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Clinical and radiological outcomes of SARS-CoV-2 related organising pneumonia in COVID-19 survivors.
Kho, S S; Lim, K C; Muhammad, N A; Nasaruddin, M Z; Ismail, I; Daut, U M; Abdul Rahaman, J A.
Afiliación
  • Kho SS; Serdang Hospital, Department of Pulmonology, Selangor, Malaysia. khosze@moh.gov.my.
  • Lim KC; Serdang Hospital, Department of Medicine, Selangor, Division of Infectious Diseases, Malaysia.
  • Muhammad NA; Serdang Hospital, Department of Pulmonology, Selangor, Malaysia.
  • Nasaruddin MZ; Serdang Hospital, Department of Pulmonology, Selangor, Malaysia.
  • Ismail I; Serdang Hospital, Department of Radiology, Selangor, Malaysia.
  • Daut UM; Serdang Hospital, Department of Pulmonology, Selangor, Malaysia.
  • Abdul Rahaman JA; Serdang Hospital, Department of Pulmonology, Selangor, Malaysia.
Med J Malaysia ; 78(2): 131-138, 2023 03.
Article en En | MEDLINE | ID: mdl-36988520
INTRODUCTION: COVID-19 patients frequently demonstrate radiological organising pneumonia (OP) pattern. The longterm outcome and treatment options for this group of patients remain uncertain. We aim to describe the clinical and radiological outcomes of patients with COVID-19-related OP and identify possible clinical factors associated with inferior radiological outcome. MATERIALS AND METHODS: Post-COVID-19 clinic attendees, consisting of post-COVID-19 patients discharged from major hospitals in the state of Selangor during the third pandemic wave of COVID-19 in Malaysia, were enrolled in this retrospective study for 6 months. Physician-scored Modified Medical Research Council (mMRC), patient self-reported quality of life (EQ-VAS) score and follow-up CT scan were evaluated. RESULTS: Our cohort comprised 131 patients, with a median age of 52 (IQR 39-60) years and median BMI of 29.40 (IQR 25.59-34.72). Majority (72.5%) had co-morbidities, and 97.7% had severe disease requiring supplementary oxygen support during the acute COVID-19 episode. 56.5% required intensive care; among which one-third were invasively ventilated. Median equivalent dose of methylprednisolone prescribed was 2.60 (IQR 1.29-5.18) mg/kg during admission, while the median prednisolone dose upon discharge was 0.64 (IQR 0.51-0.78) mg/kg. It was tapered over a median of 8.0 (IQR 5.8-9.0) weeks. Upon follow-up at 11 (IQR 8-15) weeks, one-third of patients remained symptomatic, with cough, fatigue and dyspnoea being the most reported symptoms. mMRC and EQ-VAS scores improved significantly (p<0.001) during follow-up. Repeat CT scans were done in 59.5% of patients, with 94.8% of them demonstrating improvement. In fact, 51.7% had complete radiological resolution. Intensive care admission and mechanical ventilation are among the factors which were associated with poorer radiological outcomes, p<0.05. CONCLUSION: Approximately one-third of patients with SARSCoV- 2-related OP remained symptomatic at 3 months of follow-up. Majority demonstrated favourable radiological outcomes at 5-month reassessment, except those who required intensive care unit admission and mechanical ventilation.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: COVID-19 / Neumonía Organizada Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Adult / Humans / Middle aged Idioma: En Revista: Med J Malaysia Año: 2023 Tipo del documento: Article País de afiliación: Malasia Pais de publicación: Malasia
Buscar en Google
Colección: 01-internacional Base de datos: MEDLINE Asunto principal: COVID-19 / Neumonía Organizada Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Adult / Humans / Middle aged Idioma: En Revista: Med J Malaysia Año: 2023 Tipo del documento: Article País de afiliación: Malasia Pais de publicación: Malasia