Most patients improved their clinical condition, pulmonary function, exercise capacity and quality of life one year after discharge. Nonetheless, pulmonary fibrotic-like changes were observed during the follow-ups.
In this study, we analysed the respiratory consequences of COVID-19 in patients hospitalized because of pneumonia who required NIRT [non-invasive respiratory therapy]. In our cohort, dyspnoea, quality of life, pulmonary function, and exercise capacity improved between the 3- and 12-month visits. However, HRCT scans showed that the percentage of patients with fibrotic-like changes increased six and 12 months after discharge with respect to the initial evaluation at the 3-month follow-up. The high percentage of fibrotic-like changes observed in our study, compared to a previous meta-analysis could be explained by the fact that all patients included suffered a respiratory failure requiring NIRT and that severity has been clearly associated with fibrotic-like changes in COVID-19 patients.
We report a case series of patients presenting with undiagnosed pulmonary fibrosis as a primary manifestation. On evaluation, after excluding other causes, the fibrosis was attributed to asymptomatic or mild COVID illness in the past.
“Despite apparent virological remission, lung pathology was similar to that observed in acute COVID-19 individuals, including micro- and macro-vascular thrombosis (67% of cases), vasculitis (24%), squamous metaplasia of the respiratory epithelium (30%), frequent cytological abnormalities and syncytia (67%), and the presence of dysmorphic features in the bronchial cartilage (44%).”