Interstitial lung abnormalities after hospitalization for COVID‐19 in patients with cancer: A prospective cohort study

Author:

Noh Sungryong1,Bertini Christopher2,Mira‐Avendano Isabel1,Kaous Maryam1,Patel Bela1,Faiz Saadia A.3ORCID,Shannon Vickie R.3,Balachandran Diwakar D.3,Bashoura Lara3,Adachi Roberto3,Evans Scott E.3,Dickey Burton3,Wu Carol4,Shroff Girish S.4,Manzano Joanna‐Grace5,Granwehr Bruno6,Holloway Shannon6,Dickson Kodwo5,Mohammed Alyssa5,Muthu Mayoora5,Song Hui7,Chung Caroline8,Wu Jia9,Lee Lyndon2,Jiang Ying6,Khawaja Fareed6ORCID,Sheshadri Ajay3ORCID,

Affiliation:

1. Division of Critical Care, Pulmonary and Sleep Medicine McGovern Medical School Houston Texas USA

2. Department of Internal Medicine McGovern Medical School at UT Health Houston Texas USA

3. Department of Pulmonary Medicine The University of Texas MD Anderson Cancer Center Houston Texas USA

4. Department of Thoracic Imaging The University of Texas MD Anderson Cancer Center Houston Texas USA

5. Department of Hospital Medicine The University of Texas MD Anderson Cancer Center Houston Texas USA

6. Department of Infectious Diseases, Infection Control, and Employee Health The University of Texas MD Anderson Cancer Center Houston Texas USA

7. Data‐Driven Determinants for COVID‐19 Oncology Discovery Effort (D3CODE) Team The University of Texas MD Anderson Cancer Center Houston Texas USA

8. Department of Radiation Oncology The University of Texas MD Anderson Cancer Center Houston Texas USA

9. Department of Imaging Physics, Infection Control, and Employee Health The University of Texas MD Anderson Cancer Center Houston Texas USA

Abstract

AbstractIntroductionSurvivors of SARS‐CoV‐2 pneumonia often develop persistent respiratory symptom and interstitial lung abnormalities (ILAs) after infection. Risk factors for ILA development and duration of ILA persistence after SARS‐CoV‐2 infection are not well described in immunocompromised hosts, such as cancer patients.MethodsWe conducted a prospective cohort study of 95 patients at a major cancer center and 45 patients at a tertiary referral center. We collected clinical and radiographic data during the index hospitalization for COVID‐19 pneumonia and measured pneumonia severity using a semi‐quantitative radiographic score, the Radiologic Severity Index (RSI). Patients were evaluated in post‐COVID‐19 clinics at 3 and 6 months after discharge and underwent comprehensive pulmonary evaluations (symptom assessment, chest computed tomography, pulmonary function tests, 6‐min walk test). The association of clinical and radiological factors with ILAs at 3 and 6 months post‐discharge was measured using univariable and multivariable logistic regression.ResultsSixty‐six (70%) patients of cancer cohort had ILAs at 3 months, of whom 39 had persistent respiratory symptoms. Twenty‐four (26%) patients had persistent ILA at 6 months after hospital discharge. In adjusted models, higher peak RSI at admission was associated with ILAs at 3 (OR 1.5 per 5‐point increase, 95% CI 1.1–1.9) and 6 months (OR 1.3 per 5‐point increase, 95% CI 1.1–1.6) post‐discharge. Fibrotic ILAs (reticulation, traction bronchiectasis, and architectural distortion) were more common at 6 months post‐discharge.ConclusionsPost‐COVID‐19 ILAs are common in cancer patients 3 months after hospital discharge, and peak RSI and older age are strong predictors of persistent ILAs.

Funder

National Institutes of Health

Publisher

Wiley

Subject

Cancer Research,Radiology, Nuclear Medicine and imaging,Oncology

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