https://doi.org/10.4081/monaldi.2024.3028

Fibrotic outcomes from SARS-CoV-2 virus interstitial pneumonia

Early Access
Submitted: April 18, 2024
Accepted: September 9, 2024
Published: October 16, 2024
COVID-19 interstitial pneumonia, pulmonary fibrosis
Abstract Views: 864
PDF_EARLY VIEW: 63
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Authors

Luigi Pinto
luigi.pinto@miulli.it
Respiratory Physiopathology and Bronchial Endoscopy Unit, Ecclesiastical Entity General Regional Hospital 'F. Miulli', Acquaviva Delle Fonti (BA), Italy.
Pietro Schino
Respiratory Physiopathology and Bronchial Endoscopy Unit, Ecclesiastical Entity General Regional Hospital 'F. Miulli', Acquaviva Delle Fonti (BA), Italy.
Michele Bitetto
Respiratory Physiopathology and Bronchial Endoscopy Unit, Ecclesiastical Entity General Regional Hospital 'F. Miulli', Acquaviva Delle Fonti (BA), Italy.
Ersilia Tedeschi
Respiratory Physiopathology and Bronchial Endoscopy Unit, Ecclesiastical Entity General Regional Hospital 'F. Miulli', Acquaviva Delle Fonti (BA), Italy.
Michele Maiellari
Respiratory Physiopathology and Bronchial Endoscopy Unit, Ecclesiastical Entity General Regional Hospital 'F. Miulli', Acquaviva Delle Fonti (BA), Italy.
Giancarlo De Leo
Respiratory Physiopathology and Bronchial Endoscopy Unit, Ecclesiastical Entity General Regional Hospital 'F. Miulli', Acquaviva Delle Fonti (BA), Italy.
Elena Ludovico
Radiology Unit, Ecclesiastical Entity General Regional Hospital 'F. Miulli', Acquaviva Delle Fonti (BA), Italy.
Giovanni Larizza
Unit of Internal Medicine, Ecclesiastical Entity General Regional Hospital 'F. Miulli', Acquaviva Delle Fonti (BA), Italy.
Franco Mastroianni
Unit of Internal Medicine, Ecclesiastical Entity General Regional Hospital 'F. Miulli', Acquaviva Delle Fonti (BA), Italy.

Following the onset of the new COVID-19 pandemic, particular attention is paid to the long-term outcomes, especially concerning patients affected by the SARS-CoV-2 virus leading to interstitial pneumonia. The aim of this research is to evaluate the possible evolution over time of interstitial pneumonia into post-inflammatory fibrosing interstitial disease. This research included 42 patients admitted to the COVID ward for SARS-CoV-2 interstitial pneumonia, 10 patients with mild pneumonia and respiratory failure who were treated with O2 only, 32 patients with severe pneumonia in which O2 and non-invasive ventilation were used for respiratory assistance, and 4 patients treated with invasive mechanical ventilation. At 70±30 days, 6, 12, 24, and 36 months after discharge, the cohort of patients carried out the evaluation of inflammation indices, high-resolution computed tomography (CT) chest scans, and functional respiratory tests. The comparative analysis showed that 83.3% of patients had residual parenchymal lung disease at 36-month follow-up, with a significantly higher rate in those with severe pneumonia and more extensive disease on initial CT. Regarding the pulmonary involvement model, patients presented ground-glass opacity or peripheral parenchymal bands, or a combination of them, peri- and intralobular interstitial thickening, which may be representative of fibrotic interstitial lung disease. There is a correlation between the severity of pneumonia, the inflammatory state, the need to increase respiratory support, and the quantity and persistence of CT-related lesions. Reductions in respiratory functions and exercise capacity were observed, the latter more pronounced in patients (24%) who had contracted severe pneumonia and required ventilatory support.Pulmonary outcomes from SARS-CoV-2 respiratory infections show a wide range of radiological findings, from complete recovery to stable outcomes of thickening and distortion of the interstitial architecture. From a functional point of view, there is an impairment of the alveolar-capillary diffusion capacity and, in cases who had contracted severe pneumonia, desaturation and reduced exercise tolerance in 24% of cases at a 36-month follow-up.

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Ethics Approval

The research was conducted in accordance with the World Medical Association declaration of Helsinki. Approval 6439 of 04/17/2020 Interregional Ethics Committee of the Bari Polyclinic.

How to Cite

Pinto, Luigi, Pietro Schino, Michele Bitetto, Ersilia Tedeschi, Michele Maiellari, Giancarlo De Leo, Elena Ludovico, Giovanni Larizza, and Franco Mastroianni. 2024. “Fibrotic Outcomes from SARS-CoV-2 Virus Interstitial Pneumonia”. Monaldi Archives for Chest Disease, October. https://doi.org/10.4081/monaldi.2024.3028.
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