Radiological and lung function outcomes in moderate-to-severe Coronavirus disease 2019 survivors: Progressive or regressive fibrosis? Shadows to clarity

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Background: Pulmonary fibrosis is one of the most dreaded complications of moderate to severe Coronavirus disease 2019 (COVID-19). Aims and Objectives: (1) To find out the impact of moderate-to-severe COVID-19 on clinical symptoms, pulmonary function, and functional exercise capacity. (2) To analyze long-term radiological changes insurvivors of moderate-to-severe COVID-19 patients. Materials and Methods: Survivors of moderate-to-severe COVID-19 were followed up in the post-COVID-19 outpatient department (OPD) within the study period. The patients were subjected to clinical examination, 6-min walk test, serum inflammatory markers, pulmonary function test with diffusion capacity (DLCO), and high-resolution computed tomography (HRCT) thorax at 6 weeks, 3 months, and at 6 months (selected cases) after discharge at post–COVID-19 follow-up OPD. Results: Fifty post-COVID-19 patients were followed up in the OPD. At the 1st follow-up, fatigue was most common (60%), followed by cough (40%), shortness of breath on exertion (36%), and chest pain (20%). By the 2nd follow-up, only 30% had exertional breathlessness. Serum inflammatory markers were normalized by 3 months reduced 6-min walk distance was seen in 78% initially, dropping to 20%. DLCO showed moderate-to-severe restriction in 42% initially; by 2nd follow-up, 78% had normal DLCO, and only 8% had moderate restriction. All had moderate-to-severe computed tomography severity initially, with 56% showing normal HRCT and 6% moderate changes at 3 months. Conclusion: COVID-19 infection does not cause progressive pulmonary fibrosis. There was spontaneous resolution of post-COVID-19 clinical symptoms, raised inflammatory markers, pulmonary function impairment, and radiological fibrosis with time.