PULMONARY FIBROSIS IN COVID-19 SURVIVORS -A MYTH: PROSPECTIVE ONE YEAR FOLLOW UP STUDY TO PROVE IT
Pulmonary Fibrosis in covid-19 survivors -A myth: Prospective one year follow up study to prove it. Background: Many uncertainties are prevailing regarding the chronic lung manifestations of Covid-19 and long-term sequelae of covid-19. Data are relatively lacking. To address this problem, this study is undertaken. Purpose: To look for Pulmonary fibrosis and to assess the residual pulmonary abnormalities on HRCT Chest in Covid-19 survivors at one year follow up. Materials and Methods: After discharge from Regional Institute of Medical Sciences, Imphal, Manipur covid-19 survivors with CTSS (Computed Tomography Severity Score) of moderate and severe grade, discharged between May 2021 and August 2021 were prospectively evaluated at one year through systematic assessment of HRCT thorax. Results: 40 participants (mean age ± SD,56.83 years ±12.52) were assessed. Patients with co morbidities like hypertension in 7(17.5%), diabetes mellitus in 8(20%) and pulmonary hypertension in 2(5%) were assessed. Previously seen crazy paving pattern, broncho vascular thickening, consolidation was completely absorbed in follow up studies in respective patients. Honey-combing was not observed.21 (52.5%) patients had complete resolution of lung abnormalities. No evidence of fibrosis was noted in them.19 (47.5%) patients had residual pulmonary abnormalities in the form of traction bronchiectasis, reticulation and fibrous stripes. No statistically significant difference was found between mean age in years, comorbidities, CTSS and fibrotic like changes. Clinically the patients were feeling better with no complains of shortness of breath. Conclusion: This study has revealed that significant amount of HRCT lung parenchymal abnormalities gets absorbed. Very few of them persist up to 12 months. Reticulation is observed in 65% patients but it is not considered to be a specific feature of established pulmonary fibrosis. It has been observed that reticulation and other residual abnormalities also gets absorbed in subsequent longer follow ups. We conclude that HRCT features of established pulmonary fibrosis are not observed in post covid survivors.
Post Covid-19, Pulmonary Fibrosis, HRCT Chest, One year follow-up.