Residual Lung Abnormalities after COVID-19 Hospitalization Interim Analysis of the UKILD Post-COVID-19 Study

PHOSP-COVID study collaborative group

doi:10.1164/rccm.202203-0564OC

Residual Lung Abnormalities after COVID-19 Hospitalization Interim Analysis of the UKILD Post-COVID-19 Study

PHOSP-COVID study collaborative group

Research output: Contribution to journal › Article › peer-review

14 Citations (Scopus)

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Abstract

Rationale: Shared symptoms and genetic architecture between coronavirus disease (COVID-19) and lung fibrosis suggest severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may lead to progressive lung damage.

Objectives: The UK Interstitial Lung Disease Consortium (UKILD) post-COVID-19 study interim analysis was planned to estimate the prevalence of residual lung abnormalities in people hospitalized with COVID-19 on the basis of risk strata.

Methods: The PHOSP-COVID-19 (Post-Hospitalization COVID-19) study was used to capture routine and research follow-up within 240 days from discharge. Thoracic computed tomography linked by PHOSP-COVID-19 identifiers was scored for the percentage of residual lung abnormalities (ground-glass opacities and reticulations). Risk factors in linked computed tomography were estimated with Bayesian binomial regression, and risk strata were generated. Numbers within strata were used to estimate posthospitalization prevalence using Bayesian binomial distributions. Sensitivity analysis was restricted to participants with protocol-driven research follow-up.

Measurements and Main Results: The interim cohort comprised 3,700 people. Of 209 subjects with linked computed tomography (median, 119 d; interquartile range, 83-155), 166 people (79.4%) had more than 10% involvement of residual lung abnormalities. Risk factors included abnormal chest X-ray (risk ratio [RR], 1.21; 95% credible interval [CrI], 1.05-1.40), percent predicted DL_CO less than 80% (RR, 1.25; 95% CrI, 1.00-1.56), and severe admission requiring ventilation support (RR, 1.27; 95% CrI, 1.07-1.55). In the remaining 3,491 people, moderate to very high risk of residual lung abnormalities was classified at 7.8%, and posthospitalization prevalence was estimated at 8.5% (95% CrI, 7.6-9.5), rising to 11.7% (95% CrI, 10.3-13.1) in the sensitivity analysis.

Conclusions: Residual lung abnormalities were estimated in up to 11% of people discharged after COVID-19-related hospitalization. Health services should monitor at-risk individuals to elucidate long-term functional implications.

Original language	English
Pages (from-to)	693-703
Number of pages	11
Journal	American Journal of Respiratory and Critical Care Medicine
Volume	207
Issue number	6
Early online date	1 Dec 2022
DOIs	https://doi.org/10.1164/rccm.202203-0564OC
Publication status	Published - 15 Mar 2023

Bibliographical note

Funding Information:
(Received in original form March 21, 2022; accepted in final form December 1, 2022) This article is open access and distributed under the terms of the Creative Commons Attribution 4.0 International License. Supported by the National Institute of Health Research (COV0319) and UK Research and Innovation (MR/V027859/1).

Publisher Copyright:
Copyright © 2023 by the American Thoracic Society.

Keywords

COVID-19
hospitalization
HRCT
lung abnormalities
lung damage

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine
Critical Care and Intensive Care Medicine

Access to Document

10.1164/rccm.202203-0564OCLicence: Creative Commons: Attribution (CC BY)

StewartI2022ResidualFinal published version, 0.99 MBLicence: Creative Commons: Attribution (CC BY)

Post-hospitalisation COVID-19 study: a national consortium to understand and improve long-term health outcomes (PHOSP-COVID)
Parekh, D., Sapey, E., Richter, A., Wraith, D. & Lord, J.
DEPARTMENT OF HEALTH & SOCIAL CARE
30/07/20 → 31/03/26
Project: Other Government Departments

Cite this

@article{98d86e2ce12749918accf46f891cafed,

title = "Residual Lung Abnormalities after COVID-19 Hospitalization Interim Analysis of the UKILD Post-COVID-19 Study",

abstract = "Rationale: Shared symptoms and genetic architecture between coronavirus disease (COVID-19) and lung fibrosis suggest severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may lead to progressive lung damage. Objectives: The UK Interstitial Lung Disease Consortium (UKILD) post-COVID-19 study interim analysis was planned to estimate the prevalence of residual lung abnormalities in people hospitalized with COVID-19 on the basis of risk strata. Methods: The PHOSP-COVID-19 (Post-Hospitalization COVID-19) study was used to capture routine and research follow-up within 240 days from discharge. Thoracic computed tomography linked by PHOSP-COVID-19 identifiers was scored for the percentage of residual lung abnormalities (ground-glass opacities and reticulations). Risk factors in linked computed tomography were estimated with Bayesian binomial regression, and risk strata were generated. Numbers within strata were used to estimate posthospitalization prevalence using Bayesian binomial distributions. Sensitivity analysis was restricted to participants with protocol-driven research follow-up. Measurements and Main Results: The interim cohort comprised 3,700 people. Of 209 subjects with linked computed tomography (median, 119 d; interquartile range, 83-155), 166 people (79.4%) had more than 10% involvement of residual lung abnormalities. Risk factors included abnormal chest X-ray (risk ratio [RR], 1.21; 95% credible interval [CrI], 1.05-1.40), percent predicted DLCO less than 80% (RR, 1.25; 95% CrI, 1.00-1.56), and severe admission requiring ventilation support (RR, 1.27; 95% CrI, 1.07-1.55). In the remaining 3,491 people, moderate to very high risk of residual lung abnormalities was classified at 7.8%, and posthospitalization prevalence was estimated at 8.5% (95% CrI, 7.6-9.5), rising to 11.7% (95% CrI, 10.3-13.1) in the sensitivity analysis. Conclusions: Residual lung abnormalities were estimated in up to 11% of people discharged after COVID-19-related hospitalization. Health services should monitor at-risk individuals to elucidate long-term functional implications.",

