|Year : 2020 | Volume
| Issue : 4 | Page : 349-350
Chest computed tomography in recovered and discharged COVID-19 patients
Michele Scialpi1, Irene Piscioli2
1 Full Professor of Radiology, Department of Surgical and Biomedical Sciences, Chairman of Diagnostic Imaging Division, Santa Maria della Misericordia Hospital, Perugia, Italy
2 Department of Radiology, Budrio Hospital, Bologna, Italy
|Date of Submission||13-Apr-2020|
|Date of Acceptance||15-Apr-2020|
|Date of Web Publication||01-Jul-2020|
Full Professor of Radiology, Department of Surgical and Biomedical Sciences, Chairman of Diagnostic Imaging Division, Santa Maria della Misericordia Hospital, Perugia
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Scialpi M, Piscioli I. Chest computed tomography in recovered and discharged COVID-19 patients. Lung India 2020;37:349-50
Pulmonary alterations are the most frequent manifestations of COVID-19 infection and an accurate assessment of pulmonary parenchyma is essential to prevent the “relapse” of some patients after discharge from the hospital.
The World Health Organization recommendations for the management of clinically recovered COVID-19 patients who are able to be discharged from isolation, published on 12 January 2020 (available on: https://apps.who.int/iris/bitstream/handle/10665/ 330374 / WHO-2019 -nCoV-laboratory-2020.1-eng.pdf), require two negative reverse-transcription polymerase chain and reaction (RT-PCR) results on sequential samples taken at least 24 hours apart. In recovered-discharged patients, the possibility of a reactivation of COVID-19 infection may be considered.
In a study by Zhou et al., among the factors determining the reactivation of COVID-19 infection such as re-fever and positive RT-PCR in discharged patients, the re-infection or secondary bacterial virus infection are considered. Zhou et al. suggested that in view of this phenomenon, further stratified management of discharge from hospital should be carried out on the basis of guidelines, especially for elderly patients >60-year-old and patients with underlying diseases or severe or critical pulmonary lesions. Finally, different discharge evaluation criteria should be adopted to ensure the complete cure of patients and prevent recurrence after discharge from hospital.
The role of chest computed tomography (CT) in detecting typical parenchymal patterns, their evolution over the time of COVID-19 infection,, other additional findings such as enlarged subsegmental pulmonary vessels in 59%–89% of the cases , related to pro-inflammatory factors or hyperemia , and pulmonary thromboembolism ,, has been reported.
According to Zhou et al., we suggest that in recovered COVID-19 patients before discharge from hospital, chest CT in addition to normal blood oxygen saturation, absence of symptoms, normal body temperature for more than 1 week and at least two negative RT-PCR results, with sampling time at least 24 h apart, may be considered.
The discharge should be considered on the basis of chest CT results that can show a residual or complete resolution of the pulmonary lesions. A potential secondary infection should be prevented especially after discharge of COVID-19 patients with severe or underlying diseases, partly due to the presence of hypoxia in pulmonary interstitial fibrosis.
In COVID-19 patients considered recovered, an individualized protocol, including chest CT is suggested to ensure complete recovery and to prevent “relapse” after discharge.
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Conflicts of interest
There are no conflicts of interest.
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