The University of Southampton
University of Southampton Institutional Repository
Warning ePrints Soton is experiencing an issue with some file downloads not being available. We are working hard to fix this. Please bear with us.

Risk factors for persistent abnormality on chest radiographs at 12-weeks post hospitalisation with PCR confirmed COVID-19

Risk factors for persistent abnormality on chest radiographs at 12-weeks post hospitalisation with PCR confirmed COVID-19
Risk factors for persistent abnormality on chest radiographs at 12-weeks post hospitalisation with PCR confirmed COVID-19

Background: The long-term consequences of COVID-19 remain unclear. There is concern a proportion of patients will progress to develop pulmonary fibrosis. We aimed to assess the temporal change in CXR infiltrates in a cohort of patients following hospitalisation for COVID-19. Methods: We conducted a single-centre prospective cohort study of patients admitted to University Hospital Southampton with confirmed SARS-CoV2 infection between 20th March and 3rd June 2020. Patients were approached for standard-of-care follow-up 12-weeks after hospitalisation. Inpatient and follow-up CXRs were scored by the assessing clinician for extent of pulmonary infiltrates; 0–4 per lung (Nil = 0, < 25% = 1, 25–50% = 2, 51–75% = 3, > 75% = 4). Results: 101 patients with paired CXRs were included. Demographics: 53% male with a median (IQR) age 53.0 (45–63) years and length of stay 9 (5–17.5) days. The median CXR follow-up interval was 82 (77–86) days with median baseline and follow-up CXR scores of 4.0 (3–5) and 0.0 (0–1) respectively. 32% of patients had persistent CXR abnormality at 12-weeks. In multivariate analysis length of stay (LOS), smoking-status and obesity were identified as independent risk factors for persistent CXR abnormality. Serum LDH was significantly higher at baseline and at follow-up in patients with CXR abnormalities compared to those with resolution. A 5-point composite risk score (1-point each; LOS ≥ 15 days, Level 2/3 admission, LDH > 750 U/L, obesity and smoking-status) strongly predicted risk of persistent radiograph abnormality (0.81). Conclusion: Persistent CXR abnormality 12-weeks post COVID-19 was common in this cohort. LOS, obesity, increased serum LDH, and smoking-status were risk factors for radiograph abnormality. These findings require further prospective validation.

COVID-19, Chest radiograph, Follow-up study, LDH, SARS-CoV-2
1465-9921
Wallis, T J M
cf385c2a-ef94-4435-8066-31acf23f6f99
Heiden, E
2921110b-b184-4e61-8633-116b1b8129cc
Horno, J
10876e10-ad36-40ae-9a12-bfe9e8548144
Welham, B
2606c253-7562-45e6-a284-26a9915d35bf
Burke, H
4c1f67c5-5087-429b-98d1-45dfe0e0adb2
Freeman, A
b5f45a0d-f9e4-4a91-9af0-40efb6730787
Dexter, L
f6041800-0fd7-4bfa-9e9b-03526da5eee2
Fazleen, A
d96dba0e-f819-42cf-880f-ab927665b838
Kong, A
66845e3f-a541-4154-8ce8-9a8d618bf115
McQuitty, C
905cfa08-5b27-4ba2-bfeb-69183edaed0b
Poole, S
113fe2fe-7b70-46f7-a817-d811c602113a
Brendish, N J
a8a4189e-01eb-4ab3-933e-a24cd188a4d7
Clark, T W
712ec18e-613c-45df-a013-c8a22834e14f
Wilkinson, T M A
8c55ebbb-e547-445c-95a1-c8bed02dd652
Jones, M G
a6fd492e-058e-4e84-a486-34c6035429c1
Marshall, B G
9abf382c-977f-459c-9b91-5ed8cbf2284f
Wallis, T J M
cf385c2a-ef94-4435-8066-31acf23f6f99
Heiden, E
2921110b-b184-4e61-8633-116b1b8129cc
Horno, J
10876e10-ad36-40ae-9a12-bfe9e8548144
Welham, B
2606c253-7562-45e6-a284-26a9915d35bf
Burke, H
4c1f67c5-5087-429b-98d1-45dfe0e0adb2
Freeman, A
b5f45a0d-f9e4-4a91-9af0-40efb6730787
Dexter, L
f6041800-0fd7-4bfa-9e9b-03526da5eee2
Fazleen, A
d96dba0e-f819-42cf-880f-ab927665b838
Kong, A
66845e3f-a541-4154-8ce8-9a8d618bf115
McQuitty, C
905cfa08-5b27-4ba2-bfeb-69183edaed0b
Poole, S
113fe2fe-7b70-46f7-a817-d811c602113a
Brendish, N J
a8a4189e-01eb-4ab3-933e-a24cd188a4d7
Clark, T W
712ec18e-613c-45df-a013-c8a22834e14f
Wilkinson, T M A
8c55ebbb-e547-445c-95a1-c8bed02dd652
Jones, M G
a6fd492e-058e-4e84-a486-34c6035429c1
Marshall, B G
9abf382c-977f-459c-9b91-5ed8cbf2284f

