Residual Lung Abnormalities after COVID-19 Hospitalization Interim Analysis of the UKILD Post-COVID-19 Study

Stewart, Iain, Jacob, Joseph, George, Peter M, Molyneaux, Philip L, Porter, Joanna C, Allen, Richard J, Aslani, Shahab, Baillie, J Kenneth, Barratt, Shaney L, Beirne, Paul
et al (show 68 more authors) (2023) Residual Lung Abnormalities after COVID-19 Hospitalization Interim Analysis of the UKILD Post-COVID-19 Study. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 207 (6). pp. 693-703.

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<b>Rationale:</b> Shared symptoms and genetic architecture between coronavirus disease (COVID-19) and lung fibrosis suggest severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may lead to progressive lung damage. <b>Objectives:</b> The UK Interstitial Lung Disease Consortium (UKILD) post-COVID-19 study interim analysis was planned to estimate the prevalence of residual lung abnormalities in people hospitalized with COVID-19 on the basis of risk strata. <b>Methods:</b> The PHOSP-COVID-19 (Post-Hospitalization COVID-19) study was used to capture routine and research follow-up within 240 days from discharge. Thoracic computed tomography linked by PHOSP-COVID-19 identifiers was scored for the percentage of residual lung abnormalities (ground-glass opacities and reticulations). Risk factors in linked computed tomography were estimated with Bayesian binomial regression, and risk strata were generated. Numbers within strata were used to estimate posthospitalization prevalence using Bayesian binomial distributions. Sensitivity analysis was restricted to participants with protocol-driven research follow-up. <b>Measurements and Main Results:</b> The interim cohort comprised 3,700 people. Of 209 subjects with linked computed tomography (median, 119 d; interquartile range, 83-155), 166 people (79.4%) had more than 10% involvement of residual lung abnormalities. Risk factors included abnormal chest X-ray (risk ratio [RR], 1.21; 95% credible interval [CrI], 1.05-1.40), percent predicted Dl<sub>CO</sub> less than 80% (RR, 1.25; 95% CrI, 1.00-1.56), and severe admission requiring ventilation support (RR, 1.27; 95% CrI, 1.07-1.55). In the remaining 3,491 people, moderate to very high risk of residual lung abnormalities was classified at 7.8%, and posthospitalization prevalence was estimated at 8.5% (95% CrI, 7.6-9.5), rising to 11.7% (95% CrI, 10.3-13.1) in the sensitivity analysis. <b>Conclusions:</b> Residual lung abnormalities were estimated in up to 11% of people discharged after COVID-19-related hospitalization. Health services should monitor at-risk individuals to elucidate long-term functional implications.

Item Type: Article
Uncontrolled Keywords: COVID-19, hospitalization, HRCT, lung damage, lung abnormalities
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User: Symplectic Admin
Date Deposited: 23 Jan 2023 14:41
Last Modified: 14 Mar 2024 20:32
DOI: 10.1164/rccm.202203-0564OC
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