Interstitial Lung Fibrosis Following COVID-19 Pneumonia

• Published in: Diagnostics (Basel) Vol. 12; no. 8; p. 2028
• Main Authors: Lazar, Mihai, Barbu, Ecaterina Constanta, Chitu, Cristina Emilia, Tiliscan, Catalin, Stratan, Laurentiu, Arama, Sorin Stefan, Arama, Victoria, Ion, Daniela Adriana
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 22.08.2022; MDPI
• Subjects: Bacterial pneumonia; Complications and side effects; Coronaviruses; COVID-19; Cysts; Cytokines; Disease; fibrosis predictors; Infections; long COVID; Lung diseases, Interstitial; Medical imaging; Pandemics; Patients; Pneumonia; Pulmonary fibrosis; Quantitative analysis; Regression analysis; Risk factors; SARS-COV-2; Severe acute respiratory syndrome coronavirus 2; Software; Tomography; Tuberculosis; Variables; Romania; risk factors; long COVID; quantitative analysis; SARS-COV-2; fibrosis predictors; pulmonary fibrosis
• ISSN: 2075-4418; 2075-4418
• DOI: 10.3390/diagnostics12082028

Pulmonary fibrosis represents a stage of normal physiologic response to inflammatory aggression, mostly self-limiting and reversible; however, numerous patients treated for SARS-CoV-2 pneumonia present after release from hospital residual lung fibrosis. In this article, we aim to present an optimization method for evaluating pulmonary fibrosis by quantitative analysis, to identify the risk factors/predictors for pulmonary fibrosis in patients with SARS-CoV-2 infection, and to characterize the impact of pulmonary fibrosis on the symptomatology of patients after release from the hospital. We performed a prospective observational study on 100 patients with severe forms of pneumonia, with a control group of 61 non-COVID normal patients. We found persistent interstitial changes consistent with fibrotic changes in 69% of patients. The risk of fibrosis was proportional to the values of erythrocyte sedimentation rate (ESR), C reactive protein (CRP), and lactate dehydrogenase (LDH), and to the duration of hospitalization. The imaging parameters correlated with increased risk for interstitial fibrosis were the number of affected pulmonary lobes and the percent of interstitial pulmonary fibrosis. The main risk factors for pulmonary fibrosis post-COVID-19 identified in our study are increased ESR, CRP, LDH, duration of hospitalization and the severity of pneumonia.