Presence and Evolution of Radiological Changes at 6 and 12 Months After COVID-19 Pneumonia and Their Risk Factors

<i>Background and Objectives</i>: The pulmonary sequelae of COVID-19 and their evolution are of interest to the scientific community. We aimed to determine the radiological changes at 6 and 12 months after COVID-19 pneumonia, its evolution and its risk factors. <i>Materials and Met...

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Main Authors: Celia Roig-Martí, Antonio Navarro-Ballester, María-Pilar Fernández-García, Ignacio Pérez-Catalán, Ana Segura-Fábrega, María Varea-Villanueva, Sofía Folgado-Escudero, Germán Herrero-Rodríguez, Elena Domínguez-Bajo, Sergio Fabra-Juana, María-José Esteve-Gimeno, María-Lidón Mateu-Campos, Jorge Usó-Blasco, José-Manuel Ramos-Rincón
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Language:English
Published: MDPI AG 2025-02-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/3/382
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author Celia Roig-Martí
Antonio Navarro-Ballester
María-Pilar Fernández-García
Ignacio Pérez-Catalán
Ana Segura-Fábrega
María Varea-Villanueva
Sofía Folgado-Escudero
Germán Herrero-Rodríguez
Elena Domínguez-Bajo
Sergio Fabra-Juana
María-José Esteve-Gimeno
María-Lidón Mateu-Campos
Jorge Usó-Blasco
José-Manuel Ramos-Rincón
author_facet Celia Roig-Martí
Antonio Navarro-Ballester
María-Pilar Fernández-García
Ignacio Pérez-Catalán
Ana Segura-Fábrega
María Varea-Villanueva
Sofía Folgado-Escudero
Germán Herrero-Rodríguez
Elena Domínguez-Bajo
Sergio Fabra-Juana
María-José Esteve-Gimeno
María-Lidón Mateu-Campos
Jorge Usó-Blasco
José-Manuel Ramos-Rincón
author_sort Celia Roig-Martí
collection DOAJ
description <i>Background and Objectives</i>: The pulmonary sequelae of COVID-19 and their evolution are of interest to the scientific community. We aimed to determine the radiological changes at 6 and 12 months after COVID-19 pneumonia, its evolution and its risk factors. <i>Materials and Methods</i>: This retrospective longitudinal study included adults admitted for COVID-19 pneumonia from 1 March 2020 to 30 April 2021 who had a high-resolution computed tomography (HRCT) scan at 6 months and 12 months after hospital discharge. The primary outcome was the appearance of radiological abnormalities on HRCT and the number of lung segments affected by them at 6 and 12 months, while the main explanatory variables were about the disease course, analytical parameters and treatment. <i>Results</i>: This study included n = 108 patients, with a mean age of 64 years. There was a decrease in the percentage of patients presenting parenchymal (93.5% to 88.9%, <i>p</i> < 0.001) and reticular (63% to 62%, <i>p</i> < 0.001) patterns on HRCT at 12 months compared to 6, and an increase in those presenting a fibrotic pattern (62% to 63.9%, <i>p</i> < 0.001). Ground-glass opacities were the most frequent radiological change at 6 and 12 months (91.7% and 87%, respectively). There was a significant reduction in the total number of lung segments with ground-glass opacities (445 to 382, <i>p</i> < 0.001) and consolidation (158 to 136, <i>p</i> = 0.019) and an increase in those with bronchiectasis (66 to 80, <i>p</i> = 0.033) between the two moments. After multivariate analysis, high-flow oxygen therapy (HFOT), highest ferritin levels, hypertension and ≥71 years showed an association with the development of subpleural parenchymal bands, consolidation, bronchiectasis and septal thickening at 6 and 12 months. <i>Conclusions</i>: Parenchymal patterns seem to be more frequent than reticular and fibrotic patterns after COVID-19 pneumonia. The fibrotic pattern was the only one that worsened significantly over time, with bronchiectasis being the only change that increased at 12 months. Older age, hypertension, the need for HFOT, and high levels of ferritin may be directly associated with worse radiological outcomes after COVID-19 pneumonia.