keywords = "COVID-19, hospitalization, HRCT, lung abnormalities, lung damage",

author = "{PHOSP-COVID study collaborative group} and Iain Stewart and Joseph Jacob and George, {Peter M.} and Molyneaux, {Philip L.} and Porter, {Joanna C.} and Allen, {Richard J.} and Shahab Aslani and Baillie, {J. Kenneth} and Barratt, {Shaney L.} and Paul Beirne and Bianchi, {Stephen M.} and Blaikley, {John F.} and Chalmers, {James D.} and Chambers, {Rachel C.} and Nazia Chadhuri and Christopher Coleman and Guilhem Collier and Denneny, {Emma K.} and Annemarie Docherty and Omer Elneima and Evans, {Rachael A.} and Laura Fabbri and Gibbons, {Michael A.} and Gleeson, {Fergus V.} and Bibek Gooptu and Greening, {Neil J.} and Guio, {Beatriz Guillen} and Hall, {Ian P.} and Hanley, {Neil A.} and Victoria Harris and Harrison, {Ewen M.} and Melissa Heightman and Hillman, {Toby E.} and Alex Horsley and Linzy Houchen-Wollof and Ian Jarrold and Johnson, {Simon R.} and Jones, {Mark G.} and Fasihul Khan and Rod Lawson and Olivia Leavy and Nazir Lone and Michael Marks and Hamish McAuley and Puja Mehta and Dhruv Parekh and Hanley, {Karen Piper} and Manuela Plat{\'e} and John Pear and Thickett, {David R.}",

note = "Funding Information: (Received in original form March 21, 2022; accepted in final form December 1, 2022) This article is open access and distributed under the terms of the Creative Commons Attribution 4.0 International License. Supported by the National Institute of Health Research (COV0319) and UK Research and Innovation (MR/V027859/1). Publisher Copyright: Copyright {\textcopyright} 2023 by the American Thoracic Society.",

year = "2023",

month = mar,

day = "15",

doi = "10.1164/rccm.202203-0564OC",

language = "English",

volume = "207",

pages = "693--703",

journal = "American Journal of Respiratory and Critical Care Medicine",

issn = "1073-449X",

publisher = "American Thoracic Society",

number = "6",

}

TY - JOUR

T1 - Residual Lung Abnormalities after COVID-19 Hospitalization Interim Analysis of the UKILD Post-COVID-19 Study

AU - PHOSP-COVID study collaborative group

AU - Stewart, Iain

AU - Jacob, Joseph

AU - George, Peter M.

AU - Molyneaux, Philip L.

AU - Porter, Joanna C.

AU - Allen, Richard J.

AU - Aslani, Shahab

AU - Baillie, J. Kenneth

AU - Barratt, Shaney L.

AU - Beirne, Paul

AU - Bianchi, Stephen M.

AU - Blaikley, John F.

AU - Chalmers, James D.

AU - Chambers, Rachel C.

AU - Chadhuri, Nazia

AU - Coleman, Christopher

AU - Collier, Guilhem

AU - Denneny, Emma K.

AU - Docherty, Annemarie

AU - Elneima, Omer

AU - Evans, Rachael A.

AU - Fabbri, Laura

AU - Gibbons, Michael A.

AU - Gleeson, Fergus V.

AU - Gooptu, Bibek

AU - Greening, Neil J.

AU - Guio, Beatriz Guillen

AU - Hall, Ian P.

AU - Hanley, Neil A.

AU - Harris, Victoria

AU - Harrison, Ewen M.

AU - Heightman, Melissa

AU - Hillman, Toby E.

AU - Horsley, Alex

AU - Houchen-Wollof, Linzy

AU - Jarrold, Ian

AU - Johnson, Simon R.

AU - Jones, Mark G.

AU - Khan, Fasihul

AU - Lawson, Rod

AU - Leavy, Olivia

AU - Lone, Nazir

AU - Marks, Michael

AU - McAuley, Hamish

AU - Mehta, Puja

AU - Parekh, Dhruv

AU - Hanley, Karen Piper

AU - Platé, Manuela

AU - Pear, John

AU - Thickett, David R.

