Chronic Lung Injury after COVID-19 Pneumonia: Clinical, Radiologic, and Histopathologic Perspectives
- Authors
- Cha, M.J.; Solomon, J.J.; Lee, J.E.; Choi, H.; Chae, K.J.; Lee, K.S.; Lynch, D.A.
- Issue Date
- Jan-2024
- Publisher
- Radiological Society of North America Inc.
- Citation
- Radiology, v.310, no.1, pp e231643
- Journal Title
- Radiology
- Volume
- 310
- Number
- 1
- Start Page
- e231643
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/71108
- DOI
- 10.1148/radiol.231643
- ISSN
- 0033-8419
1527-1315
- Abstract
- With the COVID-19 pandemic having lasted more than 3 years, concerns are growing about prolonged symptoms and respiratory complications in COVID-19 survivors, collectively termed post-COVID-19 condition (PCC). Up to 50% of patients have residual symptoms and physiologic impairment, particularly dyspnea and reduced diffusion capacity. Studies have also shown that 24%-54% of patients hospitalized during the 1st year of the pandemic exhibit radiologic abnormalities, such as ground-glass opacity, reticular opacity, bronchial dilatation, and air trapping, when imaged more than 1 year after infection. In patients with persistent respiratory symptoms but normal results at chest CT, dual-energy contrast-enhanced CT, xenon 129 MRI, and low-field-strength MRI were reported to show abnormal ventilation and/or perfusion, suggesting that some lung injury may not be detectable with standard CT. Histologic patterns in post-COVID-19 lung disease include fibrosis, organizing pneumonia, and vascular abnormality, indicating that different pathologic mechanisms may contribute to PCC. Therefore, a comprehensive imaging approach is necessary to evaluate and diagnose patients with persistent post-COVID-19 symptoms. This review will focus on the long-term findings of clinical and radiologic abnormalities and describe histopathologic perspectives. It also addresses advanced imaging techniques and deep learning approaches that can be applied to COVID-19 survivors. This field remains an active area of research, and further follow-up studies are warranted for a better understanding of the chronic stage of the disease and developing a multidisciplinary approach for patient management. © RSNA, 2024.
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