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spelling doaj-art-d53a4309f7694351b0689ebb6ee8a3d12025-08-20T03:43:10ZengMDPI AGMedicina1010-660X1648-91442025-02-0161338210.3390/medicina61030382Presence and Evolution of Radiological Changes at 6 and 12 Months After COVID-19 Pneumonia and Their Risk FactorsCelia Roig-Martí0Antonio Navarro-Ballester1María-Pilar Fernández-García2Ignacio Pérez-Catalán3Ana Segura-Fábrega4María Varea-Villanueva5Sofía Folgado-Escudero6Germán Herrero-Rodríguez7Elena Domínguez-Bajo8Sergio Fabra-Juana9María-José Esteve-Gimeno10María-Lidón Mateu-Campos11Jorge Usó-Blasco12José-Manuel Ramos-Rincón13Internal Medicine Department, Castellón General University Hospital, 12004 Castellón, SpainRadiology Department, Castellón General University Hospital, 12004 Castellón, SpainRadiology Department, Castellón General University Hospital, 12004 Castellón, SpainInternal Medicine Department, Castellón General University Hospital, 12004 Castellón, SpainInternal Medicine Department, Castellón General University Hospital, 12004 Castellón, SpainInternal Medicine Department, Castellón General University Hospital, 12004 Castellón, SpainInternal Medicine Department, Castellón General University Hospital, 12004 Castellón, SpainInternal Medicine Department, Castellón General University Hospital, 12004 Castellón, SpainInternal Medicine Department, Castellón General University Hospital, 12004 Castellón, SpainInternal Medicine Department, Castellón General University Hospital, 12004 Castellón, SpainInternal Medicine Department, Castellón General University Hospital, 12004 Castellón, SpainIntensive Care Unit, Castellón General University Hospital, 12004 Castellón, SpainInternal Medicine Department, Castellón General University Hospital, 12004 Castellón, SpainInternal Medicine Department, Alicante General University Hospital, 03010 Alicante, Spain<i>Background and Objectives</i>: The pulmonary sequelae of COVID-19 and their evolution are of interest to the scientific community. We aimed to determine the radiological changes at 6 and 12 months after COVID-19 pneumonia, its evolution and its risk factors. <i>Materials and Methods</i>: This retrospective longitudinal study included adults admitted for COVID-19 pneumonia from 1 March 2020 to 30 April 2021 who had a high-resolution computed tomography (HRCT) scan at 6 months and 12 months after hospital discharge. The primary outcome was the appearance of radiological abnormalities on HRCT and the number of lung segments affected by them at 6 and 12 months, while the main explanatory variables were about the disease course, analytical parameters and treatment. <i>Results</i>: This study included n = 108 patients, with a mean age of 64 years. There was a decrease in the percentage of patients presenting parenchymal (93.5% to 88.9%, <i>p</i> < 0.001) and reticular (63% to 62%, <i>p</i> < 0.001) patterns on HRCT at 12 months compared to 6, and an increase in those presenting a fibrotic pattern (62% to 63.9%, <i>p</i> < 0.001). Ground-glass opacities were the most frequent radiological change at 6 and 12 months (91.7% and 87%, respectively). There was a significant reduction in the total number of lung segments with ground-glass opacities (445 to 382, <i>p</i> < 0.001) and consolidation (158 to 136, <i>p</i> = 0.019) and an increase in those with bronchiectasis (66 to 80, <i>p</i> = 0.033) between the two moments. After multivariate analysis, high-flow oxygen therapy (HFOT), highest ferritin levels, hypertension and ≥71 years showed an association with the development of subpleural parenchymal bands, consolidation, bronchiectasis and septal thickening at 6 and 12 months. <i>Conclusions</i>: Parenchymal patterns seem to be more frequent than reticular and fibrotic patterns after COVID-19 pneumonia. The fibrotic pattern was the only one that worsened significantly over time, with bronchiectasis being the only change that increased at 12 months. Older age, hypertension, the need for HFOT, and high levels of ferritin may be directly associated with worse radiological outcomes after COVID-19 pneumonia.https://www.mdpi.com/1648-9144/61/3/382COVID-19tomographypulmonary fibrosisSARS-CoV-2pneumonia
spellingShingle Celia Roig-Martí
Antonio Navarro-Ballester
María-Pilar Fernández-García
Ignacio Pérez-Catalán
Ana Segura-Fábrega
María Varea-Villanueva
Sofía Folgado-Escudero
Germán Herrero-Rodríguez
Elena Domínguez-Bajo
Sergio Fabra-Juana
María-José Esteve-Gimeno
María-Lidón Mateu-Campos
Jorge Usó-Blasco
José-Manuel Ramos-Rincón
Presence and Evolution of Radiological Changes at 6 and 12 Months After COVID-19 Pneumonia and Their Risk Factors
Medicina
COVID-19
tomography
pulmonary fibrosis
SARS-CoV-2
pneumonia
title Presence and Evolution of Radiological Changes at 6 and 12 Months After COVID-19 Pneumonia and Their Risk Factors
title_full Presence and Evolution of Radiological Changes at 6 and 12 Months After COVID-19 Pneumonia and Their Risk Factors
title_fullStr Presence and Evolution of Radiological Changes at 6 and 12 Months After COVID-19 Pneumonia and Their Risk Factors
title_full_unstemmed Presence and Evolution of Radiological Changes at 6 and 12 Months After COVID-19 Pneumonia and Their Risk Factors
title_short Presence and Evolution of Radiological Changes at 6 and 12 Months After COVID-19 Pneumonia and Their Risk Factors
title_sort presence and evolution of radiological changes at 6 and 12 months after covid 19 pneumonia and their risk factors
topic COVID-19
tomography
pulmonary fibrosis
SARS-CoV-2
pneumonia
url https://www.mdpi.com/1648-9144/61/3/382
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