Persisting radiological abnormalities following covid-19 are common and correlate with impaired Quality of Life

Abstract

The radiological trajectory of post-COVID-19 is uncertain. Ongoing convalescent respiratory symptoms are frequently reported. We present a prospective, observational, multicentre cohort study utilising multimodality imaging to describe the pulmonary sequalae of patients hospitalised with COVID-19 (ClinicalTrials.gov ID:NCT04403607). As part of a prospective multi-system imaging study (CISCO-19) in survivors of COVID-19, we performed convalescent CTPA and HRCT imaging, with serial blood biomarkers and patient-reported outcomes 28-60 days following hospital discharge. Compared to controls(n = 29), 88(56%) of the COVID-19 cohort (n = 159; mean age, 55 years; 43% female) had persisting radiological abnormalities; including ground-glass opacification (45%), reticulation (30%), or mixed pattern (19%). The majority(68%) had less than 20% persisting radiological abnormalities, with 67% demonstrating overall improvement compared to admission imaging. Older age, pre-morbid performance status, typical acute COVID-19 radiological features, markers of severe acute COVID-19, and convalescent ICAM-1 were associated with persisting abnormalities(all P<0.05). Patients with persisting abnormalities had lower physical activity levels and predicted maximal oxygen utilization (derived VO2)(both P<0.05). Higher percentage of abnormal lung was associated with lower patient-assessed quality of life (EQ-5D-5L) score(P=0.03). This study demonstrated that persistent radiological abnormalities post-COVID-19 were common at 28-60 days post-discharge from hospital, although the overall trajectory in majority is one of improvement. Persisting abnormalities are associated with health impairment.