Avaliação tomográfica quantitativa do tórax na fase aguda e 12 meses após internação hospitalar por COVID-19 – correlação com função pulmonar e qualidade de vida

Abstract

Background: Post-COVID-19 conditions encompass a broad spectrum of signs and symptoms, from respiratory changes to cognitive and psychological alterations. Quantitative chest computed tomography (QCT) is a useful tool for assessing pulmonary involvement in post-COVID-19 patients. However, longitudinal studies correlating QCT with pulmonary function and quality of life (QoL) are scarce.

Objective: This study aimed to evaluate the association between the extent of QCT abnormalities and pulmonary function, six-minute walk test (6MWT), and QoL one year after severe COVID-19.

Methods: This prospective cohort included patients hospitalized with severe acute respiratory syndrome due to COVID-19 between May 25 and December 28, 2020. A one-year follow-up was conducted between May 14, 2021, and February 11, 2022. All patients underwent high-resolution computed tomography (HRCT) and QCT in the acute phase and at 12 months, along with complete pulmonary function tests, 6MWT, and the EQ-5D QoL questionnaire.

Results: Thirty-two patients were evaluated. High-attenuation areas (HAA) decreased from 38.7% in the acute phase to 14.7% at 12 months (p < 0.001). Pulmonary function and 6MWT results were within normal limits after 12 months. QoL impairments persisted, with mobility limitations in 53%, pain/discomfort in 71%, and anxiety/depression in 54.8%, but were not associated with HAA percentage. HAA at 12 months correlated positively with acute-phase HAA (r = 0.452; p = 0.020) and negatively with total lung capacity (r = –0.619; p < 0.001).

Conclusion: Although QCT abnormalities persisted in a considerable proportion of severe COVID-19 survivors one year after hospitalization, they were not associated with pulmonary function impairment or reduced QoL.