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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| Language: | English |
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BMJ Publishing Group
2025-02-01
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| Series: | BMJ Open Respiratory Research |
| Online Access: | https://bmjopenrespres.bmj.com/content/12/1/e001985.full |
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| author | 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 |
| author_facet | 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 |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-da7eb873ba274c4e901b2a53f24b4ee4 |
| institution | Kabale University |
| issn | 2052-4439 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Respiratory Research |
| spelling | doaj-art-da7eb873ba274c4e901b2a53f24b4ee42025-02-11T08:15:10ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392025-02-0112110.1136/bmjresp-2023-001985Radiological abnormalities persist following COVID-19 and correlate with impaired health-related quality of life: a prospective cohort study of hospitalised patients 0Rhian M TouyzNinian N LangKevin G BlythNaveed SattarPatrick B MarkStefan SiebertColin Berry1Iain McInnesGiles Roditi2Neil BasuDavid CorcoranKenneth Mangion3Alex McConnachie4David CarrickJaclyn CarberryStuart WatkinsPaul WelshSabrina NordinKatherine ScottChristian DellesBernard KellyFraser GoldieJohn GF ClelandSharon KeanPeter KellmanDavid J LoweAndrew J Morrow5Antonia HoRosemary WoodwardTracey HopkinsRyan WereskiMassimo PalmariniAlasdair McIntosh6Campbell RogersAmmani BrownCatherine BagotKathryn Scott7Robert Sykes8Colin Church9Claire Rooney10Nicola RyanClare OrangeDirk HusmeierXiaoyu LuoPETER W MACFARLANEHeerajnarain BulluckIain FindlayEvonne McLennanMichael BriscoeOliver PeckAlastair J RankinGruschen VeldtmanVarun SharmaKathryn McLarenElaine ButlerSarah MullenAndrew MorrowPatrick MarkDaniel DohertyAlexander PayneJennifer S LeesKaitlin J MayneLouise InglisAnna KamdarHannah Bayes11Vivienne B GibsonLynsey GillespieDouglas GrievePauline Hall BarrientosChristopher McGinleyConnor MckeeSarah Allwood-SpiersSarah WeedenLaura KnoxLynn AbelDavid StoboAndrew DoughertyLiam Peng12David Barrie Stobo13Sylvia WrightStephen DobbinKeith GillisSarah A SpiersIan FergusKirsty FallonLesley GilmourChloe CowanJurgen Van-MelckebekeKim Moran-JonesDebra StuartMaureen TraversLaura DymockFiona SavageNicola TynanSau Lee ChangMhairi DupreLindsey NortonGeorge BruceRosario Gonzalez-LopezRebecca StaceDionne RussellJean WattShahid LatifNick HillAmy CollinsworthRoss McGeoch Vera LennieRobin P WeirKenya National Bureau of Statistics, Nairobi, Nairobi, KenyaBHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UKRadiology, Glasgow Royal Infirmary, Glasgow, UKUniversity of Glasgow, Glasgow, UKRobertson Centre for Biostatistics, School of Health and Wellbeing, University of Glasgow, Glasgow, UKUniversity of Glasgow, Glasgow, UKUniversity of Glasgow, Glasgow, UKDepartment of Respiratory Medicine, Glasgow Royal Infirmary Department of Pathological Biochemistry, Glasgow, UKUniversity of Glasgow, Glasgow, UKScottish Pulmonary Vascular Unit, Golden Jubilee Hospital, Clydebank, UKDepartment of Respiratory Medicine, NHS Greater Glasgow and Clyde Health Board, Glasgow, UKDepartment of Respiratory Medicine, Glasgow Royal Infirmary, Glasgow, UKDepartment of Radiology, NHS Greater Glasgow and Clyde Health Board, Glasgow, UKDepartment of Radiology, NHS Greater Glasgow and Clyde Health Board, Glasgow, UKBackground 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.https://bmjopenrespres.bmj.com/content/12/1/e001985.full |
| spellingShingle | 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 Radiological abnormalities persist following COVID-19 and correlate with impaired health-related quality of life: a prospective cohort study of hospitalised patients BMJ Open Respiratory Research |
| title | Radiological abnormalities persist following COVID-19 and correlate with impaired health-related quality of life: a prospective cohort study of hospitalised patients |
| title_full | Radiological abnormalities persist following COVID-19 and correlate with impaired health-related quality of life: a prospective cohort study of hospitalised patients |
| title_fullStr | Radiological abnormalities persist following COVID-19 and correlate with impaired health-related quality of life: a prospective cohort study of hospitalised patients |
| title_full_unstemmed | Radiological abnormalities persist following COVID-19 and correlate with impaired health-related quality of life: a prospective cohort study of hospitalised patients |
| title_short | Radiological abnormalities persist following COVID-19 and correlate with impaired health-related quality of life: a prospective cohort study of hospitalised patients |
| title_sort | radiological abnormalities persist following covid 19 and correlate with impaired health related quality of life a prospective cohort study of hospitalised patients |
| url | https://bmjopenrespres.bmj.com/content/12/1/e001985.full |
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