The severity of acute COVID-19 and protracted systemic inflammation is strongly linked to persistent structural and functional lung abnormality

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Austrian researchers from the Medical University of Innsbruck, the Karl Landsteiner Institute, University Hospital Innsbruck and St. Vinzenz Hospital have in a new study found that many post COVID-19 individuals sustain continuous systemic inflammation that causes structural and functional lung abnormality.

 The study findings were published in the peer reviewed journal: eLife. 

https://elifesciences.org/articles/72500

The researchers have conducted a longitudinal, multi-center observational study in ambulatory and hospitalized COVID-19 patients recruited in early 2020 (n = 145). Pulmonary computed tomography (CT) and lung function (LF) readouts, symptom prevalence, clinical and laboratory parameters were collected during acute COVID-19 and at 60-, 100- and 180-days follow-up visits.

Recovery kinetics and risk factors were investigated by logistic regression. Classification of clinical features and participants was accomplished by unsupervised and semi-supervised multi-parameter clustering and machine learning.

Results: At the six-month follow-up, 49% of participants reported persistent symptoms. The frequency of structural lung CT abnormalities ranged from 18% in the mild outpatient cases to 76% in the ICU convalescents. Prevalence of impaired LF ranged from 14% in the mild outpatient cases to 50% in the ICU survivors.

Incomplete radiological lung recovery was associated with increased anti-S1/S2 antibody titer, IL-6 and CRP levels at the early follow-up. We demonstrated that the risk of perturbed pulmonary recovery could be robustly estimated at early follow-up by clustering and machine learning classifiers employing solely non-CT and non-LF parameters.

Conclusion: The severity of acute COVID-19 and protracted systemic inflammation is strongly linked to persistent structural and functional lung abnormality. Automated screening of multi-parameter health record data may assist at the prediction of incomplete pulmonary recovery and optimize COVID-19 follow-up management.

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