Are there pulmonary sequelae in patients recovering from COVID-19?
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LETTER TO THE EDITOR
Are there pulmonary sequelae in patients recovering from COVID‑19? Paola Rogliani1,2* , Luigino Calzetta3, Angelo Coppola1, Ermanno Puxeddu1,2, Gianluigi Sergiacomi4, Dejanira D’Amato4 and Antonio Orlacchio5,6
Abstract It has been recently hypothesized that infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may lead to fibrotic sequelae in patients recovering from coronavirus disease 2019 (COVID-19). In this observational study, hospitalized patients with COVID-19 had a HRCT of the chest performed to detect the extension of fibrotic abnormalities via Hounsfield Units (HU). At follow-up, the lung density significantly improved in both lungs and in each lobe of all patients, being in the normal range (− 950 to − 700 HU). This study provides preliminary evidence that hospitalized patients with mild-to-moderate forms of COVID-19 are not at risk of developing pulmonary fibrosis. Keywords: COVID-19, Pulmonary fibrosis, HRCT Introduction Infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) leading to coronavirus disease 2019 (COVID-19) is characterized by non-specific symptoms. The disease presentation may range from lack of clinical signs in asymptomatic patients to severe interstitial pneumonia, acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) [1]. Moving from the evidence that infection by other respiratory coronaviruses is associated with significant post-viral lung fibrosis, it has been recently hypothesized that there could also be fibrotic consequences related with COVID-19 [1, 2]. In order to assess the real risk of developing postCOVID-19 pulmonary fibrosis, we have carried out an observational study in hospitalized COVID-19 patients with high-resolution computed tomography (HRCT) at hospital admission and follow-up.
*Correspondence: [email protected] 1 Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy Full list of author information is available at the end of the article
Materials and methods Study design
A high-quality, single-group, prospective, observational study was performed in agreement with the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) recommendations at the Unit of Respiratory Disease at the University Hospital “Tor Vergata” in Rome (Italy) [3]. The study was approved by the local ethics committee of University Hospital “Policlinico Tor Vergata", Rome, Italy (protocol no. 83/20, 2020). Selection of patients
All the COVID-19 patients hospitalized at the ward of “Respiratory Medicine” between March 16th 2020 and April 16th 2020 who underwent HRCT of the chest both at admission and at follow-up were consecutively included in the study. The severity of COVID-19 was ranked in agreement with arterial blood gas analysis findings, namely mild in the presence normal ratio of the partial pressure of oxygen to the inspired fraction of oxygen (P/F) or of mild hypoxemia, moderate for
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