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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2017; 27(03): 342-349
DOI: 10.4103/ijri.IJRI_469_16
Thoracic Imaging

Follow-up chest radiographic findings in patients with MERS-CoV after recovery

Authors

  • Karuna M Das

    Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, UAE; Department of Medical Imaging, King Fahad Medical City, Riyadh, KSA

  • Edward Y Lee

    Department of Radiology and Medicine, Pulmonary Division, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA

  • Rajvir Singh

    Department of Cardiology and Biostatistics, Hamad Medical Corporation, Doha, Qatar

  • Mushira A Enani

    Department of Medicine (Infectious Disease), King Fahad Medical City, Riyadh, KSA

  • Khalid Al Dossari

    Department of Medical Imaging, King Fahad Medical City, Riyadh, KSA

  • Klaus Van Gorkom

    Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, UAE

  • Sven G Larsson

    Department of Medical Imaging, King Fahad Medical City, Riyadh, KSA

  • Ruth D Langer

    Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, UAE

Financial support and sponsorship Nil.
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Abstract

Purpose: To evaluate the follow-up chest radiographic findings in patients with Middle East respiratory syndrome coronavirus (MERS-CoV) who were discharged from the hospital following improved clinical symptoms. Materials and Methods: Thirty-six consecutive patients (9 men, 27 women; age range 21–73 years, mean ± SD 42.5 ± 14.5 years) with confirmed MERS-CoV underwent follow-up chest radiographs after recovery from MERS-CoV. The 36 chest radiographs were obtained at 32 to 230 days with a median follow-up of 43 days. The reviewers systemically evaluated the follow-up chest radiographs from 36 patients for lung parenchymal, airway, pleural, hilar and mediastinal abnormalities. Lung parenchyma and airways were assessed for consolidation, ground-glass opacity (GGO), nodular opacity and reticular opacity (i.e., fibrosis). Follow-up chest radiographs were also evaluated for pleural thickening, pleural effusion, pneumothorax and lymphadenopathy. Patients were categorized into two groups: group 1 (no evidence of lung fibrosis) and group 2 (chest radiographic evidence of lung fibrosis) for comparative analysis. Patient demographics, length of ventilations days, number of intensive care unit (ICU) admission days, chest radiographic score, chest radiographic deterioration pattern (Types 1-4) and peak lactate dehydrogenase level were compared between the two groups using the student t-test, Mann-Whitney U test and Fisher's exact test. Results: Follow-up chest radiographs were normal in 23 out of 36 (64%) patients. Among the patients with abnormal chest radiographs (13/36, 36%), the following were found: lung fibrosis in 12 (33%) patients GGO in 2 (5.5%) patients, and pleural thickening in 2 (5.5%) patients. Patients with lung fibrosis had significantly greater number of ICU admission days (19 ± 8.7 days; P value = 0.001), older age (50.6 ± 12.6 years; P value = 0.02), higher chest radiographic scores [10 (0-15.3); P value = 0.04] and higher peak lactate dehydrogenase levels (315-370 U/L; P value = 0.001) when compared to patients without lung fibrosis. Conclusion: Lung fibrosis may develop in a substantial number of patients who have recovered from Middle East respiratory syndrome coronavirus (MERS-CoV). Significantly greater number of ICU admission days, older age, higher chest radiographic scores, chest radiographic deterioration patterns and peak lactate dehydrogenase levels were noted in the patients with lung fibrosis on follow-up chest radiographs after recovery from MERS-CoV.

Keywords

Lung fibrosis - MERS-CoV - Chest radiograph


Publikationsverlauf

Artikel online veröffentlicht:
27. Juli 2021

© 2017. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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