Six-Week Follow-Up Chest Ct Changes After Severe Covid-19 Pneumonia in Arak City, Iran Publisher



Sarmadian H ; Safi F ; Akhiani AM ; Shabani S ; Sarmadian R
Source: Journal of Kerman University of Medical Sciences Published:2025

Abstract

Background: Coronavirus disease 2019 (COVID-19) can lead to lung damage. Methods: This study examines the clinical characteristics of 190 patients with severe COVID-19 admitted to a designated hospital in Arak, Iran, from initial diagnosis with chest CT to the recovery stage in the sixth week. Results: Serial evaluation of CT imaging features over time of COVID-19 showed that peripheral GGO with or without consolidation, especially in the posterior or lower lung zones, were the most common features (P < 0.001-0.002). During the first week of follow-up, patients demonstrated a higher prevalence of halo signs, peribronchvascular opacities, bronchial wall thickening, tree-in-bud appearance, and lobar in consolidations compared with pulmonary CT scans performed at the sixth week of onset. COVID-19 pneumonia showed the most severe pulmonary involvement approximately 10 days after symptom onset. After active treatment, in the second follow-up, these consolidations were complete resolution and regressed relatively faster than recovery from other types of lesions, as shown by chest CT imaging. In severe COVID-19, ground-glass opacities, consolidation, particularly in lower regions of the lungs, crazy-paving patterns, air bronchograms, and reverse halo signs are often found on the initial CT examinations (days 7 to 10). Most of these severe features gradually regressed in the absorption phase (on days 40 to 42 in early diagnosis and treatment). Conclusion: CT imaging plays a crucial role in detecting pneumonia and has a high sensitivity in detecting COVID-19 pneumonia but cannot be used as gold-standard for COVID-19 diagnosis. © 2025 Elsevier B.V., All rights reserved.