Follow-up chest radiographic findings in patients with MERS-CoV after recovery
Open accessAbstract
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.
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Both SARS-CoV-1 and MERS-CoV infections have been associated with long-term fibrotic lung disease.
“Both SARS-CoV-1 and MERS-CoV infections have been associated with long-term fibrotic lung disease (84, 85).”
From Lung epithelial and endothelial damage, loss of tissue repair, inhibition of fibrinolysis, and cellular senescence in fatal COVID-19 (2021) · cites this paper as [84]
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- Authors
- Das, K. M., Lee, E. Y., Singh, R., Enani, M. A., Al Dossari, K., Van Gorkom, K., Larsson, S. G., & Langer, R. D.
- Affiliations
- United Arab Emirates University (AE)
- Boston Children's Hospital (US)
- Hamad Medical Corporation (QA)
- King Fahd Medical City (SA)
- Department of Medical Imaging, King Fahad Medical City, Riyadh, KSA
- Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, UAE
- Corresponding author
- Das, Karuna M
- Venue
- Indian Journal of Radiology and Imaging
- Publisher
- Georg Thieme Verlag KG
- Published
- 2017-07
- Volume
- 27
- Issue
- 03
- Pages
- 342-349
- ISSN
- 0970-2016 (ISSN-L)
- 0971-3026
- 1998-3808
- PMC
- PMC5644332
- OpenAlex
- W2758783533
- Cited by
- 370
- References
- 30
- Citations by year
- 2026: 4 · 2025: 17 · 2024: 19 · 2023: 44 · 2022: 83 · 2021: 127 · 2020: 74 · 2019: 1
- FWCI
- 15.79
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- Indian journal of radiology and imaging - new series/Indian journal of radiology and imaging/Indian Journal of Radiology & Imaging (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Keywords
- MERS-CoV, post-discharge follow-up, chest X-ray abnormalities, pulmonary fibrosis, ground-glass opacities, pleural thickening, lactate dehydrogenase, intensive care unit admission, lung consolidation, reticular opacities, pneumothorax, lymphadenopathy, pleural effusion
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