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. 2022 May 5:2022:7919033.
doi: 10.1155/2022/7919033. eCollection 2022.

The Importance of Radiological Patterns and Small Airway Disease in Long-Term Follow-Up of Postacute COVID-19: A Preliminary Study

Roberto Mogami  1   2 , Ronaldo Carvalho Araújo Filho  1 , Carolina Gianella Cobo Chantong  1   3 , Fernando Carlos Santos de Almeida  1 , Ana Célia Baptista Koifman  1 , Gustavo Federico Jauregui  1 , Thiago Thomaz Mafort  4 , Hanna da Silva Bessa da Costa  1 , Glenda Aparecida Peres Dos Santos  1 , Bruna Zangerolame de Carvalho  1 , Gabriel da Silva Passos  1 , Erick de Souza Barbosa  1 , Angelo Thomaz Abalada Ghetti  4 , Laura Braga Monnerat  4 , Mariana Soares da Cal  4 , Desiree Louise Souza Santos Batista  1 , Helen Aksenow Affonso  1 , Gabriel Oliveira Bousquet  1 , Jose Ignacio Marenco Avila  1 , Anna Luiza Bento Dutra  1 , Caio Leal Leidersnaider  1 , Alexandre Malta da Costa Messeder  1 , Alexandra Monteiro  1   2   3 , Agnaldo José Lopes  2   4
Affiliations

The Importance of Radiological Patterns and Small Airway Disease in Long-Term Follow-Up of Postacute COVID-19: A Preliminary Study

Roberto Mogami et al. Radiol Res Pract. .

Abstract

Postacute COVID-19 has become a relevant public health problem, and radiological and pulmonary function tests are tools that help physicians in decision-making. The objectives of this study are to characterize the findings and patterns on a chest radiograph (CXR) and computed tomography (CT) that are most important in the postacute phase and to evaluate how these changes correlate with clinical data, spirometry, and impulse oscillometry (IOS). This was a retrospective study of 29 patients who underwent CXR, CT, spirometry, and IOS. The inclusion criteria were age >18 years and persistent respiratory symptoms after four weeks. The exclusion criteria were radiological exams with low technical quality and non-COVID-19 acute lung diseases. The inferential analysis was carried out with the chi-square (χ 2) or Fisher's exact test to evaluate the interrelationships between the clinical and COVID-19 variables according to spirometry, IOS, CT, and CXR. In our sample, 19 patients were women (65.5%). The predominance of abnormal spirometry was associated with CT's moderate/severe degree of involvement (p = 0.017; 69.2%, CI 95%: 44.1%-94.3%). There was no significant association between IOS and tomographic and radiographic parameters. A significant association was found between the classifications of the moderate/severe and normal/mild patterns on CT and CXRs (p = 0.003; 93.3%, CI 95%: 77.8%-100%). Patients with moderate/severe impairment on CXR were associated with a higher frequency of hospitalization (p = 0.033; 77.8%, CI 95%: 58.6%-97.0%) and had significantly more moderate/severe classifications in the acute phase than the subgroup with normal/mild impairment on CXR (p = 0.017; 88.9%, CI 95%: 74.4%-100%). In conclusion, the results of this study show that CXR is a relevant examination and may be used to detect nonspecific alterations during the follow-up of post-COVID-19 patients. Small airway disease is an important finding in postacute COVID-19 syndrome, and we postulate a connection between this pattern and the persistently low-level inflammatory state of the lung.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Posteroanterior CXR. Black lines demarcate the limits of the six zones.
Figure 2
Figure 2
Chest CT in a lung window. An axial section at the level of the lower lobes. Subpleural ground-glass opacities (arrows).
Figure 3
Figure 3
Chest CT in a lung window. Expiratory apnoea. An axial section at the level of the lower lobes highlights areas of air trapping (arrows).
Figure 4
Figure 4
Chest CT in a lung window. An axial section at the level of the lower lobes highlights parenchymal bands and bronchiectasis. Fibrosis-like lesions pattern.
Figure 5
Figure 5
Posteroanterior CXR. Multifocal bronchovascular lack of definition.
See this image and copyright information in PMC

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