Study assesses prevalence of residual lung abnormalities after COVID-19 hospitalization

In a new study published online at the American Thoracic Society American Journal of Respiratory and Critical Care Medicineresearchers sought to identify the proportion of COVID-19 patients discharged from hospital who had a form of fibrotic lung injury known as interstitial lung disease and who required ongoing follow-up care. These patients had varying degrees of COVID-19 severity on admission.

In “Residual Lung Abnormalities After COVID-19 Hospitalization: An Interim Analysis of the UKILD Long-Term COVID Study,” the authors examined evidence of abnormal lung patterns on follow-up CT scans of discharged COVID-19 patients. Suspected interstitial lung disease. Characteristics of his 209 study participants who had CT scans were applied to a wider posthospital cohort of approximately 3,500 people who did not have CT scans to stratify the risk of residual lung abnormalities.

“Interstitial lung disease” refers to a broad group of diseases characterized by scarring of the lungs, including idiopathic pulmonary fibrosis. This scar makes it difficult to breathe and prevents oxygen from getting into the bloodstream. Lung damage from this group of diseases is irreversible and can get worse over time.

Up to 11% of hospitalized COVID patients were estimated to have a fibrotic pattern after recovery from acute illness. Although many people experience prolonged shortness of breath, the main implication of these findings is that a significant number of people discharged from COVID hospitalizations may have fibrotic abnormalities in their lungs. These results should help focus efforts to closely follow at-risk patients. This follow-up should include repeat radiographic imaging and pulmonary function tests. ”

Iain Stewart, PhD, Corresponding Author, Senior Research Fellow (Rayne Foundation), Margaret Turner Warwick Center for Fibrosing Lung Disease, National Heart and Lung Institute, Imperial College London

“For some people, these fibrotic patterns may stabilize or resolve, but for others, they are associated with long-term progression of pulmonary fibrosis, reduced quality of life, and reduced life expectancy. Early detection of progression is essential for improving outcomes.”

The UK Interstitial Lung Disease (UKILD) study was conducted in collaboration with the PHOSP (post-hospital)-COVID study of researchers and clinicians across the UK to explore how patients who are hospitalized with COVID-19 to see if it differs from recovered. The UKILD COVID study excluded patients with PHOSP-COVID who had interstitial lung disease prior to COVID-related hospitalization.

Interim study participants were discharged by the end of March 2021, but interim data were collected until October 2021 and analyzes were restricted to 240 days after discharge. Researchers identified patients by chest CT from the PHOSP-COVID database. The primary outcome they sought to determine was the prevalence of residual lung abnormalities in people discharged from hospitalization with COVID-19. Analyzes were performed to determine participants’ risk factors for residual lung abnormalities in participants who did not undergo CT scans. These risks were used to estimate the prevalence in the total hospitalized population by the end of March 2021.

According to the authors, “The UKILD Post-COVID interim analysis of residual lung abnormalities in patients hospitalized with COVID-19 provides the largest assessment of prevalence in hospitalized individuals to date, demonstrating persistence.” Consistent with results from many small studies Radiological patterns and impaired gas movement during long-term follow-up of patients with COVID-19. It may represent early interstitial lung disease that may be present, or it may reflect pneumonia that may be stable or resolve over time.”

“The next phase of the study is the primary analysis, which will be performed in 12 months, at which point we will also use linked electronic health records of hospitalization and mortality data to support the analysis. Final Results We expect to have it in early 2023.”