The macrostructure of lungs on multislice computed tomography scans in the long-term period after COVID-19 pneumonia

The purpose of the study using MSCT monitoring data was to investigate the semiotics of residual changes in the lungs in the long-term period (up to 2 years) after pneumonia associated with COVID-19 (COronaVIrus Disease 2019).

Methods. A comparative analysis of MSCT data of the chest organs was carried out in 146 patients with a confirmed diagnosis of COVID-19-associated pneumonia in 2020 – 2021 and subsequent MSCT monitoring data until 2023. MSCT was performed using a 64-slice computed tomography scanner with data post-processed on the workstation.

Results. Based on the analysis, 4 groups of patients were identified that differed in the severity of viral pneumonia and the prevalence of lung lesions. The first group of patients had the most beneficial course. In 90% of cases, there was a complete resolution of the consequences of viral pneumonia in terms macroscopic changes in lung tissue by the second year of observation. In the second group, which consisted primarily of older people, 27 (52.94%) patients in year 1 and in 33 (64.7%) patients in year 2 showed a recovery of macrostructure. This group demonstrated fibrous cords, reticular changes, reactions of pleura, and residual lesions (“ground glass”). A similar trend, but in a more severe form, was observed in group 3 patients. 40 patients (86.95%) had residual changes similar to those in group 2 (middle, elderly age and older people) with the addition of bronchial wall thickening and bronchiectasis. Only in 2 (22.22%) of 9 patients with atypical manifestations of COVID-19 pneumonia in the form of “crazy paving” changes in the form of reticular seals, fibrous cords, localized thickening of the pleura and lymphadenopathy persisted up to 2 years of observation.

Conclusion. MSCT monitoring of the lungs of patients suffering from COVID-19-associated pneumonia up to 2 years after recovery showed that the prevalence and severity of post-COVID changes in the lungs depends on the severity of the disease (degree and nature of damage to the pulmonary parenchyma) and the patient’s age.

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