Clinical symptoms and radiological sequels after SARS-CoV-2 pneumonia: A longitudinal study

Abstract

INTRODUCTION: The long-term effects of COVID-19 have been recognized as a significant public health issue, particularly for hospitalized patients who may experience persistent symptoms and lung complications. This study aimed to determine the prevalence of persistent clinical symptoms and determine the predictive factors of persistent CT scan abnormalities (PCA) after COVID-19 pneumonia. METHODS: This was a longitudinal cohort study of patients followed up after being hospitalized for confirmed SARS-CoV-2 pneumonia. Patients were assessed for persistent clinical symptoms at one month and for PCA at four months. A logistic regression model was employed to assess the relationship between PCA and explanatory variables. RESULTS: A total of 240 patients were included. The sex ratio was 1.75, with a mean age of 57.6(± 11.5) years. The median length of stay was 10 [7-15] days. Initial CT scans revealed severe impairment in 23%. After one month, 75.8% had at least one persistent symptom. Hyperventilation syndrome was diagnosed in 15.4% of patients. At four-month follow-up, CT scan showed that 65% of patients had PCA. Factors associated with PCA, included age (p=0.001), initial dyspnea (p=0.021), length of hospital stay (p=0.001), an initial CT Severity Score (CTSS)≥ 50 (p=0.047), a low FEV1 (p=0.022), a low Total Lung capacity (TLC) (p=0.035) and impairment in DLCO (p=0.012). Logistic regression identified older age (OR=1.05 [1.02;1.08], p= 0.01), longer hospital stay (OR=1.12 [1.04;1.21], p= 0.003), and dyspnea (OR=3.11 [1.28;7.52],p= 0.012) as independent predictive factors of PCA. CONCLUSION: clinical and radiological long-term sequelae of COVID-19 are frequent, particularly in older patients, those with dyspnea, or with extended hospital stays.