M V Y Sawamura1, C G Y Verrastro2, E V M Ferreira3, A L P de Albuquerque4, S M Ribeiro5, R V Auad6, P C de Abreu Sperandio3, V C Souza3, M L Lima3, R A Prudente7, E T Franco7, A C Franco8, B G Baldi9, S E Tanni7. 1. Instituto de Radiologia, Hospital das Clínicas da Universidade de São Paulo (HCFMUSP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. 2. Radiology Division, Federal University of São Paulo, São Paulo, SP, Brazil. 3. Pulmonology Division, Paulista Medical School, Federal University of São Paulo, São Paulo, SP, Brazil. 4. Divisão de Pneumologia, Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil, Pulmonology of Internal Medicine of Botucatu Medical School, São Paulo State University, Botucatu, São Paulo, SP, Brazil. 5. Radiology Department of Botucatu Medical School, São Paulo State University, Botucatu, São Paulo, SP, Brazil. 6. Radiology Division of Hospital Sírio Libanês and Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, SP, Brazil. 7. Pulmonology Division of Internal Medicine of Botucatu Medical School, São Paulo State University, Botucatu, São Paulo, SP, Brazil. 8. Pulmonology of Internal Medicine of Botucatu Medical School, São Paulo State University, Botucatu, São Paulo, SP, Brazil. 9. Divisão de Pneumologia, Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Abstract
BACKGROUND: The prevalence of persistent respiratory symptoms tends to be low in patients with a longer recovery time after COVID-19. However, some patients may present persistent pulmonary abnormalities. OBJECTIVE: To evaluate the prevalence of tomographic abnormalities 90 days after symptom onset in patients with COVID-19 and compare two chest high-resolution computed tomography (HRCT) analysis techniques. METHODS: A multicentre study of patients hospitalised with COVID-19 having oxygen saturation <93% on room air at hospital admission were evaluated using pulmonary function and HRCT scans 90 days after symptom onset. The images were evaluated by two thoracic radiologists, and were assessed using software that automatically quantified the extent of pulmonary abnormalities. RESULTS: Of the 91 patients included, 81% had at least one pulmonary lobe with abnormalities 90 days after discharge (84% were identified using the automated algorithm). Ground-glass opacities (76%) and parenchymal bands (65%) were the predominant abnormalities. Both chest HRCT technical assessments presented high sensitivity (95.9%) and positive predictive value (92%), with a statistically significant correlation at baseline (R = 0.80) and after 90 days (R = 0.36). CONCLUSION: The prevalence of pulmonary abnormalities on chest HRCT 90 days after symptom onset due to COVID-19 was high; both technical assessments can be used to analyse the images.
BACKGROUND: The prevalence of persistent respiratory symptoms tends to be low in patients with a longer recovery time after COVID-19. However, some patients may present persistent pulmonary abnormalities. OBJECTIVE: To evaluate the prevalence of tomographic abnormalities 90 days after symptom onset in patients with COVID-19 and compare two chest high-resolution computed tomography (HRCT) analysis techniques. METHODS: A multicentre study of patients hospitalised with COVID-19 having oxygen saturation <93% on room air at hospital admission were evaluated using pulmonary function and HRCT scans 90 days after symptom onset. The images were evaluated by two thoracic radiologists, and were assessed using software that automatically quantified the extent of pulmonary abnormalities. RESULTS: Of the 91 patients included, 81% had at least one pulmonary lobe with abnormalities 90 days after discharge (84% were identified using the automated algorithm). Ground-glass opacities (76%) and parenchymal bands (65%) were the predominant abnormalities. Both chest HRCT technical assessments presented high sensitivity (95.9%) and positive predictive value (92%), with a statistically significant correlation at baseline (R = 0.80) and after 90 days (R = 0.36). CONCLUSION: The prevalence of pulmonary abnormalities on chest HRCT 90 days after symptom onset due to COVID-19 was high; both technical assessments can be used to analyse the images.