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      Manejo y seguimiento radiológico del paciente post-COVID-19 Translated title: Radiological management and follow-up of post-COVID-19 patients

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          Abstract

          La mayor parte de los pacientes que superan la infección por SARS-CoV-2 no presentan complicaciones ni requieren un seguimiento específico, pero una proporción significativa (especialmente aquellos con formas clínicas moderadas/graves de la enfermedad) necesitan un seguimiento clínico-radiológico. Aunque apenas existen referencias o guías clínicas sobre el seguimiento a largo plazo de estos pacientes post-COVID-19, se están realizando pruebas radiológicas y constituyendo consultas monográficas de vigilancia en la mayor parte de los centros hospitalarios para atender sus necesidades. El propósito de este trabajo es compartir nuestra experiencia en el manejo del paciente post-COVID-19 en dos instituciones que han tenido una elevada incidencia de la COVID-19 y proponer unas recomendaciones generales de seguimiento desde una perspectiva clínica y radiológica.

          Translated abstract

          Objective

          To describe the computed tomography (CT) findings in patients with COVID-19 in different phases of the disease and to evaluate the reliability and reproducibility of a visual radiologic score to estimate the lung inflammatory burden.

          Methods

          We retrospectively reviewed chest CT studies from 182 patients with RT-PCR findings positive for SARS-CoV-2. Patients were classified according to the time elapsed from the onset of symptoms, as follows: early (0-4 days), intermediate/progressive (5-9 days), or advanced (≥10 days). We analyzed the frequency of each radiologic finding, as well as the predominant pattern, appearance, and distribution of lung involvement. A visual tomographic score (range, 0-25) was used to estimate the inflammatory in each lobe and in the entire lung volume.

          Results

          The predominant CT finding was the ground-glass pattern (n=110; 60.4%), the most common distribution was peripheral (n = 116; 66.7%), and the most prevalent appearance was typical (n=112; 61.5%). The halo sign was seen most frequently in the early phase, whereas ground-glass opacities, the crazy paving pattern, and subpleural bands were more common in the intermediate/progressive and advanced phases. The median severity score was 10 (IQR: 5-13), and the scores increased as the disease progressed. The interobserver agreement (kappa) was 0.89 for the visual score.

          Conclusion

          The CT findings in patients with COVID-19 vary with the course of the infection. The proposed visual radiologic score is a simple, reproducible, and reliable tool for assessing lung involvement in COVID-19 pneumonia.

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          Author and article information

          Journal
          Radiologia
          Radiologia
          Radiologia
          SERAM. Published by Elsevier España, S.L.U.
          0033-8338
          1578-178X
          27 February 2021
          27 February 2021
          Affiliations
          [a ]Servicio de Radiodiagnóstico, Hospital Universitario Ramón y Cajal, Madrid, España
          [b ]Servicio de Radiodiagnóstico, Hospital Universitario La Paz, Madrid, España
          [c ]Servicio de Neumología, Hospital Universitario Ramón y Cajal, Madrid, España
          Author notes
          [* ]Autor para correspondencia.
          Article
          S0033-8338(21)00064-3
          10.1016/j.rx.2021.02.003
          7914006
          © 2021 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

          Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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