COVID-19 Chest Manifestation on CT Scan and Associated Risk Factors for Developing Pulmonary Fibrosis.

purposeThis retrospective study describes the imaging findings on chest computed tomography (CT) scans of coronavirus disease 2019 (COVID-19) patients as well as the prevalence of pulmonary fibrosis and the potential risk factors for the disease.

methodsOne of the major COVID-19 centers in the western province of Saudi Arabia, the King Abdullah Medical Complex in Jeddah, was the site of this study. All adult COVID-19 patients who got a CT chest scan between January 2020 and April 2022 were included in the trial. The imaging findings and pulmonary severity scores (PSS) were obtained from the patients' CT chest. Patients were divided into two groups according to the evidence of fibrotic-like lung changes; clinical and radiological data between the two groups were subsequently compared. Data from the patients' electronic records was collected.

resultsThe average patient age was 56.4 years, and most (73.5%) patients were men. Two-thirds of the patients had comorbidities (69.1%). CT scans revealed that diffuse lung infiltration is reported in 61% of cases, followed by lower lobes in 19.9%. Ground glass opacity (94.1%), consolidation (76.5%), septal thickening, and/or reticulation (24.4%) were the main chest findings during the initial CT scan. Fibrotic-like lung changes were developed in 9.6% of patients. Patients known to have a positive history of hypertension (p-value = 0.031) and coronary artery disease (CAD) (p-value = 0.011) were found to be significantly more likely to develop lung fibrosis. The patients' pneumonia severity score was significantly higher among the lung fibrotic patients (p-value = 0.026). Also, patients who were diagnosed with pulmonary fibrosis stayed longer in the hospital (p-value 0.001). Sex and age did not correlate significantly with risk of lung fibrosis.

conclusionPulmonary fibrosis was observed in 9.6% of COVID-19 patients. A close follow-up of patients with severe pneumonia, prolonged hospitalization, and pre-existing CAD and hypertension was necessary, as pulmonary fibrosis was more likely to occur as a result of these factors. There is a need for a thorough, long-term investigation with a large sample size.