The characteristics and evolution of pulmonary fibrosis in COVID-19 patients as assessed by AI-assisted chest HRCT.

Journal: PloS one
Published Date:

Abstract

The characteristics and evolution of pulmonary fibrosis in patients with coronavirus disease 2019 (COVID-19) have not been adequately studied. AI-assisted chest high-resolution computed tomography (HRCT) was used to investigate the proportion of COVID-19 patients with pulmonary fibrosis, the relationship between the degree of fibrosis and the clinical classification of COVID-19, the characteristics of and risk factors for pulmonary fibrosis, and the evolution of pulmonary fibrosis after discharge. The incidence of pulmonary fibrosis in patients with severe or critical COVID-19 was significantly higher than that in patients with moderate COVID-19. There were significant differences in the degree of pulmonary inflammation and the extent of the affected area among patients with mild, moderate and severe pulmonary fibrosis. The IL-6 level in the acute stage and albumin level were independent risk factors for pulmonary fibrosis. Ground-glass opacities, linear opacities, interlobular septal thickening, reticulation, honeycombing, bronchiectasis and the extent of the affected area were significantly improved 30, 60 and 90 days after discharge compared with at discharge. The more severe the clinical classification of COVID-19, the more severe the residual pulmonary fibrosis was; however, in most patients, pulmonary fibrosis was improved or even resolved within 90 days after discharge.

Authors

  • Jia-Ni Zou
    Department of Radiology, General Hospital of Central Theater Command of the PLA, Wuhan, Hubei, P. R. China.
  • Liu Sun
    Department of Otolaryngology-Head and Neck Surgery, General Hospital of Central Theater Command of the PLA, Wuhan, Hubei, P. R. China.
  • Bin-Ru Wang
    Department of Otolaryngology-Head and Neck Surgery, Tongren Hospital of Wuhan University (Wuhan Third Hospital), Wuhan, Hubei, P. R. China.
  • You Zou
    Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, P. R. China.
  • Shan Xu
    Department of Intensive Care Unit, First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China.
  • Yong-Jun Ding
    Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, P. R. China.
  • Li-Jun Shen
    Eye Hospital of Wenzhou Medical University, Hangzhou, Zhejiang, China. slj20101119@163.com.
  • Wen-Cai Huang
    Department of Radiology, PLA Central Theater General Hospital of Chinese, Wuhan, China.
  • Xiao-Jing Jiang
    Department of Infectious Diseases, General Hospital of Central Theater Command of the PLA, Wuhan, Hubei, P. R. China.
  • Shi-Ming Chen
    Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, P. R. China.