Background

The chest CT manifestations of COVID-19 from hospitalization to convalescence after 1 year are unknown.

Purpose

To assess chest CT manifestations of COVID-19 up to 1 year after symptom onset.

Materials and Methods

Patients were enrolled if they were admitted to the hospital because of COVID-19 and underwent CT during hospitalization at two isolation centers between January 27, 2020, and March 31, 2020. In a prospective study, three serial chest CT scans were obtained at approximately 3, 7, and 12 months after symptom onset and were longitudinally analyzed. The total CT score of pulmonary lobe involvement, ranging from 0 to 25, was assessed (score of 1–5 for each lobe). Univariable and multivariable logistic regression analyses were performed to explore independent risk factors for residual CT abnormalities after 1 year.

Results

A total of 209 study participants (mean age, 49 years ± 13 [standard deviation]; 116 women) were evaluated. CT abnormalities had resolved in 61% of participants (128 of 209) at 3 months and in 75% of participants (156 of 209) at 12 months. Among participants with chest CT abnormalities that had not resolved, there were residual linear opacities in 25 of the 209 participants (12%) and multifocal reticular or cystic lesions in 28 of the 209 participants (13%). Age 50 years or older, lymphopenia, and severe or aggravation of acute respiratory distress syndrome were independent risk factors for residual CT abnormalities at 1 year (odds ratios = 15.9, 18.9, and 43.9, respectively; P < .001 for each comparison). In 53 participants with residual CT abnormalities at 12 months, reticular lesions (41 of 53 participants [77%]) and bronchial dilation (39 of 53 participants [74%]) were observed at discharge and were persistent in 28 (53%) and 24 (45%) of the 53 participants, respectively.

Conclusion

One year after COVID-19 diagnosis, chest CT scans showed abnormal findings in 53 of the 209 study participants (25%), with 28 of the 209 participants (13%) showing subpleural reticular or cystic lesions. Older participants with severe COVID-19 or acute respiratory distress syndrome were more likely to develop lung sequelae that persisted at 1 year.

© RSNA, 2021

Online supplemental material is available for this article.

See also the editorial by Lee and Wi et al in this issue.

中文翻译：

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COVID-19 患者从诊断到随访 1 年的胸部 CT 模式

背景

COVID-19从住院到康复1年后的胸部CT表现尚不清楚。

目的

评估症状出现后长达 1 年的 COVID-19 胸部 CT 表现。

材料和方法

如果患者因 COVID-19 入院并在 2020 年 1 月 27 日至 2020 年 3 月 31 日期间在两个隔离中心住院期间接受了 CT 扫描，则该患者被纳入研究。在一项前瞻性研究中，大约在大约在症状发作后 3、7 和 12 个月进行纵向分析。评估了肺叶受累的总 CT 评分，范围从 0 到 25（每个肺叶的评分为 1-5）。进行单变量和多变量逻辑回归分析以探索 1 年后残留 CT 异常的独立危险因素。

结果

共评估了 209 名研究参与者（平均年龄，49 岁 ± 13 [标准差]；116 名女性）。3 个月时，61% 的参与者（209 名中的 128 名）和 12 个月时 75% 的参与者（209 名中的 156 名）的 CT 异常得到了解决。在胸部 CT 异常未消退的参与者中，209 名参与者中有 25 名（12%）存在残留的线性阴影，209 名参与者中有 28 名（13%）存在多灶性网状或囊性病变。50 岁或以上、淋巴细胞减少、急性呼吸窘迫综合征严重或加重是 1 年残留 CT 异常的独立危险因素（优势比分别 = 15.9、18.9 和 43.9；P< .001 每次比较）。在 12 个月时有残留 CT 异常的 53 名参与者中，出院时观察到网状病变（53 名参与者中的 41 名 [77%]）和支气管扩张（53 名参与者中的 39 名 [74%]），并且在 28 名（53%）和53 名参与者中分别有 24 名（45%）。

结论

在 COVID-19 诊断一年后，209 名研究参与者中有 53 名（25%）的胸部 CT 扫描显示异常发现，209 名参与者中有 28 名（13%）显示胸膜下网状或囊性病变。患有严重 COVID-19 或急性呼吸窘迫综合征的老年参与者更有可能出现持续 1 年的肺部后遗症。

© 北美放射学会，2021

本文提供在线补充材料。

另见本期 Lee 和 Wi 等人的社论。