P131 The degree of acute respiratory support with COVID-19 pneumonia, smoking status on admission and non-resolving CT features at three months- are there links?
Year: 2021
Type: conference-paper
Study design: Observational Study
Abstract: Introduction and Objectives BTS guidelines suggest radiological follow up at 12 weeks for patients with COVID-19 associated pneumonia. It is suggested development of post-covid fibrotic changes is more prevalent with severity of illness.1 We compared illness severity based on maximal respiratory support with non-resolving changes on CT imaging at >12 weeks. Smoking status at time of admission was also collected. Methods Retrospective analysis of COVID-19 patients surviving to follow up identified either by CVCX1 coded CXR or CVCX2 coded CXR and positive PCR between March 2020-January 2021. This identified 912 patients reviewed at 12 weeks with CXR ± CT imaging. 50/912 patients (5.5%) had evidence of either established fibrotic change or ongoing pneumonitis on CT. Imaging was reviewed by radiologist using suggested scoring system for Covid-19 follow-up 2 based on sum of 0–5 severity in 5 lobes (total 0–25) for markers of fibrosis/pneumonitis. Results Comparison is shown in table 1. All patients requiring more than 60% oxygen therapy received advanced respiratory support. 10/50 patients (20%) required no supplementary oxygen and 6/10 were not admitted to hospital. Comparison mean fibrosis score; IPPV-18.6, CPAP/HFNO-9.23, RA- 8.5. There were no current smokers in the follow-up cohort, 24 ex-smokers. Conclusions We noted significant risk for developing post-Covid pneumonic fibrotic changes even in clinically mild cases. With SpO2 at times of peak incidence being main indicator for CXR and/or admission we surmise there may be a significant unrecognized population without an initial CXR to prompt follow-up. It is not clear whether these patients will develop significant symptoms to prompt future investigations and what impact this might have. No patients developing ongoing CT changes were current smokers- a topic we suggest for further study and correlation. References McGroder CF, et al. Pulmonary fibrosis 4 months after COVID-19 is associated with severity of illness and blood leucocyte telomere length. Thorax29April 2021. doi:10.1136/thoraxjnl-2021-217031 Xiaoyu Han, et al. Six-month follow-up chest CT findings after severe COVID-19 pneumonia. Radiology 2021;299:1, E177–E186.
Authors: H Karimzadeh, R Penfold, U Nnajiuba, A Wight
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W3212737146