Post-COVID-19 respiratory sequelae two years after hospitalization: an ambidirectional study (2024)
We evaluated the results in a transversal (18–24 months) and longitudinal (6–12 months vs 18–24 months) manner and found a persistent functional impairment with demonstrated restrictive pattern, as well as progressing CT abnormalities pointing to evolving fibrotic-like lesions and small airways involvement 18–24 months after hospital discharge…in our study, 20 (8%) of 237 patients with chest CT abnormalities in the 6-12-month follow-up, progressed to fibrotic lesions 18–24 months after hospital discharge.
This cohort study revealed that post-COVID-19 patients presenting persistent pulmonary involvement in previous follow-ups can evolve to late fibrosis-like lesions 18–24 months after hospital discharge.
“In the main and replication cohorts, individuals with SARS-CoV-2 infection had a higher adjusted hazard ratio (HR) for post-acute respiratory sequelae compared to the general population (main: HR, 1.68 [95% confidence interval (CI), 1.62–1.75]; replication: HR, 3.32 [95% CI, 3.27–3.37]) in Table 2. Furthermore, patients with SARS-CoV-2 infection had an increased risk for acute respiratory complication compared to non-infected controls (main: HR, 8.06 [95% CI, 6.92–9.38]; replication: HR, 4.17 [95% CI, 3.90–4.45]). When directly comparing the risk for acute respiratory complication between SARS-CoV-2 and influenza infections, SARS-CoV-2 infection was significantly associated with an increased risk (main: HR, 4.32 [95% CI, 2.73–6.83]; replication: HR, 6.51 [95% CI, 5.38–7.87])”
Long-term respiratory consequences of COVID-19 related pneumonia: a cohort study (2023)
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.
A silent march-Post covid fibrosis in asymptomatics – A cause for concern? (2023)
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.
Persistent SARS-CoV-2 infection in patients seemingly recovered from COVID-19 (2003)
“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%).”
