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Sci Rep . Early pulmonary fibrosis-like changes between delta and pre-delta periods in patients with severe COVID-19 pneumonia on mechanical ventil

tetano

Editor, Senior Moderator
Sci Rep


. 2024 Oct 30;14(1):26101.
doi: 10.1038/s41598-024-77405-7. Early pulmonary fibrosis-like changes between delta and pre-delta periods in patients with severe COVID-19 pneumonia on mechanical ventilation

Jung-Wan Yoo[SUP] 1 [/SUP], Won-Young Kim[SUP] 2 [/SUP], Chi Ryang Chung[SUP] 3 [/SUP], Young-Jae Cho[SUP] 4 [/SUP], Jinwoo Lee[SUP] 5 [/SUP], Yangjin Jegal[SUP] 6 [/SUP], Junghyun Kim[SUP] 7 [/SUP], Joon-Sung Joh[SUP] 8 [/SUP], Tae Yun Park[SUP] 9 [/SUP], Ae-Rin Baek[SUP] 10 [/SUP], Joo Hun Park[SUP] 11 [/SUP], Ganghee Chae[SUP] 6 [/SUP], Jung Hwa Hwang[SUP] 12 [/SUP], Jin Woo Song[SUP] 13 [/SUP]



Affiliations
Abstract

It remains unclear whether pulmonary fibrosis-like changes differ in patients with different SARS-CoV-2 variants. This study aimed to compare pulmonary fibrotic changes between two SARS-CoV-2 variant periods (delta vs. pre-delta) in critically ill patients with SARS-CoV-2 pneumonia. Clinical data and chest CT images of patients with SARS-CoV-2 pneumonia receiving mechanical ventilation were collected from 10 hospitals in South Korea over two periods: delta (July-December, 2021; n = 64) and pre-delta (February, 2020-June, 2021; n = 120). Fibrotic changes on chest CT were evaluated through visual assessment. Of 184 patients, the mean age was 64.6 years, and 60.5% were ale. Fibrosis-like changes on chest CT (median 51 days from enrollment to follow up CT scan, interquartile range 27-76 days) were identified in 75.3%. Delta group showed more fibrosis-like changes (≥ 2) (69.8% vs. 43.1%, P = 0.001) and more frequent reticulation and architectural distortion+/-parenchymal band than pre-delta group. Even after propensity score matching with clinical variables, delta group had more severe (≥ 2) fibrosis-like changes (71.4% vs. 38.8%, P = 0.001), and more frequent reticulation and architectural distortion+/-parenchymal band than pre-delta group. Our data suggest that critically ill patients with SARS-CoV-2 in delta period had more severe pulmonary fibrosis-like changes than those in pre-delta period.

Keywords: Mechanical ventilation; Pulmonary fibrosis-like change; SARS-CoV-2.

 
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