The lingering manifestations of COVID-19 during and after convalescence: update on long-term pulmonary consequences of c
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CHEST RADIOLOGY
The lingering manifestations of COVID‑19 during and after convalescence: update on long‑term pulmonary consequences of coronavirus disease 2019 (COVID‑19) Brian Shaw1 · Mahyar Daskareh2 · Ali Gholamrezanezhad1 Received: 14 June 2020 / Accepted: 21 September 2020 © Italian Society of Medical Radiology 2020
Abstract The long-term sequelae of coronavirus disease 2019 (COVID-19) are still unknown. Lessons from past viral epidemics reveal that, after recovery, patients with viral pulmonary infections can suffer from irreversible pulmonary dysfunction and demonstrate residual imaging or functional abnormalities. Residual ground glass opacities, consolidations, reticular and linear opacities, residual crazy paving pattern, melted sugar sign, and parenchymal fibrotic bands are several features found in the late or remission stages of COVID-19. These radiologic findings have been observed weeks after symptom onset, even after hospital discharge, and they may or may not correlate with clinical manifestations. High-resolution CT may be indicated to establish new baselines and track changes in residual impairments. In our previous review, we observed significant pulmonary sequelae in some COVID-19 survivors at follow-up. In this update, we review the current literature on the clinical and radiologic manifestations of post-recovery COVID-19 toward the end of hospital admission and after discharge. Keywords COVID-19 · High-resolution CT · SARS-CoV-2 · Co-morbidities · Surveillance · Recovery
Introduction In December 2019, a severe respiratory illness outbreak appeared in Wuhan, China. The causative agent was identified as a novel coronavirus, later termed Severe Acute Respiratory Syndrome—Coronavirus—2 (SARS-CoV-2) by the World Health Organization (WHO). Infection by SARS-CoV-2, termed Coronavirus disease 2019 (COVID19), causes most commonly fever, cough, fatigue, and dyspnea [1–5]. In severe cases, COVID-19 results in severe acute respiratory syndrome, respiratory failure, and death. Multiple different extrapulmonary findings and manifestations have been also described in this disease. SARS-CoV-2 is a * Ali Gholamrezanezhad [email protected]
Brian Shaw [email protected]; [email protected]
Mahyar Daskareh [email protected] 1
Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
Independent Researcher, Tehran, Iran
2
highly contagious virus. Given the alarming number of cases and deaths, the WHO declared COVID-19 as a pandemic in early March 2020 [1]. Over the past several months, the risk factors, clinical manifestations, diagnosis, and management of COVID-19 have been investigated in numerous publications. Older age, male sex, diabetes mellitus, hypertension, and cardiovascular diseases are all associated with higher rates of respiratory failure, ICU admission, and mortality [2–4]. Although there is published literature describing the clinical and radiologic progression and course of COVID-19 throughout the hospital stay, there is a scar
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