Wallis, T J M, Heiden, E, Horno, J, Welham, B, Burke, H, Freeman, A, Dexter, L, Fazleen, A, Kong, A, McQuitty, C, Poole, S, Brendish, N J, Clark, T W, Wilkinson, T M A, Jones, M G and Marshall, B G (2021) Risk factors for persistent abnormality on chest radiographs at 12-weeks post hospitalisation with PCR confirmed COVID-19. Respiratory Research, 22 (1), [157]. (doi:10.1186/s12931-021-01750-8).

Record type: Article

Abstract

Background: The long-term consequences of COVID-19 remain unclear. There is concern a proportion of patients will progress to develop pulmonary fibrosis. We aimed to assess the temporal change in CXR infiltrates in a cohort of patients following hospitalisation for COVID-19. Methods: We conducted a single-centre prospective cohort study of patients admitted to University Hospital Southampton with confirmed SARS-CoV2 infection between 20th March and 3rd June 2020. Patients were approached for standard-of-care follow-up 12-weeks after hospitalisation. Inpatient and follow-up CXRs were scored by the assessing clinician for extent of pulmonary infiltrates; 0–4 per lung (Nil = 0, < 25% = 1, 25–50% = 2, 51–75% = 3, > 75% = 4). Results: 101 patients with paired CXRs were included. Demographics: 53% male with a median (IQR) age 53.0 (45–63) years and length of stay 9 (5–17.5) days. The median CXR follow-up interval was 82 (77–86) days with median baseline and follow-up CXR scores of 4.0 (3–5) and 0.0 (0–1) respectively. 32% of patients had persistent CXR abnormality at 12-weeks. In multivariate analysis length of stay (LOS), smoking-status and obesity were identified as independent risk factors for persistent CXR abnormality. Serum LDH was significantly higher at baseline and at follow-up in patients with CXR abnormalities compared to those with resolution. A 5-point composite risk score (1-point each; LOS ≥ 15 days, Level 2/3 admission, LDH > 750 U/L, obesity and smoking-status) strongly predicted risk of persistent radiograph abnormality (0.81). Conclusion: Persistent CXR abnormality 12-weeks post COVID-19 was common in this cohort. LOS, obesity, increased serum LDH, and smoking-status were risk factors for radiograph abnormality. These findings require further prospective validation.

Text
CXRpostCOVIDFinal - Accepted Manuscript
Available under License Creative Commons Attribution.
Download (117kB)
Text
s12931-021-01750-8 - Version of Record
Available under License Creative Commons Attribution.
Download (893kB)

More information

e-pub ahead of print date: 21 May 2021
Published date: 21 May 2021
Additional Information: Funding Information: The corresponding author TJMW receives a research fellowship grant from the NIHR Southampton Clinical Research Facility (Southampton, UK). Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
Keywords: COVID-19, Chest radiograph, Follow-up study, LDH, SARS-CoV-2

Identifiers

Local EPrints ID: 449544
URI: http://eprints.soton.ac.uk/id/eprint/449544
ISSN: 1465-9921
PURE UUID: 76256925-f376-41bc-be41-bea5b7bcd393
ORCID for T J M Wallis: ORCID iD orcid.org/0000-0001-7936-9764
ORCID for N J Brendish: ORCID iD orcid.org/0000-0002-9589-4937
ORCID for T W Clark: ORCID iD orcid.org/0000-0001-6026-5295
ORCID for M G Jones: ORCID iD orcid.org/0000-0001-6308-6014

Catalogue record

Date deposited: 07 Jun 2021 16:31
Last modified: 26 Nov 2021 03:21

Export record

Altmetrics

Contributors

Author: T J M Wallis ORCID iD
Author: E Heiden
Author: J Horno
Author: B Welham
Author: H Burke
Author: A Freeman
Author: L Dexter
Author: A Fazleen
Author: A Kong
Author: C McQuitty
Author: S Poole
Author: N J Brendish ORCID iD
Author: T W Clark ORCID iD
Author: T M A Wilkinson
Author: M G Jones ORCID iD
Author: B G Marshall

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×