Residual lesions on chest-Xray after SARS-CoV-2 pneumonia: Identification of risk factors

COVID-19 pneumonia is the most frequent clinical manifestation of this disease, and its long-term sequelae and possible progression to pulmonary fibrosis are still unknown. The aim of this study is a mid-term review of the sequelae on plain chest radiography (CXR) in patients with a previous diagnosis of COVID-19 pneumonia. Retrospective review of patients with a diagnosis of COVID-19 pneumonia, assessing the persistence of residual lesions in the control CXR and analysing their possible relationship with epidemiological factors, risk factors, treatments received and initial radiological patterns. A total of 143 patients (52 women and 91 men) were analysed. Mean age was 64 years. Radiological complete resolution (CR) was observed in 104 (73%) and partial resolution (PR) in 39 (27%). Of the risk factors only age was significantly related to persistence of residual lesions (OR 1.06 CI95% (1.02,1.10). In relation to treatments, significant differences were found with tocilizumab and glucocorticoids, where treated patients had a higher risk of residual lesions (OR 2.44 (1.03,5.80) and 3.05(1.43,6.51) respectively. In the analysis of radiological patterns, significant differences were observed in patients with peripheral condensations in the acute course and a pattern of early radiological worsening. A clinical-radiological dissociation was evident: 83% of patients with residual lesions had no respiratory symptoms. COVID19 pneumonias may have a slower radiological resolution in older patients with certain initial radiological patterns, but the development of pulmonary fibrosis in these patients is still questionable. La neumonía por la enfermedad por el coronavirus 19 (COVID-19) es la manifestación clínica más frecuente de esta afección, siendo aún desconocidas sus secuelas a largo plazo y la posible evolución a fibrosis pulmonar. El objetivo de este trabajo es una revisión a medio plazo de las secuelas en la radiografía simple de tórax (RxTx) de pacientes con diagnóstico previo de neumonía por la COVID-19. Revisión retrospectiva de pacientes con diagnóstico de neumonía por la COVID-19 en la que hemos valorado la persistencia de lesiones residuales en la RxTx de control y hemos analizado su posible relación con factores epidemiológicos, factores de riesgo, tratamientos recibidos y patrones radiológicos iniciales. Se analizan 143 pacientes (52 mujeres y 91 hombres). Edad media de 64 años. Se objetivó una resolución completa (RC) radiológica en 104 (73%) y resolu