Post-COVID-19 chest imaging evaluation: which patients should be prioritized for follow-up pulmonary assessment?

Aims: The current study evaluated the long-term lung abnormalities based on initial and follow-up chest computed tomography (CT) images of COVID-19 patient and investigates the possible factors associated with them.Materials and Methods: 124 hospitalized COVID-19 patients who received a follow-up chest CT scan in three hospitals in Tehran between February 20th and September 21th 2021, were included. Based on the presence of persistent lesions in the follow-up images, patients were divided into residual and non-residual groups and logistic regression analysis was performed to investigate the association between different disease characteristics and long-term lung abnormalities.Results: The most frequent abnormality in the initial imaging was ground-glass opacities which was observed in 95.3% of patients and residual lesions were observed in 39.8% of patients at the follow-up date. Patients in the residual group were generally older, more frequently suffered from hypertension and dyspnea and had lower oxygen saturation, lymphocyte count and lymphopenia were more prevalent among them. Moreover, patients in the residual group had higher initial lung involvement score and the presence of lymphadenopathy and consolidation were more frequent among them. After adjustment for age, gender and intervals between the two imaging, logistic regression results showed that hospitalization period, dyspnea, decreased oxygen saturation, decreased lymphocyte count, lymphopenia, consolidation, lymphadenopathy and high initial lung involvement were strongly associated with the presence of long-term abnormalities.Conclusion: The current study revealed multiple discrepancies between residual and non-residual groups which can be used to better identify the patients at risk of long-term COVID-19 lung complications.