decreased the risk of fibrotic tracts (ORa = 0.02; p = 0.003).

Conclusions

Lung damage persists with high frequency one year after COVID-19 pneumonia. Male sex, high peak admission IL-6 levels and obesity were risk factors for radiological abnormalities while systemic corticosteroid therapy decreased the occurrence of fibrotic tracts 12 months after hospital admission.