tetano
Editor, Senior Moderator
ERJ Open Res
. 2022 May 30;8(2):00056-2022.
doi: 10.1183/23120541.00056-2022. eCollection 2022 Apr.
Pulmonary function test and computed tomography features during follow-up after SARS, MERS and COVID-19: a systematic review and meta-analysis
Christopher C Huntley[SUP] 1 2 [/SUP], Ketan Patel[SUP] 2 3 [/SUP], Shahnoor-E-Salam Bil Bushra[SUP] 4 [/SUP], Farah Mobeen[SUP] 3 [/SUP], Michael N Armitage[SUP] 5 [/SUP], Anita Pye[SUP] 2 [/SUP], Chloe B Knight[SUP] 4 [/SUP], Alyaa Mostafa[SUP] 4 [/SUP], Marie Kershaw[SUP] 3 [/SUP], Aishah Z Mughal[SUP] 4 [/SUP], Emily McKemey[SUP] 3 [/SUP], Alice M Turner[SUP] 2 3 [/SUP], P Sherwood Burge[SUP] 1 [/SUP], Gareth I Walters[SUP] 1 2 [/SUP]
Affiliations
Abstract
Background: The COVID-19 pandemic follows severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronavirus epidemics. Some survivors of COVID-19 infection experience persistent respiratory symptoms, yet their cause and natural history remain unclear. Follow-up after SARS and MERS may provide a model for predicting the long-term pulmonary consequences of COVID-19.
Methods: This systematic review and meta-analysis aims to describe and compare the longitudinal pulmonary function test (PFT) and computed tomography (CT) features of patients recovering from SARS, MERS and COVID-19. Meta-analysis of PFT parameters (DerSimonian and Laird random-effects model) and proportion of CT features (Freeman-Tukey transformation random-effects model) were performed.
Findings: Persistent reduction in the diffusing capacity for carbon monoxide following SARS and COVID-19 infection is seen at 6 months follow-up, and 12 months after MERS. Other PFT parameters recover in this time. 6 months after SARS and COVID-19, ground-glass opacity, linear opacities and reticulation persist in over 30% of patients; honeycombing and traction dilatation are reported less often. Severe/critical COVID-19 infection leads to greater CT and PFT abnormality compared to mild/moderate infection.
Interpretation: Persistent diffusion defects suggestive of parenchymal lung injury occur after SARS, MERS and COVID-19 infection, but improve over time. After COVID-19 infection, CT features are suggestive of persistent parenchymal lung injury, in keeping with a post-COVID-19 interstitial lung syndrome. It is yet to be determined if this is a regressive or progressive disease.
. 2022 May 30;8(2):00056-2022.
doi: 10.1183/23120541.00056-2022. eCollection 2022 Apr.
Pulmonary function test and computed tomography features during follow-up after SARS, MERS and COVID-19: a systematic review and meta-analysis
Christopher C Huntley[SUP] 1 2 [/SUP], Ketan Patel[SUP] 2 3 [/SUP], Shahnoor-E-Salam Bil Bushra[SUP] 4 [/SUP], Farah Mobeen[SUP] 3 [/SUP], Michael N Armitage[SUP] 5 [/SUP], Anita Pye[SUP] 2 [/SUP], Chloe B Knight[SUP] 4 [/SUP], Alyaa Mostafa[SUP] 4 [/SUP], Marie Kershaw[SUP] 3 [/SUP], Aishah Z Mughal[SUP] 4 [/SUP], Emily McKemey[SUP] 3 [/SUP], Alice M Turner[SUP] 2 3 [/SUP], P Sherwood Burge[SUP] 1 [/SUP], Gareth I Walters[SUP] 1 2 [/SUP]
Affiliations
- PMID: 35642193
- PMCID: PMC9035766
- DOI: 10.1183/23120541.00056-2022
Abstract
Background: The COVID-19 pandemic follows severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronavirus epidemics. Some survivors of COVID-19 infection experience persistent respiratory symptoms, yet their cause and natural history remain unclear. Follow-up after SARS and MERS may provide a model for predicting the long-term pulmonary consequences of COVID-19.
Methods: This systematic review and meta-analysis aims to describe and compare the longitudinal pulmonary function test (PFT) and computed tomography (CT) features of patients recovering from SARS, MERS and COVID-19. Meta-analysis of PFT parameters (DerSimonian and Laird random-effects model) and proportion of CT features (Freeman-Tukey transformation random-effects model) were performed.
Findings: Persistent reduction in the diffusing capacity for carbon monoxide following SARS and COVID-19 infection is seen at 6 months follow-up, and 12 months after MERS. Other PFT parameters recover in this time. 6 months after SARS and COVID-19, ground-glass opacity, linear opacities and reticulation persist in over 30% of patients; honeycombing and traction dilatation are reported less often. Severe/critical COVID-19 infection leads to greater CT and PFT abnormality compared to mild/moderate infection.
Interpretation: Persistent diffusion defects suggestive of parenchymal lung injury occur after SARS, MERS and COVID-19 infection, but improve over time. After COVID-19 infection, CT features are suggestive of persistent parenchymal lung injury, in keeping with a post-COVID-19 interstitial lung syndrome. It is yet to be determined if this is a regressive or progressive disease.