Long-term pulmonary assessment in Iranian severe COVID-۱۹ ICU survivors in ۲۰۲۰-۲۰۲۱: A Cohort Study

Background: Severe coronavirus infections may lead to long-term effects, such as persistent lung dysfunction and residual involvement. This study aimed to evaluate pulmonary function tests (PFT) and chest computed tomography (CT) scans of severe COVID-۱۹ intensive care unit (ICU) survivors one year after discharge. Methods: A cohort study was conducted, assessing spirometry and chest CT scans in patients with severe COVID-۱۹ admitted to the ICU. Patients with pre-existing lung disease were excluded. Initial laboratory tests, clinical information, and medication (antivirals and corticosteroids) were reported in patients with and without fibrosis on chest CTs. Results: Thirty patients (۵۷% female) with a mean (SD) age of ۵۰ (۱۳.۵) years were included. Initial pulmonary involvement had a mean score of ۱۶ (±۴), with ground-glass opacification (GGO) observed in all patients, consolidation in ۸۸%, and pneumomediastinum in ۱۰% of patients. One-year chest CT scans revealed mild fibrotic changes in ۷۰% of patients, presenting as a fibrotic band (۴۷%) or a fibrotic band with GGO (۲۳%). Patients with fibrosis had lower serum albumin levels, lower platelet counts, and were older. One-year follow-up spirometry showed that ۷۳% had normal results, ۲۰% had mild obstruction, and ۷% exhibited a hyperreactive airway pattern. Spirometry parameters did not significantly differ between the fibrosis and non-fibrosis groups. Conclusion: Most patients who survived severe COVID-۱۹ infection showed significant improvement in one-year follow-up chest CT scans, and their PFT was not severely impaired. Importantly, our findings indicate no association between the severity of initial lung involvement, medication use, and follow-up chest CT results.

کلیدواژه ها:

COVID-۱۹ ، Intensive Care Units ، Pulmonary fibrosis ، X-Ray CT Scan