N1 - Funding Information: (Received in original form March 21, 2022; accepted in final form December 1, 2022) This article is open access and distributed under the terms of the Creative Commons Attribution 4.0 International License. Supported by the National Institute of Health Research (COV0319) and UK Research and Innovation (MR/V027859/1). Publisher Copyright: Copyright © 2023 by the American Thoracic Society.

PY - 2023/3/15

Y1 - 2023/3/15

N2 - Rationale: Shared symptoms and genetic architecture between coronavirus disease (COVID-19) and lung fibrosis suggest severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may lead to progressive lung damage. Objectives: The UK Interstitial Lung Disease Consortium (UKILD) post-COVID-19 study interim analysis was planned to estimate the prevalence of residual lung abnormalities in people hospitalized with COVID-19 on the basis of risk strata. Methods: The PHOSP-COVID-19 (Post-Hospitalization COVID-19) study was used to capture routine and research follow-up within 240 days from discharge. Thoracic computed tomography linked by PHOSP-COVID-19 identifiers was scored for the percentage of residual lung abnormalities (ground-glass opacities and reticulations). Risk factors in linked computed tomography were estimated with Bayesian binomial regression, and risk strata were generated. Numbers within strata were used to estimate posthospitalization prevalence using Bayesian binomial distributions. Sensitivity analysis was restricted to participants with protocol-driven research follow-up. Measurements and Main Results: The interim cohort comprised 3,700 people. Of 209 subjects with linked computed tomography (median, 119 d; interquartile range, 83-155), 166 people (79.4%) had more than 10% involvement of residual lung abnormalities. Risk factors included abnormal chest X-ray (risk ratio [RR], 1.21; 95% credible interval [CrI], 1.05-1.40), percent predicted DLCO less than 80% (RR, 1.25; 95% CrI, 1.00-1.56), and severe admission requiring ventilation support (RR, 1.27; 95% CrI, 1.07-1.55). In the remaining 3,491 people, moderate to very high risk of residual lung abnormalities was classified at 7.8%, and posthospitalization prevalence was estimated at 8.5% (95% CrI, 7.6-9.5), rising to 11.7% (95% CrI, 10.3-13.1) in the sensitivity analysis. Conclusions: Residual lung abnormalities were estimated in up to 11% of people discharged after COVID-19-related hospitalization. Health services should monitor at-risk individuals to elucidate long-term functional implications.

AB - Rationale: Shared symptoms and genetic architecture between coronavirus disease (COVID-19) and lung fibrosis suggest severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may lead to progressive lung damage. Objectives: The UK Interstitial Lung Disease Consortium (UKILD) post-COVID-19 study interim analysis was planned to estimate the prevalence of residual lung abnormalities in people hospitalized with COVID-19 on the basis of risk strata. Methods: The PHOSP-COVID-19 (Post-Hospitalization COVID-19) study was used to capture routine and research follow-up within 240 days from discharge. Thoracic computed tomography linked by PHOSP-COVID-19 identifiers was scored for the percentage of residual lung abnormalities (ground-glass opacities and reticulations). Risk factors in linked computed tomography were estimated with Bayesian binomial regression, and risk strata were generated. Numbers within strata were used to estimate posthospitalization prevalence using Bayesian binomial distributions. Sensitivity analysis was restricted to participants with protocol-driven research follow-up. Measurements and Main Results: The interim cohort comprised 3,700 people. Of 209 subjects with linked computed tomography (median, 119 d; interquartile range, 83-155), 166 people (79.4%) had more than 10% involvement of residual lung abnormalities. Risk factors included abnormal chest X-ray (risk ratio [RR], 1.21; 95% credible interval [CrI], 1.05-1.40), percent predicted DLCO less than 80% (RR, 1.25; 95% CrI, 1.00-1.56), and severe admission requiring ventilation support (RR, 1.27; 95% CrI, 1.07-1.55). In the remaining 3,491 people, moderate to very high risk of residual lung abnormalities was classified at 7.8%, and posthospitalization prevalence was estimated at 8.5% (95% CrI, 7.6-9.5), rising to 11.7% (95% CrI, 10.3-13.1) in the sensitivity analysis. Conclusions: Residual lung abnormalities were estimated in up to 11% of people discharged after COVID-19-related hospitalization. Health services should monitor at-risk individuals to elucidate long-term functional implications.

KW - COVID-19

KW - hospitalization

KW - HRCT

KW - lung abnormalities

KW - lung damage

UR - http://www.scopus.com/inward/record.url?scp=85150397052&partnerID=8YFLogxK

U2 - 10.1164/rccm.202203-0564OC

DO - 10.1164/rccm.202203-0564OC

M3 - Article

C2 - 36457159

AN - SCOPUS:85150397052

SN - 1073-449X

VL - 207

SP - 693

EP - 703

JO - American Journal of Respiratory and Critical Care Medicine

JF - American Journal of Respiratory and Critical Care Medicine

IS - 6

ER -

Residual Lung Abnormalities after COVID-19 Hospitalization Interim Analysis of the UKILD Post-COVID-19 Study

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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Projects

Post-hospitalisation COVID-19 study: a national consortium to understand and improve long-term health outcomes (PHOSP-COVID)

Cite this