Interstitial lung disease sequelae of COVID-19
Research type
Research Study
Full title
Interstitial lung disease sequelae of COVID-19
IRAS ID
302642
Contact name
Onn Min Kon
Contact email
Sponsor organisation
Imperial College Healthcare NHS Trust
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Research summary:
Long-term pulmonary sequelae of Coronavirus 2019 (COVID-19) remain unclear. Thus, we aimed to establish post-COVID-19 temporal changes in chest computed tomography (CT) features of pulmonary fibrosis and to investigate associations with respiratory symptoms and physiological parameters at 3 and 12 months' follow-up. Adult patients who attended our initial COVID-19 follow-up service and developed chest CT features of interstitial lung disease, in addition to cases identified using British Society of Thoracic Imaging codes, were evaluated retrospectively. Clinical data were gathered on respiratory symptoms and physiological parameters at baseline, 3 months, and 12 months. Corresponding chest CT scans were reviewed by two thoracic radiologists. Associations between CT features and functional correlates were estimated using random effects logistic or linear regression adjusted for age, sex and body mass index. In total, 58 patients were assessed. No changes in reticular pattern, honeycombing, traction bronchiectasis/bronchiolectasis index or pulmonary distortion were observed. Subpleural curvilinear lines were associated with lower odds of breathlessness over time. Parenchymal bands were not associated with breathlessness or impaired lung function overall. Based on our results, we conclude that post-COVID-19 chest CT features of irreversible pulmonary fibrosis remain static over time; other features either resolve or remain unchanged. Subpleural curvilinear lines do not correlate with breathlessness. Parenchymal bands are not functionally significant. An awareness of the different potential functional implications of post-COVID-19 chest CT changes is important in the assessment of patients who present with multi-systemic sequelae of COVID-19 infection.
COVID-19 infection may damage the lungs in different ways and has been seen to result in scarring of the lungs, known as interstitial lung disease (ILD). This can result in significant symptoms, including breathlessness, which may have a significant impact on a patient's quality of life. There is currently limited evidence regarding which patients who have had COVID-19 are at risk of developing ILD, how long their symptoms may last and what their blood tests, lung function test results and radiological scans may show. Understanding correlation between these factors and outcome at 12-months post infection will enable clinicians to tailor care and be able to explain to patients what to expect should they develop fibrotic changes on their scans. Understanding this will also have important implications for the way in which this group of patients are cared for in healthcare institutions both in the short-term and long-term. This study aims to address this research gap and area of important unmet clinical need. By developing an understanding of the clinical characteristics of patients who develop ILD after COVID-19, we aim to describe the clinical findings in these patients and identify how they should be optimally investigated and managed in an outpatient clinic setting.
REC name
South West - Cornwall & Plymouth Research Ethics Committee
REC reference
21/SW/0138
Date of REC Opinion
1 Nov 2021
REC opinion
Favourable Opinion