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Background <p>Several patients exhibit a severity-dependent reduced pulmonary diffusing capacity (D<sub>LCOc</sub>) following coronavirus disease 2019 (COVID-19) infection. This has been attributed to fibrosis-like restrictive lung disease, as shown by chest high-resolution computed tomography (HRCT), and concurrent ventilatory disturbances observed by ventilation-perfusion single-photon emission computed tomography (V/Q SPECT) imaging. The aim of this study was to investigate whether reductions in D<sub>L,COc</sub> at short- and intermediate-term follow-up were associated with initial severity of COVID-19, and to which extend this was linked to the presence of fibrosis-like abnormalities on HRCT and ventilatory disturbances on V/Q SPECT.</p> Methods <p>A total of 153 patients diagnosed with COVID-19 between March 2020 and March 2021 were included in the study. The patients underwent lung function testing, chest HRCT, and V/Q SPECT at short-term (5.6 months) follow-up. Individuals exhibiting any evidence of post-COVID-19 sequelae (<i>n</i> = 121) were also referred to intermediate follow-up (12.5 months).</p> Results <p>At short-term follow-up, a severity dependent reduction in D<sub>L,COc</sub> was observed, which was not evident at intermediate follow-up. At both short-term and intermediate follow-up, HRCT showed ground-glass opacity (GGO) and fibrosis-like abnormalities related to disease severity. Most patients had V/Q defects mainly with ventilatory abnormalities, including both matched and inversely matched defects at both follow-up times.</p> Conclusion <p>The severity-dependent reduction in D<sub>L,COc</sub> at short-term follow-up, associated with restrictive lung function pattern, GGO and fibrosis on HRCT, and ventilatory disturbances on V/Q SPECT, showed spontaneous recovery by intermediate follow-up. However, the restrictive ventilatory disturbances and associated morphological changes persisted.</p>

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Relation of pulmonary diffusing capacity changes to HRCT chest and V/Q SPECT findings at short-term and intermediate follow-up after COVID-19: a prospective cohort study (The secure study)

  • 期刊论文

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  • 发表日期：

    2025年10月30日

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  • Thora Wesenberg Helt,
  • Rie Skovly Thomsen,
  • Jan Christensen,
  • Thomas Kromann Lund,
  • Anna Kalhauge,
  • Frederikke Rönsholt,
  • Daria Podlekavera,
  • Elisabeth Arndal,
  • Anne-Mette Lebech,
  • Ronan M. G. Berg,
  • Terese L. Katzenstein,
  • Jann Mortensen

摘要

Background

Several patients exhibit a severity-dependent reduced pulmonary diffusing capacity (DLCOc) following coronavirus disease 2019 (COVID-19) infection. This has been attributed to fibrosis-like restrictive lung disease, as shown by chest high-resolution computed tomography (HRCT), and concurrent ventilatory disturbances observed by ventilation-perfusion single-photon emission computed tomography (V/Q SPECT) imaging. The aim of this study was to investigate whether reductions in DL,COc at short- and intermediate-term follow-up were associated with initial severity of COVID-19, and to which extend this was linked to the presence of fibrosis-like abnormalities on HRCT and ventilatory disturbances on V/Q SPECT.

Methods

A total of 153 patients diagnosed with COVID-19 between March 2020 and March 2021 were included in the study. The patients underwent lung function testing, chest HRCT, and V/Q SPECT at short-term (5.6 months) follow-up. Individuals exhibiting any evidence of post-COVID-19 sequelae (n = 121) were also referred to intermediate follow-up (12.5 months).

Results

At short-term follow-up, a severity dependent reduction in DL,COc was observed, which was not evident at intermediate follow-up. At both short-term and intermediate follow-up, HRCT showed ground-glass opacity (GGO) and fibrosis-like abnormalities related to disease severity. Most patients had V/Q defects mainly with ventilatory abnormalities, including both matched and inversely matched defects at both follow-up times.

Conclusion

The severity-dependent reduction in DL,COc at short-term follow-up, associated with restrictive lung function pattern, GGO and fibrosis on HRCT, and ventilatory disturbances on V/Q SPECT, showed spontaneous recovery by intermediate follow-up. However, the restrictive ventilatory disturbances and associated morphological changes persisted.