Short- and Long-Term Chest-CT Findings after Recovery from COVID-19: A Systematic Review and Meta-Analysis
While ground-glass opacity, consolidation, and fibrosis in the lungs are some of the hallmarks of acute SAR-CoV-2 infection, it remains unclear whether these pulmonary radiological findings would resolve after acute symptoms have subsided. We conducted a systematic review and meta-analysis to evalua...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-03-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/14/6/621 |
| _version_ | 1797241473921449984 |
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| author | Mustufa Babar Hasan Jamil Neil Mehta Ahmed Moutwakil Tim Q. Duong |
| author_facet | Mustufa Babar Hasan Jamil Neil Mehta Ahmed Moutwakil Tim Q. Duong |
| author_sort | Mustufa Babar |
| collection | DOAJ |
| description | While ground-glass opacity, consolidation, and fibrosis in the lungs are some of the hallmarks of acute SAR-CoV-2 infection, it remains unclear whether these pulmonary radiological findings would resolve after acute symptoms have subsided. We conducted a systematic review and meta-analysis to evaluate chest computed tomography (CT) abnormalities stratified by COVID-19 disease severity and multiple timepoints post-infection. PubMed/MEDLINE was searched for relevant articles until 23 May 2023. Studies with COVID-19-recovered patients and follow-up chest CT at least 12 months post-infection were included. CT findings were evaluated at short-term (1–6 months) and long-term (12–24 months) follow-ups and by disease severity (severe and non-severe). A generalized linear mixed-effects model with random effects was used to estimate event rates for CT findings. A total of 2517 studies were identified, of which 43 met the inclusion (N = 8858 patients). Fibrotic-like changes had the highest event rate at short-term (0.44 [0.3–0.59]) and long-term (0.38 [0.23–0.56]) follow-ups. A meta-regression showed that over time the event rates decreased for any abnormality (β = −0.137, <i>p</i> = 0.002), ground-glass opacities (β = −0.169, <i>p</i> < 0.001), increased for honeycombing (β = 0.075, <i>p</i> = 0.03), and did not change for fibrotic-like changes, bronchiectasis, reticulation, and interlobular septal thickening (<i>p</i> > 0.05 for all). The severe subgroup had significantly higher rates of any abnormalities (<i>p</i> < 0.001), bronchiectasis (<i>p</i> = 0.02), fibrotic-like changes (<i>p</i> = 0.03), and reticulation (<i>p</i> < 0.001) at long-term follow-ups when compared to the non-severe subgroup. In conclusion, significant CT abnormalities remained up to 2 years post-COVID-19, especially in patients with severe disease. Long-lasting pulmonary abnormalities post-SARS-CoV-2 infection signal a future public health concern, necessitating extended monitoring, rehabilitation, survivor support, vaccination, and ongoing research for targeted therapies. |
| first_indexed | 2024-04-24T18:23:54Z |
| format | Article |
| id | doaj.art-c75d97d57e044d748a11394808c8eecf |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-04-24T18:23:54Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-c75d97d57e044d748a11394808c8eecf2024-03-27T13:33:21ZengMDPI AGDiagnostics2075-44182024-03-0114662110.3390/diagnostics14060621Short- and Long-Term Chest-CT Findings after Recovery from COVID-19: A Systematic Review and Meta-AnalysisMustufa Babar0Hasan Jamil1Neil Mehta2Ahmed Moutwakil3Tim Q. Duong4Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USADivision of Surveillance and Policy Evaluation, National Cancer Center Institute for Cancer Control, Tokyo 104-0045, JapanDepartment of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USADepartment of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USADepartment of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USAWhile ground-glass opacity, consolidation, and fibrosis in the lungs are some of the hallmarks of acute SAR-CoV-2 infection, it remains unclear whether these pulmonary radiological findings would resolve after acute symptoms have subsided. We conducted a systematic review and meta-analysis to evaluate chest computed tomography (CT) abnormalities stratified by COVID-19 disease severity and multiple timepoints post-infection. PubMed/MEDLINE was searched for relevant articles until 23 May 2023. Studies with COVID-19-recovered patients and follow-up chest CT at least 12 months post-infection were included. CT findings were evaluated at short-term (1–6 months) and long-term (12–24 months) follow-ups and by disease severity (severe and non-severe). A generalized linear mixed-effects model with random effects was used to estimate event rates for CT findings. A total of 2517 studies were identified, of which 43 met the inclusion (N = 8858 patients). Fibrotic-like changes had the highest event rate at short-term (0.44 [0.3–0.59]) and long-term (0.38 [0.23–0.56]) follow-ups. A meta-regression showed that over time the event rates decreased for any abnormality (β = −0.137, <i>p</i> = 0.002), ground-glass opacities (β = −0.169, <i>p</i> < 0.001), increased for honeycombing (β = 0.075, <i>p</i> = 0.03), and did not change for fibrotic-like changes, bronchiectasis, reticulation, and interlobular septal thickening (<i>p</i> > 0.05 for all). The severe subgroup had significantly higher rates of any abnormalities (<i>p</i> < 0.001), bronchiectasis (<i>p</i> = 0.02), fibrotic-like changes (<i>p</i> = 0.03), and reticulation (<i>p</i> < 0.001) at long-term follow-ups when compared to the non-severe subgroup. In conclusion, significant CT abnormalities remained up to 2 years post-COVID-19, especially in patients with severe disease. Long-lasting pulmonary abnormalities post-SARS-CoV-2 infection signal a future public health concern, necessitating extended monitoring, rehabilitation, survivor support, vaccination, and ongoing research for targeted therapies.https://www.mdpi.com/2075-4418/14/6/621SARS-CoV-2long COVIDpost-acute COVID-19 syndrome (PASC)computed tomographypulmonary sequela |
| spellingShingle | Mustufa Babar Hasan Jamil Neil Mehta Ahmed Moutwakil Tim Q. Duong Short- and Long-Term Chest-CT Findings after Recovery from COVID-19: A Systematic Review and Meta-Analysis Diagnostics SARS-CoV-2 long COVID post-acute COVID-19 syndrome (PASC) computed tomography pulmonary sequela |
| title | Short- and Long-Term Chest-CT Findings after Recovery from COVID-19: A Systematic Review and Meta-Analysis |
| title_full | Short- and Long-Term Chest-CT Findings after Recovery from COVID-19: A Systematic Review and Meta-Analysis |
| title_fullStr | Short- and Long-Term Chest-CT Findings after Recovery from COVID-19: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Short- and Long-Term Chest-CT Findings after Recovery from COVID-19: A Systematic Review and Meta-Analysis |
| title_short | Short- and Long-Term Chest-CT Findings after Recovery from COVID-19: A Systematic Review and Meta-Analysis |
| title_sort | short and long term chest ct findings after recovery from covid 19 a systematic review and meta analysis |
| topic | SARS-CoV-2 long COVID post-acute COVID-19 syndrome (PASC) computed tomography pulmonary sequela |
| url | https://www.mdpi.com/2075-4418/14/6/621 |
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