Radiological abnormalities persist following COVID-19 and correlate with impaired health-related quality of life: a prospective cohort study of hospitalised patients

Radiological abnormalities persist following COVID-19 and correlate with impaired health-related quality of life: a prospective cohort study of hospitalised patients

Background The radiological trajectory of post-COVID-19 is uncertain. We present a prospective, observational, multicentre cohort study using multimodality imaging to describe the pulmonary sequelae of patients hospitalised with COVID-19, predictors of persistent abnormal radiology and implications...

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Main Authors: Rhian M Touyz, Ninian N Lang, Kevin G Blyth, Naveed Sattar, Patrick B Mark, Stefan Siebert, Colin Berry, Iain McInnes, Giles Roditi, Neil Basu, David Corcoran, Kenneth Mangion, Alex McConnachie, David Carrick, Jaclyn Carberry, Stuart Watkins, Paul Welsh, Sabrina Nordin, Katherine Scott, Christian Delles, Bernard Kelly, Fraser Goldie, John GF Cleland, Sharon Kean, Peter Kellman, David J Lowe, Andrew J Morrow, Antonia Ho, Rosemary Woodward, Tracey Hopkins, Ryan Wereski, Massimo Palmarini, Alasdair McIntosh, Campbell Rogers, Ammani Brown, Catherine Bagot, Kathryn Scott, Robert Sykes, Colin Church, Claire Rooney, Nicola Ryan, Clare Orange, Dirk Husmeier, Xiaoyu Luo, PETER W MACFARLANE, Heerajnarain Bulluck, Iain Findlay, Evonne McLennan, Michael Briscoe, Oliver Peck, Alastair J Rankin, Gruschen Veldtman, Varun Sharma, Kathryn McLaren, Elaine Butler, Sarah Mullen, Andrew Morrow, Patrick Mark, Daniel Doherty, Alexander Payne, Jennifer S Lees, Kaitlin J Mayne, Louise Inglis, Anna Kamdar, Hannah Bayes, Vivienne B Gibson, Lynsey Gillespie, Douglas Grieve, Pauline Hall Barrientos, Christopher McGinley, Connor Mckee, Sarah Allwood-Spiers, Sarah Weeden, Laura Knox, Lynn Abel, David Stobo, Andrew Dougherty, Liam Peng, David Barrie Stobo, Sylvia Wright, Stephen Dobbin, Keith Gillis, Sarah A Spiers, Ian Fergus, Kirsty Fallon, Lesley Gilmour, Chloe Cowan, Jurgen Van-Melckebeke, Kim Moran-Jones, Debra Stuart, Maureen Travers, Laura Dymock, Fiona Savage, Nicola Tynan, Sau Lee Chang, Mhairi Dupre, Lindsey Norton, George Bruce, Rosario Gonzalez-Lopez, Rebecca Stace, Dionne Russell, Jean Watt, Shahid Latif, Nick Hill, Amy Collinsworth, Ross McGeoch Vera Lennie, Robin P Weir
Format: Article
Language:English
Published: BMJ Publishing Group 2025-02-01
Series:BMJ Open Respiratory Research
Online Access:https://bmjopenrespres.bmj.com/content/12/1/e001985.full
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Summary:Background The radiological trajectory of post-COVID-19 is uncertain. We present a prospective, observational, multicentre cohort study using multimodality imaging to describe the pulmonary sequelae of patients hospitalised with COVID-19, predictors of persistent abnormal radiology and implications on health status.Methods In survivors of COVID-19, we performed convalescent CT pulmonary angiogram and high-resolution CT imaging as part of the CISCO-19 study (ClinicalTrials.gov ID NCT04403607). This included serial blood biomarkers and patient-reported outcomes 28–60 days following discharge from hospital.Results Of the COVID-19 cohort, 88 (56%) patients of the COVID-19 cohort (n = 159; mean age, 55 years; 43% female) had persisting radiological abnormalities at 28–60 days postdischarge. This included ground-glass opacification (45%), reticulation/architectural distortion (30%) or mixed pattern (19%). These features were very infrequent among a group of age-matched, sex-matched and cardiovascular risk factor-matched controls (n=29). The majority of COVID-19 cohort (68%) had less than 20% persisting radiological abnormalities, with 67% demonstrating overall improvement compared with admission imaging. Older age, premorbid performance status, typical acute COVID-19 radiological features, markers of severe acute COVID-19, convalescent ICAM-1 and P-selectin were associated with persisting lung abnormalities (all p<0.05). Patients with persisting abnormalities were shown to have lower levels of physical activity and predicted maximal oxygen utilisation (derived VO2) (both p<0.05). Higher percentage of abnormal lung parenchyma was associated with lower patient-assessed quality of life (EQ-5D-5L) score (p=0.03).Conclusions Persistent radiological abnormalities post-COVID-19 were common at 28–60 days postdischarge from hospital, although most improved. Patients with persisting radiological abnormalities 28–60 days postdischarge are at risk of persisting health impairment in the longer term and represent a population for targeted intervention.Trial registration number NCT04403607.
ISSN:2052-4439

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