Radiological sequelae in patients with ARDS due to SARS-CoV-2 pneumonia

Abstract

Research Questions: To describe the prevalence of radiological sequelae, 1 year after admission, of patients with pneumonia and adult respiratory distress syndrome (ARDS) due to SARS-CoV-2 and avaluate their relationship with ventilatory support and/or corticosteroids (CC)

Material and methods: Observational study of patients with pneumonia and ARDS due to SARS-CoV-2 who required admission to the ICU/IRCU of Granollers Hospital between March and May 2020. We collect clinical and radiological data, the treatment received (ventilatory support and CC) and radiological features (thoracic CT) at 12 months

Results: Of a total of 109 admitted patients, 23 died during hospital stay. 78 patients were followed up. 69% were men; mean age 61 (±11) years. 49% required invasive ventilation (IV), 27% non-invasive positive pressure support (NIV), and 24% high-flow nasal cannula oxygen therapy (HFNC). 66% received CC therapy Of the 71 patients who were followed up at year, 31% presented normal radiology, 7% ground glass opacities, 53.5% reticulum and 8.5% fibrosis. In relation to residual/fibrotic sequelae, a higher proportion was observed in >60 years (73.9% vs 40%; p=0.005) and in patients who required IV, compared to NIV and HFNC (73.5% vs 61.9 vs 37.5%; p=0.05), with no significant differences in the use of CC (72.1% vs 55.6%; p=0.156) In the multivariate analysis, age (>60 years) and invasive ventilation were associated with the presence of pulmonary sequelae (OR 3.92 [95% CI 1.31-11.75]) and (OR 3.85 [95% CI 1.01-14.64])

Conclusions: 8.5% of patients presented pulmonary fibrosi at 1 year. Age (>60) years and invasive ventilation were related to a higher frequency of pulmonary radiological sequelae, regardless of administration of CC